Understanding the Link Between Atopic Dermatitis and the Gut Microbiome 

 

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Atopic dermatitis, more commonly known as eczema, is an inflammatory skin condition which causes red, inflamed and itchy skin. The symptoms of the condition can be very debilitating, with the constant itching and skin discomfort leading to sleep disturbances, and even anxiety and depression (1) Atopic dermatitis is a prevalent condition which typically begins in childhood and affects around 2% of adults and 4% of children globally (2) While its exact cause is unknown, researchers believe that both genetic and environmental factors play a role in its etiology. Interestingly, individuals with atopic dermatitis often have a family history of the condition or other allergic conditions, such as asthma and hay fever. This suggests that these individuals may have a genetic predisposition to developing atopic dermatitis, but the start or progression of the disease may be triggered by environmental influences, including air pollutants, allergens, infections, climate and stress.

Is There a Link Between Atopic Dermatitis and Gut Health? 

The microbes residing on our skin and within our gut continuously interact and influence each other, creating what is known as the gut-skin axis. This connection explains why understanding the gut microbiome is so crucial for learning how to effectively manage skin disorders, such as eczema.  Research suggests that there is an exciting connection between the composition and diversity of the gut microbiome and the development of atopic dermatitis (3) In fact, changes in gut microbiome composition can take place as far back as early infancy, and these changes can determine the severity of atopic dermatitis (4)

A review article published in 2018 indicates that atopic dermatitis patients typically have low overall gut microbiome diversity and an increased abundance of certain bacteria, such as Clostridia, Clostridium difficile, Escherichia coli, and Staphylococcus aureus, compared to healthy controls. Conversely, beneficial bacteria such as Bifidobacteria, Bacteroidetes, and Bacteroides tend to be decreased in these patients. (5) Likewise, a 2021 review article highlights that individuals with atopic dermatitis have a disturbed gut microbial composition, with increased levels of Faecalibacterium prausnitzii, Clostridium, and, in infants, Escherichia and reduced levels of Akkermansia, Bacteroidetes, and Bifidobacterium. (6) While infants with atopic dermatitis have been shown to have increased Faecalibacterium, Oscillospira, Bacteroides, Parabacteroides and Sutterella levels and a decrease in short-chain fatty acid (SCFA)-producing bacteria, including Bifidobacterium, Blautia and Eubacterium. (7)  A study looking at 132 subjects, including 90 patients with atopic dermatitis,found that an overabundance of a particular subspecies of Faecalibacterium prausnitzii is strongly associated the patient’s fecal samples. These are SCFAs produced by certain gut bacteria and they have anti-inflammatory effects. This reduction seems to be due to a shift in the types of F. prausnitzii present, with fewer of the butyrate-producing strains. Furthermore, the gut microbiome in atopic dermatitis patients showed an enrichment of genes that help bacteria to utilize nutrients released from a damaged gut lining. This suggests that gut inflammation in atopic dermatitis may be creating an environment where certain bacteria can thrive, further contributing to the problem. 

The current evidence in this field suggests that changes in the overall makeup of the gut microbiome in individuals with atopic dermatitis may lead to an impaired gut epithelial barrier and altered immune reponses to allergens and other environmental factors, both of which could contribute to the progression of atopic dermatitis.

Can We Manage Eczema by Modulating the Microbiome?

Emerging evidence about the gut-skin axis and its influence on atopic dermatitis opens up exciting possibilities for novel strategies to manage the skin disorder. Modulating the gut microbiome, either through dietary interventions, prebiotics, probiotics, or other approaches, may hold the key to managing eczema symptoms and improving the quality of life of those affected. By improving balance within the gut microbiome, we could reduce systemic inflammation, strengthen and support the skin’s natural barrier function, repair gut permeability and regulate the immune system, all of which are crucial factors in managing atopic dermatitis. 

Notably, there is evidence to suggest that targeting the gut microbiome through various approaches may be successful. For example, a meta analysis which includes data from 1,382 atopic dermatitis patients over 25 randomized controlled trials, suggests that probiotics may help to reduce eczema symptoms. (9) Probiotics appeared to work best for people with mild or moderate eczema, those who took them for longer than three months, and those using specific strains of probiotics that contain Lactobacillus.  Meanwhile, a study using a murine model showed that acupuncture treatment has the potential to significantly alter the gut microbial structure and improve gut barrier dysfunction, which in turn, led to an improvement in atopic dermatitis symptoms. (10)

Managing Atopic Dermatitis with Enbiosis AI-powered Microbiome Analysis 

Enbiosis offers an innovative approach to gaining a deeper understanding of your unique gut microbiome profile. Our state-of-the-art, AI-driven gut microbiome analysis provides personalized food and supplement recommendations designed to optimize gut health and address conditions like atopic dermatitis at their root. Backed by multiple clinical studies, our AI-powered analysis has been shown to improve symptoms, enhance quality of life, and promote noticeable shifts in gut microbiome diversity in patients with IBS and functional constipation. (10,11,12)  By applying the same data-driven approach to atopic dermatitis, we help restore microbial balance, reduce inflammation, and strengthen the skin barrier. Understanding the gut-skin connection opens the door to targeted, science-backed solutions. Enbiosis empowers you with personalized nutrition strategies that support long-term skin health. Start your journey toward healthier skin today with Enbiosis—because true wellness begins in the gut.

 

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References:

1 Schonmann, Y., Mansfield, K. E., Hayes, J. F., Abuabara, K., Roberts, A., Smeeth, L., & Langan, S. M. (2020). Atopic Eczema in Adulthood and Risk of Depression and Anxiety: A Population-Based Cohort Study. The Journal of Allergy and Clinical Immunology. in Practice, 8(1), 248.
2 Tian, J., Zhang, D., Yang, Y., Huang, Y., Wang, L., Yao, X., & Lu, Q. (2023). Global epidemiology of atopic dermatitis: a comprehensive systematic analysis and modelling study. The British Journal of Dermatology, 190(1), 55–61.
3 Pessemier, B. D., Grine, L., Debaere, M., Maes, A., Paetzold, B., & Callewaert, C. (2021). Gut–Skin Axis: Current Knowledge of the Interrelationship between Microbial Dysbiosis and Skin Conditions. Microorganisms, 9(2), 353.
4 Liu, X., Cai, M., Chen, M., Chen, J., Zhu, T., Wu, S., & Jia, J. (2024). Alterations in gut microbiome associated with severity of atopic dermatitis in infants. The Australasian Journal of Dermatology, 65(4), 328–336.
5 Lee, S. Y., Lee, E., Park, Y. M., & Hong, S. J. (2018). Microbiome in the gut-skin axis in atopic dermatitis. Allergy, Asthma & Immunology Research, 10(4), 354-362.
6 Pessemier, B. D., Grine, L., Debaere, M., Maes, A., Paetzold, B., & Callewaert, C. (2021). Gut–Skin Axis: Current Knowledge of the Interrelationship between Microbial Dysbiosis and Skin Conditions. Microorganisms, 9(2), 353.
7 Reddel, S., Chierico, F. D., Quagliariello, A., Giancristoforo, S., Vernocchi, P., Russo, A., Fiocchi, A., Rossi, P., Putignani, L., & Hachem, M. E. (2019). Gut microbiota profile in children affected by atopic dermatitis and evaluation of intestinal persistence of a probiotic mixture. Scientific Reports, 9, 4996.
8 Song, H., et al. (2016). Faecalibacterium prausnitzii subspecies–level dysbiosis in the human gut microbiome underlying atopic dermatitis. Journal of Allergy and Clinical Immunology, 137(3), 852-860.9 Kim, K., Lee, E., Kim, M., Lee, K. S., Sol, I. S., Min, T. K., Yang, H. J., & Hong, S. J. (2023). Therapeutic effectiveness of probiotics for atopic dermatitis: A systematic review and meta-analysis of randomized controlled trials with subgroup analysis. Asian Pacific Journal of Allergy and Immunology, 10.12932/AP-280323-1576. Advance online publication.
10 Yeom, M., Ahn, S., Hahm, D., Jang, S., Jang, S. H., Park, S., Jang, J., Park, J., Oh, J., Lee, I., Kim, K., Kwon, S., & Park, H. (2024). Acupuncture ameliorates atopic dermatitis by modulating gut barrier function in a gut microbiota-dependent manner in mice. Journal of Integrative Medicine, 22(5), 600-613.
11 Tunali, V., Arslan, N. Ç., Ermiş, B. H., Derviş Hakim, G., Gündoğdu, A., Hora, M., & Nalbantoğlu, Ö. U. (2024). A multicenter randomized controlled trial of microbiome-based artificial intelligence-assisted personalized diet vs low-fermentable oligosaccharides, disaccharides, monosaccharides, and polyols diet: A novel approach for the management of irritable bowel syndrome. The American Journal of Gastroenterology, 119(9), 1901-1912.
12 Arslan, N. Ç., Gündoğdu, A., Tunali, V., Topgül, O. H., Beyazgül, D., & Nalbantoğlu, Ö. U. (2022). Efficacy of AI-Assisted Personalized Microbiome Modulation by Diet in Functional Constipation: A Randomized Controlled Trial. Journal of Clinical Medicine, 11(22), 6612.