Like many other chronic inflammatory diseases, the exact cause of atopic dermatitis, most commonly referred to as eczema, has long eluded researchers and skin care professionals. However, the most recent study on the topic, carried out by a team of researchers from Johns Hopkins University, seems to have come one huge step closer to identifying and better understanding the root cause of eczema. Below is an overview of what researchers discovered and the implications of these findings for eczema treatment and management in the future.
Why the Skin Microbiome Matters
To fully understand the study findings, it is crucial to first understand what the skin microbiome is and why it is so important to skin health. By definition, a microbiome is a group of living microorganisms in a particular space, such as the skin, eyes, or gut (Merriam Webster Dictionary). So even though we don’t see or feel them, there are millions of tiny living organisms that are currently inhabiting our skin, eyelashes, and inside of our bodies.
These microorganisms include bacteria, viruses, and fungi. However, while some of these species can certainly be harmful to the skin, not all are. In fact, many types of bacteria are beneficial to the human skin and body. Problems can arise, then, when the ratio of “good” to “bad” microorganisms in the skin’s microbiome is off balance. This can happen for a number of reasons, including using harsh skin care products, the foods we eat, or simply due to the natural aging process and even genetics.
One type of bacteria that has been shown to be part of the skin microbiome in about one-third of adults is Staphylococcus aureus (Centers for Disease Control and Prevention). This bacteria is a type of “bad” bacteria that can lead to a wide range of illnesses, infections, and skin problems, including pimples, cellulitis, abscesses, eczema, pneumonia, and meningitis. However, while many people come into contact with this bacteria at some point in their lives, only some experience these health concerns or skin problems. For others, a “normal” population size of this bacteria doesn’t seem to have any adverse effects at all.
Why Do Only Some People Get Eczema?
Researchers from Johns Hopkins University set out to learn more about why S. aureus bacteria, although present in the skin microbiome of many people, seems to result in skin inflammation and eczema for some, but not others.
The study findings, which were published in Cell Host & Microbe this November, shed light on the mechanisms that connect S. aureus bacteria on the skin with the inflammation seen in eczema sufferers. First, if the skin’s outer protective layer is damaged or weakened, which is the case with virtually all cases of eczema across the board, the skin is much more susceptible to infection and other complications because the bacteria that normally inhabit the surface of the skin are able to more easily reach the underlying layers.
Then, once the bacteria has entered the skin, the body responds by activating its inflammatory response system to fight off that infection. However, what researchers have found is that most, if not all, people with eczema and other chronic inflammatory skin diseases possess a specific genetic mutation to a protein called interleukin 36 (IL-36), in which this protein overreacts to inflammatory responses within the skin. This research marks the first time that the IL-36 gene has been directly linked with the chronic inflammation that is at the root of eczema and other inflammatory skin problems.
To come to this conclusion, researchers tested two groups of mice. The first was a normal group of mice, and the second group had been genetically modified to exclude the IL-36 receptor. Both groups were then exposed to an overpopulation of S. aureus bacteria. The normal mice in the first group experienced inflamed, dry, flaky skin, while the mice in the second group without the receptor for the over-reactive IL-36 protein experienced little to no skin inflammation and other symptoms.
How Do Current Eczema Treatments Stack Up?
Thanks to this breakthrough research, there is hope that new more effective treatments for eczema could be developed to target IL-36 expression, which should calm underlying inflammation. However, currently, there are no treatment options that target this specific gene. The problem with most available drugs for managing atopic dermatitis is that they aren’t addressing the underlying inflammatory response mechanism, nor are they eliminating the bacteria on the surface of the skin.
Moreover, many of the newest drugs used to treat eczema come with a long list of serious side effects, including infection, oral herpes, and inflammation of the cornea, as well as a hefty price tag that is typically not fully covered by insurance (New York Times, RxList).
Topical treatments for eczema often include the use of corticosteroids to help with inflammation, but these ingredients cannot be used for more than one to two weeks at a time because they can thin the skin, delay wound healing, and cause secondary infections (Indian Dermatology Online Journal).
Gentler, Naturally-Derived Treatments for Eczema
While the latest research does open up the doors for much more effective and potentially gentler eczema treatment options to be developed, many people who are struggling to live with severely dry, cracked, and itchy skin are still left without an effective option. Thus, more and more eczema sufferers are looking for natural alternatives to these medications to help not only offset the rising costs of managing their condition but to also do so without experiencing adverse side effects.
For these very reasons, Epiphany Therapeutics has developed Eksem Moisturizing Body Cream to help those struggling with dry, uncomfortable skin find fast-acting relief from their symptoms without worrying about serious side effects. Eksem contains naturally-derived micronutrients like vitamins A, C, and E to help gently alleviate signs of inflammation without side effects. Because of this, Eksem can be applied frequently throughout the day or night while still remaining gentle on the skin. Additionally, this product does not contain harsh ingredients like steroids, petrolatum, parabens, or fragrances that could otherwise cause skin irritation and even contribute to inflammation.
Many men and women have already tried Eksem Moisturizing Body Cream and found that it made a huge difference in not only their eczema symptoms but also their overall quality of life. In fact, many current Eksem users have found such merit in this formula that they have shared their personal stories with us and you. You can read or view what real Epiphany Therapeutics customers have to say about this product on our Testimonials Page.
You can also try to adjust your diet to include more anti-inflammatory foods and supplements and less pro-inflammatory foods. Some of the most common foods that have been shown to possess strong anti-inflammatory properties include:
- Green, leafy vegetables
- Wild-caught salmon
- Flax seeds
On the other hand, eating lots of pro-inflammatory foods, which include fried foods, sugar, white flour, and dairy, can trigger even more inflammation and the eczema flares that come with it.
Thanks to advancements in medical technology and research, experts continue to move closer to more fully understanding the “big picture” behind which mechanisms in the body cause atopic dermatitis. While the latest research certainly uncovers crucial information towards this effort, it still leaves questions that have yet to be answered.
The hope is that with continued research efforts, we may be able to develop more effective and safer medications to treat or potentially even cure this condition. But the bottom line is that the underlying inflammation needs to be effectively targeted and diminished in order to achieve this end.
Stay tuned for updates on more of the latest news and research regarding eczema causes and treatment options!
About the Authors
William Goolsbee has spent his career in Life Sciences including leading roles in drug development in immunology and genetic medicine. Recent senior positions include Chairman of the Board at Sarepta Therapeutics and Founder and CEO at Metrodora Therapeutics.
Dr. Gil Price
Gil Price M.D. is the Chief Medical Officer at the Propharma Group, where he provides medical supervision for all clinical trials. He previously served as the Chief Executive Officer of Drug Safety Solutions, where he oversaw safety monitoring for drugs in clinical development. Dr. Price also served as the Director of Clinical Development at Medimmune Oncology and Director of Medical Affairs at Glaxo.