The Role of Staphylococcus aureus in Eczema (Atopic Dermatitis)

While there is some debate as to whether more children have eczema these days, it certainly seems that this is true. As natural health practitioners it is one of the most common reasons for children being brought into the clinic. Previously we have discussed the possible underlying factors which may contribute to the development of eczema, and written up case studies. Here however we’d like to highlight the specific role of the bacteria Staphylococcus aureus in the development and maintenance of eczema.

 

Our skin, in its most basic sense, is a barrier. The problem with eczema is that the integrity of this barrier breaks down a little. Bugs produce special enzymes called proteases to try to get through the skin barrier, while our own immune system produces special protease-inhibitors to keep the bugs out. One of the best bugs at producing proteases is Staphylococcus aureus, or “Golden Staph”.

 

Other factors contributing to the breakdown of our natural skin barrier may include:

  • Allergens
  • Dust Mites
  • Scratching
  • Irritants
  • Climate
  • Stress
  • Soaps and detergents

 

One of the body’s natural responses to invading bugs and increased protease activity is to try to increase its rate of growth and turnover of some skin cells (keratinocytes), which causes the distinctive thickening and hardening or ‘roughness’ of the skin that can happen with eczema.

 

While Staph aureus is found on most people’s skin, in those with eczema there is not only a higher load, but on their eczema lesions there is often a specific strain of Staph aureus which produces toxins that are particularly irritating and inflammatory. Staph aureus triggers and drives an immune response that increases inflammation and makes eczema increasingly worse. Some people do get particularly bad infections on their eczema lesions and can be routinely treated with antibiotics.

 

Often children with atopic eczema do have increased intestinal permeability (also known as ‘leaky gut’), and so it seems the dysfunction and loss of integrity on the barrier of the skin is mirrored in the loss of gut integrity too. The answers, as ever, may just be within us. Just as taking specific oral probiotic strains are showing promise in the treatment or prevention of eczema, some new biotechnology is looking at using the enzymes which our immune system makes to break down bacterial walls, to treat Staph infections. Basically, using enzymes (endolysins) as a new way to kill bacteria. This is especially exciting because of the rise of ‘superbugs’, or antibiotic resistant strains of Staph such as MRSA (Methicillin-Resistant Staphylococcus aureus).

 

So what does this mean for treatment options for eczema?

  • As ever, discovering underlying triggers and reactivities, both internal (foods, diet) and external (dust mites, wool, contact allergens etc) is key.
  • Addressing nutrient imbalances is key, as deficiencies in Vitamin D, Essential Fatty Acids and Zinc may all contribute to poor skin health.
  • Reducing any topical irritants such as soaps and detergents, or anything which weakens further the skin barrier.
  • Utilising natural anti-microbials (botanical extracts etc) which have been shown to be effective against Staph aureus  to reduce the microbial load and balance skin flora.
  • Enhancing innate gut health.
  • Enhancing natural immunity with the use of specific botanical extracts and nutrients.

 

For further discussions of eczema you may be interested in reading the following:

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