Is Eczema Hereditary?

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Introduction

Eczema which is also referred to as Atopic dermatitis is a chronic, inflammatory skin condition. Hallmarks of eczema include dry, itchy skin with red rashes that may come in flares. It is a common skin disease worldwide. According to research, it may affect up to 30% of children and in some of them, eczema will continue in to adulthood. Although eczema usually appear during infancy and childhood, it can arise in adolescents and adults too, who never had eczema in their childhood.

Eczema is now found to be caused by an interaction of your genes and environmental factors. Most will have a family history, but not everyone with eczema has a genetic link. If you have a sibling or a parent who has eczema, then there is a higher chance for you to develop eczema too. Is this because of the role that genetics play in eczema? Let us find out.

Scientific evidence is strong in supporting the genetic predisposition for development of eczema. Multiple research done worldwide proves that the evidence of gene mutations in several genes may play a role in causing eczema. In this article we will further discuss how eczema becomes hereditary and the research evidence for the relationship between eczema and genetics.

Does research, point towards a relationship between your genetics and eczema?

Birth cohort studies are ideal to assess the health outcome from birth in to childhood with regards to eczema. Given the age specific emergence of eczema, it provides that eczema can be in fact hereditary.

Research data indicates that several genes may be associated in developing eczema. A research review done in 2010 analyzed the whole human genome. Several genes were found to significantly alter the function and composition of skin in patients with eczema. There is an allergic or an inflammatory response in eczema. Some genes affect the immune system leading to this inflammatory response. The other genes will impact specifically on the eczematous skin.

Genes coding for the function of our skin

Our skin has 3 layers – the epidermis, dermis and hypodermis. Epidermis is the outermost layer which is responsible in maintaining the barrier function of our skin. If your skin barrier is healthy, it will support retention of moisture as well as protecting your body from foreign substances that can harm us, such as allergens, bacteria and toxins.

A gene called the FLG gene, instructs the skin cells to make a large protein named ‘Filaggrin’ in the epidermis. Filaggrin plays an important role in barrier function of our skin. It connects the structural proteins in the outermost skin cells and form tight bundles. Filaggrin strengthens the skin cells and create a strong barrier for protection. Research shows that the FLG gene has a mutation in the DNA sequence in about 50% of patients with eczema. Therefore, specific instructions are not given by this defective gene to cells to make filaggrin. Filaggrin is not produced properly when the message is defective. Less Filaggrin will make your skin barrier weak. Epidermis will become dry and unhealthy which will be prone to allergic reactions and infections. When the filaggrin forming gene is mutated and defective, the protective barrier function is lost. This will make you prone for eczema.

When there are anomalies in the FLG gene, these people will also be prone to develop asthma and hay fever. This is a classic triad. It is known as atopy. The classic triad of atopy includes eczema, asthma and allergies like hay fever and allergic conjunctivitis. Atopy refers to this genetic tendency to develop allergic diseases and they run in families. These families are known as atopic families. Atopy is typically associated with heightened immune response to many common allergens such as inhaled allergens and food allergens.

In another study, a gene called SPINK5 is also found to be mutated in patients with eczema. This gene is known to instruct skin cells to make proteins. How this mutation in the SPINK5 gene affects to develop eczema is still not clear.

Genes coding for the function of our immune system

The genes that are associated with our immune system include genes forming IL (interleukin) 4, 5 and 13. These genes are found to promote allergy and inflammation. They can cause a reduction in the immune response towards pathogens as well as affecting the skin barrier function.

Interleukin 33 is an inflammatory cytokine that is over expressed in the skin cells of patients with eczema. IL 33 gene stimulates many cells to produce cytokines and create inflammation. It is mainly associated with the itch – scratch cycle of eczema.

Can Eczema be a feature of a separate genetic disorder?

Eczema can be associated with some genetic disorders that have many signs and symptoms including skin abnormalities and immunodeficiency. Examples of such disorders include;

Immune dysregulation, X- linked (IPEX) syndrome, Netherton syndrome, Poly-endocrinopathy, Enteropathy, severe dermatitis, metabolic wasting syndrome (SAM) and multiple allergies.

Are genetics the only reason to get eczema?

Although genetics increases your risk of developing eczema, this is not the only cause. There are many causes that are associated with developing eczema. Usually it is a combination of several causes and risk factors. As mentioned earlier, both genetics and environmental factors play a role in developing eczema.

Here are some of the identified causes and risk factors of eczema;

  • Exposure to cigarette smoke during infancy – smoking indoors and maternal cigarette smoking
  • If the mother went through high levels of psychological stress during the pregnancy, the offspring can be affected
  • If your immune system is defective or over reactive
  • If your skin is very dry and unhealthy
  • Dysfunction of the skin barrier – dysregulation of the immune system may be a cause
  • Certain endocrine disorders like thyroid dysfunction

Now that we know that eczema has a genetic tendency, we will learn more on how an eczema flare occurs.

An eczema flare up is triggered by environmental factors. Once our skin is already at risk to develop eczema because of our genes, many factors can act as triggers to develop a flare.

Environmental triggers for eczema flare-ups include;

  • Irritants such as soap, detergents, cosmetics, perfume, cleaning products, formaldehyde – irritants are found in everyday products we use. One chemical which may act as an irritant to a particular individual to trigger an eczema flare may not be so for another person.
  • Cold air
  • Hot weather and heat
  • Cigarette smoke
  • Airborne allergens
  • Out- door pollutants
  • Fabrics like polyester, wool
  • Certain metals like nickel

You may be having eczema because of your genes, or you still may not have developed any symptoms although you have a strong family history. Naturally you will be worried because of this hereditary tendency, whether you will be a victim of eczema. But if we are careful and we look after our skin well, we should be able to delay onset of eczema or prevent a flare up.

What can we do to prevent an eczema flare up, even if we are genetically prone?

  • Moisturize and hydrate your skin well
  • Use a humidifier at home when using heaters during winter to prevent dehydration of your skin
  • Manage your stress well by practicing relaxation techniques such as yoga and meditation
  • Identify and avoid irritants which can trigger a flare such as wool, certain chemicals and other irritants
  • Avoid using harsh soaps and detergents

Conclusion

Eczema can affect up to 30% of children worldwide. It often afflicts infants in the 1st few months of life. This can be the first indicator of this atopic tendency. Research indicates that eczema or atopic dermatitis has a strong genetic link. Several genes that affect our immune system and skin function may play a role while environmental factors and stress can trigger eczema. There are many things you can practice to prevent getting a flare. However, once you are genetically prone towards eczema, you may get a flare at some time in your life. Do not get disheartened. Seek treatment early. Although there is no cure for eczema you can successfully manage flares and keep your condition under check, if you stick to your treatment plan and follow up regularly with your dermatologist.

 

 

 

References:

https://medlineplus.gov/genetics/condition/atopic-dermatitis/

https://www.aaaai.org/Tools-for-the-Public/Allergy,-Asthma-Immunology-Glossary/Atopy-Defined

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2957505/

https://pubmed.ncbi.nlm.nih.gov/31455506/#:~:text=Interleukin%2D33%20(IL%2D33,for%20the%20development%20of%20AD.

 

 

How probiotics play a role in treating Eczema?

Table of Content

Eczema is a chronic skin condition characterized by thick scaly, red inflamed skin with an itchy rash. Affecting more than 31 million Americans alone and overall, up to 3% of the world population, the condition still doesn’t have an exact known cause. However, researchers have come to a close conclusion that it results due to the combination of genetic and environmental factors. Moreover, it is also found that the microbes that dwell on our skin commonly known as skin microbiome also play a vital role in developing this eczema condition also known as Atopic Dermatitis. Scientists in studies also targeted a particular gene called Filaggrin that is indirectly responsible for the onset of Eczema condition. This confirms that Eczema is related to the genes and though necessary, can be passed on to the next generation Basically, eczema has no completely known cure. But it can be managed by following a strict care routine and keeping a record of things and activities that one does in order to avoid the eczema flares. one needs to manage their eczema actively by following a strict care routine plan.

Do you have a care routine plan in place? Let us help you to manage your care plan in a way that’s effective for your eczema treatment 

Affecting the quality of life of a person, a common eczema sufferer may require to spend an average of 30 min to a couple of hours in a day to take care of their moderate to severe eczema. This may include moisturizing, applying ointments/steroids, wet wraps, bleach bath controlling the room humidity, etc.

When there is a link between microbiome and eczema then definitely there should be a link between eczema and probiotics right…???

Let us understand if, what and how probiotics may play role in treating eczema…

Role of Microbes in Eczema

Despite their microscopic size, bacteria play a vital role in eczema and in the overall health of the skin. To understand probiotics, one should 1st know that our body possesses trillions of good and bad bacteria. The major chunk of them is present in our gut and the one which colonizes our skin is collectively known as the skin microbiome Skin microbiomes influence the skin barrier by controlling ecological factors, such as humidity, temperature, pH, and lipid content. These changes can exacerbate skin barrier dysfunction. They are associated with abnormalities in the functions of skin barrier-associated genes which produce a structural protein required to form an outermost protective layer of the skin. Earlier studies have found that the Microbe Staphylococcus aureus creates susceptibility to develop Atopic Dermatitis and is directly linked to Eczema Flares.

Often many people think of bacteria and other microorganisms as harmful “germs,” but many are actually helpful. There are certain bacteria that help in fighting this problem, in common words, they are also called as Good Bacteria which benefit humans. The treatment or management of eczema has a gamut of things involved in the care plan also gives rise to the idea of probiotics. But will it really make a significant difference in the journey to treat eczema?? Albeit of a lot of works and programs by different researchers and scientists in the field of use of probiotics to treat eczema the response or the information to support the effect of probiotics is only a little evident. What are Probiotics?

With rising eczema cases and there being a complete cure, there is always a search for alternative treatment methods. In such case use of probiotics as a treatment method for treating atopic dermatitis is rising in coming recent days. Probiotics are nothing but live microorganisms, also known as good bacteria, that are intended to have health benefits when consumed or applied to the body. Some help digest food, some destroy disease-causing cells and others produce vitamins. Many of the microorganisms in probiotic products are the same as or similar to microorganisms that naturally live in our bodies. The most common foods with probiotics include yogurt and other fermented foodstuffs.

What are prebiotics?

Prebiotics are nondigestible food components that selectively beneficial the growth or activity of beneficial microorganisms. They act as food for human microflora and are used with the intention of improving the balance of good bacteria.

What are symbiotics?

Synbiotics as the name suggest referring to food ingredients or dietary supplements combining probiotics and prebiotics in a form of synergism. The act by inhibiting the growth of pathogenic bacteria and enhancing the growth of beneficial organisms.

How do probiotics Works?

Probiotics act by maintaining a healthy balance between good bacteria in the human body. When a person falls ill or gets any infection the number of bad or harmful bacteria increases in the body disturbing. Probiotics restore the balance by fighting these harmful bacteria and supporting the immune system within the body so that it can prevent the kill and prevent the invasion of harmful bacteria’s in the body. Apart from fighting the bad bacteria’s they also aid in digestion, breakdown and absorb medications, etc create medicines and others. Probiotics also help to alleviate inflammation. When eczema is closely associated with skin inflammation. The probiotic sprays can be applied directly to areas of the affected skin. However, since chronic inflammation tends to be systemic, it is also important to target inflammation from the inside out. This means also eating probiotic foods or taking a quality supplement may help in fighting chronic inflammation.

Probiotics and Eczema

Probiotics can be an important value addition to the approach of eczema treatment. One can look at various perspectives in which this tiny organism that can’t be seen with the naked eye can be useful to curb eczema symptoms.

  1. Eczema is now for a long time suspected to be associated with the Leaky Gut Syndrome which is caused due to the increase in the gap between tight junctions. The Gut flora plays a vital role in maintaining the decorum of the tight junctions. In this case, probiotics can be a booster in improving the population of Good bacteria in maintaining the balance of Gut microbiomes improving the over-all condition making it a healthy Gut.
  2. When the eczema is severe, the individual is subjected to a good dose of anti-biotics, these antibiotics are known to damage the good bacteria too. A good supplement of Probiotics may help to regain the strength of the good microbiome which benefits our body in a various good task. This way intake of Probiotics helps to keep a balance of Microflora in our body while treating severe eczema infections with antibiotics.
  3. Numerous clinical trials have been conducted using different probiotic strains for their ability to help improve the lives of people suffering from eczema. A particular strain of probiotics has been found beneficial in subsidizing eczema symptoms in individuals. Clinical trials have been conducted using Lactobacillus rhamnosus HN001 to study its effect on eczema. In a trial of around 298 women and their infants, administration of 6 billion CFU of L. rhamnosus HN001 to infants from birth to 6 months yielded a significant improvement in their life.
  4. Lotions consisting of the specific microbiome (probiotics) are applied to the skin infected with eczema. A topical lotion with S. epidermis and S. hominis strains to test their effects on atopic dermatitis patients was created by Dr. Gallo’s and team. Application of this lotion on volunteers suffering from eczema gave results in 24 hrs vanishing S. aureus (which are responsible for destroying the outermost protective layer of the skin). The same Lotion without these microbes remained ineffective on the patients.
  5. Spraying water solution containing probiotics was proved beneficial in controlling the eczema symptoms. In a finding from a study led by Anthony S. Fauci, M.D., director NIAID suggests that R. mucosa therapy may help relieve some children of both the burden of eczema symptoms and the need for daily treatment.” For 12 weeks, twice a week a solution containing live R. Mucosa was sprayed on the affected part of the skin of children suffering from eczema. 17 of 20 children enrolled in the study experienced a greater than 50% improvement in eczema severity following treatment. Improvement occurred on all treated skin sites reducing the symptoms such as Itch and rash.
  6. Nowadays Topical preparations containing probiotics are gaining popularity for their role in skincare. These products are available over the counter (OTC) as all the probiotic products available currently are considered as cosmetics by the US FDA. Hence these products can be found at the beauty and cosmetic stores, salons, spas, etc.

Probiotic-Rich Foods to consider

When it comes to probiotics you have to consider certain things as specific strains of organisms are known for improving specific functions in the body. It is important to take advice from your physician before you go for a particular probiotic and its dose other than those are available naturally in the form of foods.

· Look for the supplement that has prebiotics also or symbiotic product

· Look for the Potency and CFU (colony-forming unit) at least 10 billion (Consult Doctor)

· Choose the one which has balanced strain and a known a brand to avoid the risk

· It is better to have more than one or multi-strain (5-6) of our tiny little friends

· Look for allergen-free probiotics which are free from the contents like GMO or other triggers which may cause flares

· Look for a better packaged probiotic which may not be vulnerable to environmental condition and is shelf-stable.

· Selecting the right probiotics may require little experimenting as different body react differently to the same probiotics

Among Probiotics strain, Lactobacillus and Bifidobacterium are the most common supplements and have their own benefits they are typically found in yogurt, fermented products, and other dairy products.

Common foods that are rich in probiotics naturally include:

  • Yogurt
  • Buttermilk
  • Kefir
  • Sauerkraut
  • Kimchi
  • Fermented Pickles
  • Dark chocolate
  • Kombucha
  • Miso Soup
  • Raw cheese
  • Apple cider vinegar
  • Tempeh
  • Cultured vegetables
  • Cottage cheeses

Prebiotics helping probiotics

Apart from probiotics as discussed it is good to consume the foods that may have content that acts as prebiotics. They promote the increase of good bacteria in the gut, help with various digestive problems, and even boost your immune system, these include:

  • Chicory root
  • Flaxseed
  • Barley
  • Oats
  • Garlic
  • Raw onion
  • Banana
  • Raw dandelion greens
  • Raw leek
  • Asparagus
  • Apples
  • Konjac roots
  • Cocoa
  • Jacon root
  • Seaweed
  • Wheat Bran

Conclusion

Eczema treatment has reached new levels with novel methods of treatment and products/medicines that are used to treat Eczema. As the quench for treating and managing eczema seems to be a very long journey. As far as Probiotics in treating eczema, there has been interesting research showing evidence of the potential of using Pro-biotics in treating Eczema.

Probiotics can be beneficial for both adults and kids. Moreover, no evidence is found suggesting probiotics supplements may worsen the eczema symptoms or the skin condition and studies have demonstrated the positive effects of probiotics on reducing the incidence of eczema considerably. While there are a number of other proven benefits to probiotic bacteria consumption, aiming for improved immune function, digestion. So even if you say that it is not benefitting eczema it is definitely beneficial for your body in other functions.

So, it is always a good habit to include probiotic food in your meals. One easy way to start can be by simply introducing probiotic-rich foods into your diet, like yogurt and Buttermilk. However, if you are considering probiotic as a supplement and want to go for certain probiotic products or particular strain it’s worth a conversation with your healthcare provider.

References

· https://www.optibacprobiotics.com/professionals/latest-research/general-health/do-probiotics-help-with-eczema

· Wickens K, Barthow C, Mitchell EA, et al. Effects of Lactobacillus rhamnosus HN001 in early life on the cumulative prevalence of allergic disease to 11 years. Pediatr Allergy Immunol. 2018;29(8):808-814. doi:10.1111/pai.12982

· https://www.nih.gov/news-events/news-releases/probiotic-skin-therapy-improves-eczema-children-nih-study-suggests

· https://www.niams.nih.gov/newsroom/spotlight-on-research/role-microbiota-eczema-findings-suggest-striking-right-balance-keeps

· https://www.contemporarypediatrics.com/pediatric-dermatology/microbiome-based-therapy-eczema-horizon