Atopic dermatitis is the most common childhood skin disease in France. In sufferers, eczema flare-ups reflect an imbalance in the skin and immunity. What if the micro-organisms of the cutaneous and intestinal flora contributed to the development of this pathology? Discover the role of the microbiota in atopic dermatitis, and how to promote its balance.
Eczema can characterize many different dermatoses (skin diseases). We find for example contact eczema, nummular eczema, varicose eczema... Atopic dermatitis, also called atopic eczema , is most common in infants and young children. It affects more than one in ten children.
Atopic dermatitis (or atopic eczema) is a chronic skin disease . It follows an evolution by flare-ups of eczema , interspersed with periods of remissions .
Inflammatory patches of eczema are characterized by:
Infant eczema lesions are often acute with oozing blisters on very inflamed patches. They first affect the cheeks, the forehead, as well as the outer faces of the arms and thighs, then the hands and ankles as well as the folds of the elbows and knees.
Xerosis , that is, intense dryness of the skin, is a characteristic component of the disease. Atopic dermatitis usually occurs in children with an allergic background , that is to say that many of them will also develop other allergic pathologies such as asthma, allergic rhinitis, or even food allergies.
A consultation with the pediatrician or a dermatologist is necessary. The itching also leads to scratching lesions which are likely to become infected.
Atopic dermatitis comes from a genetic disorder which impacts the skin balance. According to INSERM, more than half of people affected by atopic dermatitis have a parent affected by the disease. In these people, there is an alteration:
The allergens responsible for eczema thus penetrate the skin more easily and cause more local inflammatory reactions by stimulating the immune system. It is said that the skin is more permeable to allergens. This is when patches of eczema appear.
As a general rule, atopic dermatitis appears during the first trimester of life and improves around 5 to 6 years of age. It can also completely disappear. However, it sometimes persists into adolescence or adulthood (10 to 15% of cases according to INSERM), or even begins at an advanced age.
New research studies have led to a better understanding of the role that microorganisms present on our skin and in our intestines play in the development of atopic dermatitis.
The skin microbiota corresponds to all the micro-organisms present on the skin. Among them, good bacteria are of great service to us by regulating the balance of the skin and reducing the risk of infection and cutaneous inflammation.
A cutaneous dysbiosis , i.e. an imbalance of the skin microbiota, has been demonstrated in people affected by atopic dermatitis. Bacterial diversity is reduced, allowing pathogenic bacteria (Staphylococcus aureus or Staphylococcus aureus) to proliferate. This species of staphylococcus would play a major role in outbreaks of eczema. It is also responsible for secondary infections when the skin is damaged following scratching of the eczema patches.
The gut microbiota corresponds to all the micro-organisms that live in our intestines. Recent research studies have been able to demonstrate an astonishing phenomenon:certain bacteria of our intestinal microbiota would migrate to our intestinal lymphoid organs, responsible for the immunity of the intestinal mucosa, but also to other organs of immunity further away in the body. organism such as the spleen and certain lymph nodes. These bacteria would be able to modulate our defense mechanisms by curbing skin inflammation but also our tolerance towards microbiota bacteria!
A dysfunction of this phenomenon would intervene in the appearance of atopic dermatitis . intestinal dysbiosis , or gut microbiota imbalances, have been found in children with this skin condition.
Preventing flare-ups of eczema and atopic dermatitis means above all promoting a good balance of the skin and the skin microbiota. Choose hygiene products that respect the skin, and take the right steps to avoid irritation.
Some simple measures can help avoid irritating the skin of infants affected by atopic dermatitis:
For the toilet, avoid Marseille soaps, Aleppo soaps and other shower gels whose pH is much too alkaline. Their "stripping" effect destabilizes the cutaneous flora and dries the skin. These products promote the resurgence of eczema flare-ups.
Use hygiene products specifically formulated for atopic skin. Their degree of acidity is said to be "physiological pH which avoids damaging the skin microbiota too much. Surgras cleansing care, syndets, or even adapted cleansing oils are available from your pharmacist.
Some cleansing products contain probiotics , i.e. bacterial strains that promote the balance of the skin microbiota. Others contain prebiotics :these are sugars (polysaccharides) on which the good bacteria of the skin microbiota feed.
Daily hydration of the skin using barrier creams (which isolate and protect the skin from external aggressions) or emollient treatments allows:
These treatments will be all the more moisturizing if they are applied after bathing or showering. Hydration products suitable for atopic dermatitis do not harm the skin microbiota. They can be applied without restriction, ask your pharmacist for advice.
Some anti-itch emollients contain probiotics or prebiotics in order to contribute to the balance of the cutaneous microbiota.
