Treating the gut to heal the skin

The study included 60 children with moderate to severe eczema who were assigned to receive one capsule of a probiotic plus prebiotic combination or one capsule of a prebiotic alone twice daily for eight weeks. Each capsule of the combination supplement provided 2 billion colony-forming units of Lactobacillus salivarius and 475 mg of fructo-oligosaccharide, while each capsule of the prebiotic provided just 475 mg of fructo-oligosaccharide.

Parents kept track of their children's eczema symptoms by scoring factors such as the percentage of the body affected, the intensity of redness, crusting, oozing, swelling, dryness, scratch marks, and skin thickening, and the degree of itching and sleep loss. They also monitored quality of life factors such as whether their symptoms interfered with their ability and willingness to take part in ordinary life activities and events and how often they needed medication creams to manage their symptoms.

Pre + pro = more effective treatment

Quality of life scores were similar in both groups throughout the study and children in both groups improved during the study--however, the ones who received the combination supplement improved more. By the eighth week of treatment, moderate or severe symptoms improved in 30% of those in the prebiotic group and 52% of those in the combination group.

Medication use dropped significantly in the combination supplement group but not in the prebiotic group."In light of our findings, the use of combinations of prebiotics, which selectively promote the growth of certain bacterial species and their activities, and probiotics, which elicit immune modulating effects, may be an effective strategy for treating childhood eczema," said lead study author Dr. Keh-Gong Wu at the Taipei Veterans General Hospital in Taiwan.

Taking care of your child's skin

Here are some treatment options to consider if your child has eczema:

• Identify food allergies. Many children with eczema have associated food allergies or sensitivities. Avoiding reactive foods can reduce inflammation and relieve eczema symptoms.
• Add some fats. Although the results from studies do not all agree, supplementing with or evening primrose oil might reduce eczema symptoms. Researchers have also found that fish oil helps some eczema sufferers.
• Be gentle. Hot water and drying soaps can irritate eczematous skin.
• Keep the moisture in. Covering the affected skin with a layer of cotton after moisturizing can prevent skin from becoming overly dry. If your child's hands are eczematous, consider having them wear cotton or medical-grade silk gloves at night.
• Consider a prebiotic-probiotic combination. The current study provides more compelling evidence that supporting health gut bacteria is one way to support the skin.

(Br J Dermatol 2011; Sep 6. doi: 10.1111/j.1365-2133.2011.10596.x; e-pub)