Is eczema a sign of something more serious? Does it mean that you have an autoimmune disease or have inflammation? Does it mean you're eating the wrong foods or that there is something wrong with your liver?
In this article we will address these questions and get into some of the details on what eczema is a sign of in your body. We will also look at what some of the research says about this question, how eczema is typically treated and some of the things that I think about when treating eczema holistically.
If this interests you, keep reading we are going to discuss the details
Is eczema a sign of something more serious (link to Is Eczema Linked To Gut Health)? What is going on with eczema is it telling you that something is off in your diet? Yes eczema is a sign of something more serious, specifically it tends to be more of an issue with gut health. What we find is that with eczema there is a shift and your body's overall immune system and inflammatory balance . We will discuss what that means in more detail but first we need to understand what is meant by eczema.
What is Eczema?
Eczema is also known as dermatitis where the derma refers to skin and itis inflammation. So eczema is inflammation of the skin. Often times it presents like dry itchy red scales on the skin not to be confused with something like psoriasis. Psoriasis is a thick white scaly patch but eczema has less of the scale. We don't want to focus too much on the diagnostic differences. Eczema is almost always itchy and red. Sometimes it can form blisters and over time may get more scales and become thicker. What we want to look at and understand in this article is what this itching and skin inflammation is telling us? What is triggering this inflammation and is that trigger a sign of something deeper in your body.
The Deeper Issue With Eczema
Studies have found significant changes in the intestines of patients with atopic dermatitis and eczema compared to their peers. One of these changes is a change in the metabolites of the gut flora. The microbes in your intestines and the things they produce through their normal course of living, play a very active role in priming the immune system. This process can explain how and why we respond to certain foods the way we do. For example, if your gut flora have a relatively larger amount of pathogen microbes compared to the good or commensal microbes, the immune system will be primed to have more of an inflammatory response. That response is from the microbes themselves and their byproducts. These are all cues to the immune system.
Let me back up and say a little bit on pathogenic microbes versus commensal or good bacteria. We often talk about that in a very generalized way and that is because currently our knowledge is limited in this area. I can give you a little bit of terminology and explanation that will further your understanding.
In your digestive tract there is suppose to be a relative balance between what we call the Firmicutes and the Bacterioides. In general your body should have more of the Firmicutes than the Bacteriodies. Part of the reason for this is because the Firmicutes group have microbes like lactobacillus and Bifidobacterium. These types of bacteria don't have lipopolysaccharide and tend to not produce as much of the toxic things that inflame the immune system. These toxins trigger the macrophages and other types of cells in the innate immune system to respond in an aggressive manner towards the bacterium. So when there are more of the Bateriodies (which have LPS) or even just decline and the Firmicutes, it starts to prime the immune system away from the Th1 response and toward Th2.
In the immune system the Th stands for T helper and these are lines of white blood cells that help the body prepare and respond to problems in and appropriate manner. Depending on what the immune cells see will determine which type of T helper cells are produced. This particular scenario we are describing creates more of the Th2. So how does this relate to eczema?
With eczema there is this relative shift in the bacterial flora. Many studies (see link) have found that eczema patients have less of the Firmicutes and more of the Bactericides. This leads to less production of small chain fatty acids, because the Firmicutes produce more these. The short chain fatty acids act like a barrier and add another layer of protection against things getting into the into the body through the intestines. This shift also creates more inflammation because of the byproducts that are present in the in these bacteria. You get things like the LPS which stands for a lipopolysaccharide and other products that trigger the immune system to respond in a way.
If this is always going on you will always have inflammation in your intestines. This triggers a reciprocal reaction that tends to repeat itself over and over again. This will continue until the balance of microbes is reset.
Let me give you a mental illustration to help you picture this better. The lumen of the digestive tract where food is passing through and being absorbed is made up of cells. These cells are connected and the connections can open and close. They are linked by protein. When you have a lot of inflammation, these proteins tend to degenerate over time. Then these cell to cell connections are just open and more food, bacteria, toxins etc. can travel inside and further trigger the immune system. It creates a cascading effect of more of the helper cells to more of the Th2 response and less of the Th1.
Just on the outside of the intestinal lumen inside your body, there is a kind-of open space. Just below this or deeper inside is your gut associated lymphoid tissue (GALT). This tissue and channel is responsible for signals and toxins (in this case) getting transferred to the rest of the body. This lymph tissue is oftentimes where the T helper cells are sitting and also where the shift to more of the Th2 occurs. That shift and corresponding signals are then carried all over the body through via the lymph and blood. This is how the same types of cells can be activated in the gut and skin at the same time.
Those signals are then passed along locally to the skin tissue as well. The actual lymph tissue is carrying along those undigested food particles and the LPS and other toxins.
To summarize it is the leaky gut in atopic dermatitis and eczema patients that propels the skin inflammation by enabling the penetration of toxins, poorly digested food particles and microbes into this systemic circulation. As these toxins and signals reaches the skin the Th2 response is initiated locally in the skin causing more tissue damage. This further propels that same type of reaction locally in the skin.
You might be asking yourself why have I not heard this before, why did my doctor tell me about this? Most doctors are interested in helping you with the acute reaction. They are going to prescribe a topical anti-inflammatory type of medication (corticosteroid). This will suppress the immune response locally on your skin. This is fine especially if you have an acute type of reaction like an allergic type of atopic dermatitis. However, chronic uses of these steroids will lead to problems systemically. For instance the steroid is shutting off that immune response locally which is why it helps the symptoms go away. Your skin feels better but when your body's trying to fight something off systemically, it is weaker.
You have these signals coming from your digestive tract going all over your body. When you are on the steroid you don't see the signs on your skin. The signals are still there and this systemic reaction is going on in your immune system. You can think of this like a military trying to fight multiple battle fronts at the same time. It can be done but it is harder. It is harder for your immune system too. As a result you have a relatively weaker response to cancer infections, etc. Theoretically that's going to lower your ability to fight those off.
Some of the steroids depending on how strong they are can cause other issues – like bone loss. It really depends on how much you are using and how long you are using it. If you read the package insert on the stronger steroid medications, you will see this. You might be asking, where can I learn more about this. This link has a lot of nice pictures and that give you a better understanding of how all this process looks and works.
Also watch out for my next video on eczema where we will discuss how you can permanently cure eczema without medications. More detail on how you would actually go about this with strategies and specific things you can do to get rid of the eczema without using medications. That should answer the question is eczema a sign of something more serious going on in my body.
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