Understanding the Impact of Infections in Treatment Resistant Eczema

The Impact of Eczema Infections

In my previous two articles on treatment resistant eczema, I discussed the challenges of maintaining skin health for eczema prone skin and the effects of chronic skin dehydration. Another factor that can make eczema difficult to manage is the increased susceptibility to infections. Even mild infections, especially those caused by Staphylococcus aureus (commonly known as Golden Staph), can exacerbate eczema and contribute to its resistance to standard treatments.

Staphylococcus Aureus: A Common Cause of Treatment Resistant Eczema

Staphylococcus aureus is a type of bacteria that is found on the skin of up to 90% of children with eczema. While this bacteria can live harmlessly on healthy skin, it poses a significant risk to those with compromised skin barriers;

• Colonisation and Infection: When the skin barrier is weakened, Staphylococcus aureus can easily colonise the skin, leading to infections. These infections can manifest as red, inflamed patches, pus filled blisters, or crusty sores. The presence of these infections often causes the eczema to flare up, making it more challenging to control.
• Toxin Production: Staphylococcus aureus produces toxins that further inflame the skin. These toxins irritate the already sensitive skin, leading to increased redness, swelling, and itching. This exacerbation of symptoms can make the eczema appear more severe and resistant to treatment.
• Biofilm Formation: One of the most insidious ways Staphylococcus aureus worsens eczema is through the formation of biofilms. A biofilm is a protective layer that the bacteria create around themselves, which makes them resistant to the immune system’s defences and many topical treatments. Biofilms can significantly complicate the treatment of eczema, as they make it harder to eliminate the bacteria and reduce inflammation.

The Vicious Cycle of Infection and Inflammation

Once Staphylococcus aureus eczema skin, it can create a vicious cycle of infection and inflammation;

• Increased Itching and Scratching: The toxins produced by the bacteria increase the itchy feeling, which of course leads to more scratching. Scratching breaks the skin further, creating more entry points for bacteria and worsening the infection.
• Persistent Inflammation: The ongoing presence of bacteria and their toxins keeps the immune system in a state of constant activation. This persistent inflammation weakens the skin’s ability to repair itself, leading to chronic symptoms and treatment resistance.
• Difficulty in Healing: The combination of infection, inflammation, and a compromised skin barrier makes it extremely difficult for the skin to heal. As the skin remains damaged, the cycle continues, making standard treatments less effective.

Managing Infections in Treatment Resistant Eczema

Managing infections is a crucial aspect of overcoming treatment resistant eczema;

• Topical support: In cases where Staphylococcus aureus colonisation is significant, the use of herbal and nutritional medicines in topical ointments and creams are often prescribed to reduce the bacterial load on the skin. These work by breaking down that biofilm coating on the bacteria that protects staph from many different kinds of antibiotics. 
• Antiseptic Baths: Regular antiseptic baths using herbal soaks or other natural antiseptic solutions can help reduce the number of bacteria on the skin, working to reduce the frequency and severity of infections.
• Targeted Skincare: Using skincare products designed to restore the skin barrier can help prevent bacterial colonisation. Personalised creams, ointments and moisturisers may contain ingredients like ceramides, zinc, vitamin E and niacinamide, which rebuild the integrity of the skin barrier and protect against infections and inflammation. 
• Probiotic Skincare: Emerging research suggests that probiotics, both oral and topical, may help rebalance the skin microbiome and reduce the prevalence of harmful bacteria like Staphylococcus aureus. This approach offers a promising avenue for managing infections in eczema, as we focus on getting rid of the bad bugs and encouraging the growth of beneficial microorganisms that we want living on healthy skin.

Breaking the Cycle of Infection and Inflammation

Increased susceptibility to infections, particularly from Staphylococcus aureus, is a major contributor to treatment resistant eczema. These infections not only worsen symptoms but also make the condition more difficult to treat with standard interventions. By understanding how pathogenic microorganisms can get into the compromised skin barrier, it’s possible to break the cycle of inflammation and improve treatment outcomes. If your child’s eczema is complicated by frequent infections, it’s essential to seek professional advice to put together an effective management plan.

– Ash Yates, Children’s Health Naturopath