Exploring the Eczema-Asthma Connection

In my previous articles on treatment resistant eczema, I’ve discussed how a compromised skin barrier and increased susceptibility to infections can make eczema challenging to manage. Something else to consider is the connection between eczema and other allergic conditions, particularly asthma. Children with treatment resistant eczema are at a higher risk of developing asthma, and understanding this link is crucial for managing both conditions effectively.

The Eczema-Asthma Connection: What You Need To Know

Eczema and asthma are both part of the “atopic march,” a progression of allergic diseases that often begins in early childhood with eczema and can later develop into asthma and allergic rhinitis. This connection is well documented, and children with severe, treatment resistant eczema are particularly susceptible.

  • Shared Genetic Factors Between Eczema and Asthma: One of the reasons for the connection between eczema and asthma is the genetic overlap. Mutations in genes that affect the skin barrier, such as the filaggrin (FLG) gene, are linked to both eczema and asthma. These genetic factors can lead to a dysfunctional skin barrier and heightened immune responses to environmental allergens, contributing to the development of both conditions.
  • Immune System Dysregulation in Eczema and Asthma: Both eczema and asthma are characterised by an overactive immune response. In eczema, this overactivity leads to chronic inflammation in the skin, while in asthma, it causes inflammation in the airways. The immune cells involved in these responses are similar, and the persistent inflammation in eczema can set the stage for the development of asthma.
  • Environmental Triggers Affecting Both Eczema and Asthma: Environmental factors that exacerbate eczema, such as exposure to allergens (like dust mites, pollen, and pet dander) and irritants (like pollution, household cleaning products, and even essential oils), can also trigger asthma. Children with a compromised skin barrier are more susceptible to these environmental triggers, which can affect both their skin and respiratory systems.

How Staphylococcus Aureus Contributes to the Eczema-Asthma Link

As discussed in my previous article, Staphylococcus aureus colonisation is common in children with eczema and can worsen the condition. However, this bacterial colonisation doesn’t just affect the skin – it can also influence the respiratory system, increasing the risk of asthma developing.

  • Superantigens and Airway Hyperreactivity: Staphylococcus aureus produces toxins known as superantigens, which can cause airway hyperreactivity – a hallmark of asthma. These superantigens, such as staphylococcal enterotoxin B, can lead to symptoms like wheezing, shortness of breath, and chronic cough.
  • Bacterial Migration from Skin to Respiratory System: Microorganisms present on the skin can migrate to other parts of the body, including the nose and respiratory tract. Staphylococcus aureus, for instance, can move from the skin to the nasal passages, where it can contribute to respiratory issues.

Managing the Risk of Asthma in Children with Eczema

Given the connection between eczema and asthma, it’s important to take steps to manage the risk of developing asthma in children with severe eczema.

  • Proactive Eczema Management to Reduce Asthma Risk: Effectively managing eczema can help reduce the risk of asthma. This includes maintaining the skin barrier, reducing exposure to known allergens, and controlling inflammation with appropriate treatments.
  • Regular Monitoring for Early Detection of Asthma: Children with severe eczema should be regularly monitored for signs of asthma, especially if they are exposed to common asthma triggers. Early detection of asthma symptoms allows for early intervention, which can prevent the condition from worsening.
  • Environmental Control to Prevent Triggers: Minimising exposure to environmental triggers such as dust mites, pet dander, and environmental irritants can help reduce the risk of both eczema flare ups and asthma attacks.

Reducing Asthma Risk Through Effective Eczema Management

The connection between eczema and asthma is an important consideration in managing both conditions – especially if eczema appears first. By understanding the shared genetic factors, immune system dysfunction, and the role of infections like Staphylococcus aureus helps to create more effective treatment strategies. By managing eczema proactively and reducing exposure to environmental triggers, it’s possible to lower the risk of asthma developing later in life and improve the severity of symptoms for children living with these conditions.

– Ash Yates, Children’s Health Naturopath