Two Microbiomes That Affect Eczema
When researchers talk about the microbiome and eczema, they are actually discussing two distinct but interconnected ecosystems: the gut microbiome and the skin microbiome. Both are dysregulated in atopic dermatitis, and both can be influenced by diet. Understanding each one—and how they interact— opens up practical dietary strategies that go beyond simple trigger avoidance.
The Skin Microbiome in Eczema
Healthy skin hosts a diverse community of bacteria, fungi, and other microorganisms that maintain barrier function and regulate local immune responses. In eczema, this diversity collapses.Staphylococcus aureus—a pathobiont that is present in small amounts on most healthy skin— colonises eczema lesions in numbers that can account for 90% of bacteria present during flares. S. aureus produces toxins (superantigens) that directly activate the Th2 immune response and worsen inflammation. Restoring skin microbiome diversity reduces S. aureus dominance and calms the inflammatory cycle.
The Gut Microbiome in Eczema
Infants with eczema consistently show lower gut microbiome diversity than matched healthy infants, with reduced Lactobacillus and Bifidobacterium and higher Clostridium species. This dysbiosis is associated with increased intestinal permeability, systemic inflammation, and Th2 immune skewing—all of which drive atopic eczema. Longitudinal studies show that gut dysbiosis often precedes eczema onset rather than resulting from it, making the gut microbiome a meaningful intervention target.
Dietary Strategies That Support Both Microbiomes
Prebiotic Foods (Feed Beneficial Gut Bacteria)
- Garlic, leeks, asparagus, and Jerusalem artichoke — rich in fructooligosaccharides (FOS)
- Bananas and oats — contain inulin and beta-glucan, which feed Bifidobacteria
- Diverse vegetables and whole grains — increase microbiome diversity overall
Probiotic Foods (Add Beneficial Bacteria)
- Live-culture yogurt, kefir, and fermented milk products — best-studied probiotic foods for atopic disease
- Sauerkraut and kimchi — contain Lactobacillus strains and produce short-chain fatty acids
- Tempeh — fermented soy providing both Lactobacillus and prebiotics in one food (avoid if soy is a confirmed trigger)
Diversity-Supporting Eating Pattern
Eating at least 30 different plant foods per week—a target from the American Gut Project research— is one of the strongest predictors of gut microbiome diversity. This does not require exotic foods: variety in legumes, grains, vegetables, herbs, spices, and fruits all count. Each plant species feeds different bacterial species and increases the resilience of the whole ecosystem.
Probiotic Strains with Eczema Evidence
- Lactobacillus rhamnosus GG: Most studied; prenatal and postnatal maternal supplementation reduces eczema incidence in infants
- Lactobacillus reuteri: Shown to reduce eczema severity in some adult trials
- Bifidobacterium longum: Reduces skin inflammation markers in atopic dermatitis
What Harms the Microbiome
- Antibiotics (necessary at times, but each course significantly disrupts gut diversity for 6–12 months)
- Highly processed foods with emulsifiers, artificial sweeteners, and low fibre
- Excessive alcohol, which kills beneficial bacteria and increases pathobionts
- Chronic high-sugar diets that favour less diverse microbiome profiles
How to Track
Sensio lets you log dietary diversity and probiotic food intake alongside eczema flare severity. After starting a probiotic-rich diet or supplement protocol, tracking for 8–12 weeks provides enough data to see whether the intervention is shifting your flare frequency and severity. Microbiome changes take weeks to establish, so consistency and patience are essential.
FAQ
Should I take a probiotic supplement for eczema?
The evidence is most consistent for specific strains in infants. For adults, the data is more mixed but some people respond well. Starting with probiotic-rich foods is a low-risk first step; supplements can be trialled if foods alone are insufficient.
Can improving the microbiome replace topical treatment?
No—microbiome-targeted dietary strategies are a complementary approach, not a replacement for prescribed treatments. They address underlying inflammatory drivers while topical treatments manage acute symptoms.
Related Reading
Medical Disclaimer: Educational only; consult a dermatologist or registered dietitian for personalised treatment guidance.
Track your probiotic food intake and eczema flare patterns in Sensio to see whether supporting your microbiome shifts your skin outcomes over time.