Is there a connection between eczema and early antibiotic use? – Medical News Today

There is a strong genetic component to eczema, but rising case numbers in recent decades suggest that external factors may also contribute to the development of eczema in significant ways.

Research suggests that approximately 1 in 5 children and more than 1 in 100 adults experience eczema, making it one of the most common skin conditions around the world. Eczema is particularly prevalent among younger children, with nearly half of all cases developing within the first year of life.

Eczema is a chronic inflammatory condition that results from a combination of genetic, immune, and environmental factors. In people with eczema, the immune system overreacts to environmental irritants and allergens.

Given the role of inflammation in eczema, factors that affect the development of the immune system in early childhood, including the use of antibiotics, have been of particular interest to experts.

In this article, we examine how antibiotics can affect the developing immune system and how this might influence a persons risk of eczema in the future.

The microbiome is the collection of bacteria, viruses, and other microorganisms that live in and on the body. It includes bacteria in the gut, as well as those on the skin.

A well-balanced microbiome provides a variety of health benefits by:

The microbiome helps support immune development by training the immune system to distinguish the pathogenic microbes that can cause disease from the beneficial ones that support human health.

Disruption of the microbiome ecosystem, particularly early in life, can interrupt this training process and make it difficult for the immune system to recognize friend from foe.

Antibiotic use, for example, can disrupt essential interactions between the microbiome and the immune system by killing healthy bacteria in the gut and on the skin, resulting in the development of abnormal immune responses.

As a result, the immune system reacts to the normal microflora of the gut or skin, leading to chronic inflammation.

Researchers have linked exposure to antibiotics to inflammation that contributes to a variety of health conditions, including allergies and autoimmune diseases.

Given the inflammatory nature of eczema, many experts have wondered whether early antibiotic use may trigger the development of eczema, as well.

Overall, most studies suggest an association between antibiotic use and eczema. According to an analysis of 34 clinical studies spanning the last 6 decades, children who had exposure to antibiotics within the first 2 years of life were 26% more likely to develop eczema than those who had no exposure.

A more recent study involving more than 700,000 children from Sweden reaffirmed these results. It found that children who had exposure to antibiotics in the womb or during the first year of life were 52% more likely to develop eczema than other children.

However, not all studies have seen the same association between eczema and antibiotic use, and others suggest that there may be more to the relationship.

For example, some studies suggest that the timing of antibiotic use may be important.

A 2019 review looked at seven different studies that examined antibiotic exposure during specific intervals throughout pregnancy. It found that although prenatal exposure did increase the likelihood of developing eczema, antibiotic use during the third trimester did not affect eczema risk.

Underlying genetics or familial factors likely play a role as well. Many studies that have identified a relationship between antibiotic use and eczema have found that this relationship becomes attenuated or completely lost in sibling pairs.

These findings suggest that there may be one or more underlying factors that affect several family members and increase the likelihood of both eczema and infections that require antibiotics.

Therefore, an increased risk of eczema may not be a direct result of antibiotic use but the result of some other trigger that also increases the risk of infections.

Genetics are likely to play a role in moderating this dual effect. A recent study found that among nearly 600 children in China, those with a genetic mutation in an immune-related gene were over three times more likely to develop eczema after antibiotic use than those without the mutation.

If eczema is the result of the dysregulation of the gut microbiome, some experts have suggested that the use of probiotics may help control symptoms of eczema.

However, a 2018 analysis of 39 clinical trials found no association between the use of probiotics and improvement in symptoms in people with established eczema.

Additionally, in a randomized controlled trial of infants at high risk of developing eczema, the use of a probiotic during the first 6 months of life did not decrease the likelihood of developing eczema by 2 years of age.

Although current evidence suggests that probiotics are unlikely to affect a persons risk of eczema, studies have not directly examined the use of probiotics after antibiotic use. Some research does suggest that probiotics may help prevent other antibiotic-associated diseases in infants, though, so more research is necessary to define this relationship.

Probiotics are not a risk-free treatment, and it is best to consult a doctor before initiating their use, particularly for young children.

Eczema occurs as a result of a variety of internal and external factors that result in immune dysregulation and contribute to chronic inflammation.

Antibiotic use early in life may disrupt the development of the immune system and increase the likelihood of developing eczema. Other factors, such as genetics, likely modulate these effects as well.

If children who are already at increased risk of eczema or other allergic diseases have exposure to antibiotics, their parents or caregivers should talk with a doctor about how to reduce the risk of eczema developing.

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Is there a connection between eczema and early antibiotic use? - Medical News Today