Crawling over your skin are more than 1,000 species of bacteria. Some bacteria help protect you. Some make painful conditions such as eczema worse.
The bacteria Staphylococcus aureus, in particular, is found on the skin of people with eczema. It flourishes in the dry, itchy rashes caused by the condition, making those with eczema more susceptible to infections.
Those same people often lack the good bacteria that would typically fight off invaders.
To cope, eczema treatments today often include antibiotics, which kill off both the bad and any remaining good bacteria. There are also steroid creams, which can have serious side effects over the long term.
But now researchers are beginning to take a new approach: adding more good guys to the fight.
In a clinical trial led by scientists in Colorado, researchers are testing a cream containing beneficial bacteria that can be applied to the skin of those with eczema twice a day for a week. Researchers hope the cream will reduce the amount of bad bacteria on the skin.
In another trial whose results were published last week, researchers sprayed a solution containing a beneficial bacteria species into the inner elbows — one of eczema’s favorite spots — twice a week for six weeks for adults. For children, they sprayed twice a week for 12 weeks followed by every other day for four weeks.
Nearly all the eczema patients showed improvements.
Pharmaceutical giant Johnson & Johnson has also been pursuing skin treatments based on increasing the amount of good bacteria on skin.
If bacteria-based treatments can be brought to market, it could offer those who’ve had longtime eczema a cheaper, more sustainable solution without the side effects of current treatments.
“It’s sort of like probiotics for the skin,” said Dr. Donald Leung, head of the Colorado clinical trial and head of the Division of Pediatric Allergy & Immunology at National Jewish Health in Denver.
The study is also taking place at the University of California, San Diego.
“Current therapy is not addressing the types of bacteria on your skin,” Leung told Healthline. “They’re currently getting antibiotics that wipe out both the good and bad bacteria, so we want to put the good bacteria back on there.”
It’s all about the bacteria
This lack of good bacteria can cause a number of problems in eczema patients.
Essentially, the skin barrier that protects most people isn’t working correctly in these patients and that lets a lot of stuff get, literally, under their skin.
“So things that might not irritate others might irritate those with eczema,” said Dr. Joseph Fowler, a dermatologist in Kentucky who specializes in eczema and similar skin conditions. “The normal bacteria on the skin sit there and don’t hurt us and keep down the other bacteria that might be problematic. They take up all the nutrients in the space, and some of them produce toxins that are bad for other bacteria.”
Fowler told Healthline that work to bring that balance back to patients who lack it by developing something that might act like a “probiotic for the skin” is really interesting and exciting.
He compares it to what’s been done in recent years to address gastrointestinal (GI) health.
“There’s a whole ton of work being done on the GI tract with the microbiome and it’s just starting to be done with the skin,” he said. “So I think that work to regulate the skin microbiome is really interesting.”
Relief not coming immediately
But there won’t be probiotic skin creams available any time soon.
Leung said it will be at least a year before his team knows the final results from their study.
Then, there would be the wait for approval from the U.S. Food and Drug Administration for any products that emerge.
The treatments tested in the study led by researchers at the National Institutes of Health in Maryland would also have a long road ahead.
The initial trial included just 10 adults and 5 children.
Fowler said questions to address include how exactly to adjust the bacteria on the skin to get just the right balance of good bacteria to bad.
Could adding too few good ones inadvertently allow the bad ones to grow more?
Will the bad ones eventually just go back to the way they were once a patient stops applying the cream?
Will the bad ones develop resistance to the bacteria in the cream over time?
“All this is great theoretically, but the work is so early,” he said. “I think it’s very interesting — fairly revolutionary — but years away.”
For now, the focus is on making sure nothing bad happens when dumping more bacteria on the skin of vulnerable patients.
Leung’s team has been looking out for any additional infections or irritation of the skin.
So far, he said, there hasn’t been any.