Investigating Eczema: The Relationship Between Bacteria and Lipids
Atopic dermatitis, commonly known as eczema, is an inflammatory condition in which the skin becomes red, itchy, and may form dark patches and bumps on the hands, wrists, some portions of the face, feet, and other areas. Although eczema patients primarily show symptoms since early childhood, adults can also have initial eczema symptoms. Eczema affects 31.6 million people in the U.S. and is not disproportionately found in any race or ethnicity. A gene mutation called FLG is known to be a cause of atopic dermatitis, but it only accounts for approximately ⅔ of cases. Thus, despite the prevalence of eczema, many of the exact causes are still unknown and are being researched.
There are two accepted observations that eczema conditions correlate to: decreased amounts of skin lipids (oils on the skin that serve as a protective barrier) and greater numbers of the bacteria Staphylococcus aureus (S. aureus) on the skin. Researchers at Binghamton University proposed that there was a relationship between these two outcomes. The researchers suggested that a decrease in skin lipids on the outermost layer of the skin, the stratum corneum (SC), weakened the skin barrier enough to allow S. aureus to pass through and trigger an inflammatory response in the skin.
There are two accepted observations that eczema conditions correlate to: decreased amounts of skin lipids (oils on the skin that serve as a protective barrier) and greater numbers of the bacteria Staphylococcus aureus (S. aureus) on the skin. Researchers at Binghamton University proposed that there was a relationship between these two outcomes. The researchers suggested that a decrease in skin lipids on the outermost layer of the skin, the stratum corneum (SC), weakened the skin barrier enough to allow S. aureus to pass through and trigger an inflammatory response in the skin.
The researchers then tested the ability of S. aureus to pass through artificial SC lipid barriers. They observed the differences between normal and lipid-depleted barriers—SC sheets that had a control amount of lipids in the skin barrier and SC sheets that had reduced amounts of lipids in the skin barrier, respectively—by visualizing the lipid barrier and bacteria.
However, the researchers concluded that their experiment showed no statistically significant difference between the permeability of S. aureus into lipid-depleted skin cells and normal lipid-level skin cells. Although the graphs of the results did indicate that S. aureus had penetrated in greater numbers and deeper into the skin for lipid-depleted sheets than normal lipid-level sheets, the results were not definitive enough to make actual comparisons.
One major limitation to these conclusions was the set-up of the experiment. Because the experiment was done in the lab and the skin cell sheets were submerged in liquid throughout the experiment, the results were not completely applicable to an actual atopic dermatitis patient, whose skin cells live in much more complex conditions and are not constantly submerged in liquid. In order to better understand the relationship between S. aureus and the SC barrier, the researchers also acknowledged that future experiments could test S. aureus’ competition with other bacteria common on the skin and the importance of specific proteins in protecting the SC barrier from these bacteria.
The exact causes of eczema still remain unanswered, and the researchers’ results convey this to some extent. Even though the experiment failed to find a relationship between SC lipids and S. aureus, the fact that SC lipids are important for the skin barrier is very well known and accepted. Today, eczema flares can be temporarily treated by the use of topical creams, oral medications, or possibly injections. Those with eczema can continue to care for their skin and prevent possible eczema flares by moisturizing their skin frequently, limiting prolonged water exposure in baths or showers, using warm water instead of hot water, gently drying sensitive areas, using gentle soaps, and following other lifestyle recommendations. These preventive methods are especially important with COVID-19, which has called for more frequent hand washing; the resulting depletion of skin oils dries the hands and weakens the skin barrier. Through more research, scientists will be able to gain a better understanding of atopic dermatitis and find improved solutions for those affected by eczema.
However, the researchers concluded that their experiment showed no statistically significant difference between the permeability of S. aureus into lipid-depleted skin cells and normal lipid-level skin cells. Although the graphs of the results did indicate that S. aureus had penetrated in greater numbers and deeper into the skin for lipid-depleted sheets than normal lipid-level sheets, the results were not definitive enough to make actual comparisons.
One major limitation to these conclusions was the set-up of the experiment. Because the experiment was done in the lab and the skin cell sheets were submerged in liquid throughout the experiment, the results were not completely applicable to an actual atopic dermatitis patient, whose skin cells live in much more complex conditions and are not constantly submerged in liquid. In order to better understand the relationship between S. aureus and the SC barrier, the researchers also acknowledged that future experiments could test S. aureus’ competition with other bacteria common on the skin and the importance of specific proteins in protecting the SC barrier from these bacteria.
The exact causes of eczema still remain unanswered, and the researchers’ results convey this to some extent. Even though the experiment failed to find a relationship between SC lipids and S. aureus, the fact that SC lipids are important for the skin barrier is very well known and accepted. Today, eczema flares can be temporarily treated by the use of topical creams, oral medications, or possibly injections. Those with eczema can continue to care for their skin and prevent possible eczema flares by moisturizing their skin frequently, limiting prolonged water exposure in baths or showers, using warm water instead of hot water, gently drying sensitive areas, using gentle soaps, and following other lifestyle recommendations. These preventive methods are especially important with COVID-19, which has called for more frequent hand washing; the resulting depletion of skin oils dries the hands and weakens the skin barrier. Through more research, scientists will be able to gain a better understanding of atopic dermatitis and find improved solutions for those affected by eczema.
Featured Image Source: Moose Photos
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