Ask the Doctor:  Dr. Lio on Eczema and Children

Ask the Doctor: Dr. Lio on Eczema and Children

Without a healthy microbiome, or the community of bacteria that protect your skin, it can make it much harder to manage chronic skin conditions like acne, rosacea, and—you guessed it—eczema. Put simply, when the microbiome is out of whack and there’s more bad bacteria present than there is good, skin ailments like eczema tend to flare up. For instance, many eczema patients experience an overgrowth of what’s known as Staphylococcus aureus (i.e. Staph) bacteria on their skin, which can worsen symptoms of redness, dryness, and itching. The good news? One of our favorite eczema-focused brands, Gladskin, figured out a way to restore balance to the skin’s microbiome with a cream that contains their patented smart protein, Micreobalance™.

 

All this to say: We know managing your child’s eczema is no easy feat, so we spoke with Gladskin dermatologist and Scientific Advisory Board member for the National Eczema Association, Dr. Peter Lio, to help answer some of your burning questions about the skin microbiome.

 

TREATMENTS

 

Question:  First things first, how does Gladskin work?

 

Dr. Peter Lio: A lot of patients come to me looking for something new and innovative, so I’ve tried Gladskin on the youngest babies and the oldest adults, as well as every possible disease severity from mild, moderate, and even super-duper severe. It helps rebalance the microbiome, which is so important, and it's also not going to cause damage to the skin because it doesn't have fragrances or preservatives. It's distilled down to just the good parts of what we need. Lastly, because it's a good moisturizer, it helps restore the skin barrier, which is a critical part of eczema. One of the most impressive things I’ve found is that many patients have called saying they want to buy more — they want to keep using it, and that’s probably the highest form of feedback I could possibly ask for.

 

Question:  Is it safe for my newborn?

 

DPL: Yes! Many chemicals that aren’t harmful to adults can potentially cause trouble for babies because their skin barrier is premature and thus products are absorbed into the skin at a higher rate. For this reason, you want something that is preservative-free because you don't want them absorbing anything unnecessary. One of the best parts about Gladskin is that by being preservative-free, I feel very comfortable using it on even my littlest patients.

 

Question: How does Gladskin compare to traditional eczema therapies?

 

         We have been in a relative desert for new eczema therapies in the past decade. We only have had one or two new entries into our armamentarium, and that's pretty distressing to me and to anybody who's taking care of patients with eczema. So far, we really only have our topical corticosteroids, which have been with us in some form since really the late 1950s, early 1960s, our calcineurin inhibitors, which are tacrolimus and pimecrolimus, and then a newer treatment called crisaborole, which is a phosphodiesterase-4 inhibitor, anti-inflammatory. Each one has pluses and minuses, so there is a huge need for new non-drug therapies and approaches to eczema. That's part of why I'm so interested in Gladskin, because I feel that this is something that when I first learned about it, I thought it might've been made up. It didn't seem like it was something we could actually have. It works by harnessing endolysin, which targets specific bacteria to bring balance back to the microbiome while moisturizing at the same time, as well as not damaging the good guys because it is preservative-free.

 

Question: But how can Gladskin be safe enough for babies, yet still effective enough for adults?

 

DPL: A perfectly designed tool — or in this case, a product like Gladskin — is going to bring important aspects to anyone that has eczema, be it a baby with the most delicate, sensitive skin or an adult with thick, leathery skin from a lifetime of inflammation and damage. The truth is, because it's doing these three things so nicely, it's going to help restore the skin barrier with moisturization and help rebalance the microbiome. It's also not going to damage things because it doesn't have preservatives, so it can be useful for all of these patients and anyone in between.

 
 
 

THE SKIN MICROBIOME 

 

Question: Why does the microbiome impact the skin? 

 

DPL: The microbiome is the community of healthy bacteria that lives on our skin and in our body that plays a number of different roles. One of the things that we know it does is play a role in metabolism and metabolizing drugs, medicines, and foods, but on our skin, it's also there to keep a balance. When the microbiome becomes unbalanced, we see a lot of problems happen.

For instance, we know there’s certain undesirable bacteria to look out for, and particularly with eczema, we see some of these strains growing out of control. When that happens, it can throw everything into disarray. Historically, we thought that this was more of a response to other factors like the skin barrier being broken, or the immune system being out of whack, but now, we're learning more than ever that this can be a primary issue — that the bacterial imbalance can drive eczema itself. We’ve learned that bacteria can actually make toxins and these toxins can directly damage the skin barrier and drive inflammation, both of which we do not want in atopic dermatitis or eczema.

 

Question: What does a “balanced” microbiome entail? 

 

         A healthy skin barrier is really composed of a number of different layers, if you will, or parts. We have the acidity of the skin, sometimes called the acid mantle [because] that lower pH has to be present. Then we have the actual barrier function itself, and there's a whole bunch of important proteins in there that keep the wall built and strong against outside invaders. There's also the immune system playing a role in surveillance, aka making sure that we don't let invaders in. But, an important part of a healthy skin barrier and healthy skin, is a microbiome that is diverse — that has a number of different bacterial elements, and probably even some viruses and fungal elements that we don't know as much about yet. They just have to be all playing well together.

 

Question: What else should we know about the microbiome? 

 

DPL: I think we're heading a new respect for that “balance” [of bacteria] as a concept. Using a broad-spectrum antiseptic or antibiotic is probably not the answer anymore, and as we're seeing increasing strains of super-bacteria and bacteria resistant to drugs, we need to keep our eye on that point that it is possible to overuse broad-spectrum medications.