What Does the Gut Microbiome Have to Do With Eczema?
When we think about eczema, we naturally focus on the skin. But for some children, what’s happening within the gut may also be one piece of the eczema picture.
The gut microbiome is the community of microorganisms living within the digestive tract. During childhood, this ecosystem is still developing and plays an important role in digestion, gut-barrier health and immune regulation.
This communication between the gut, immune system and skin is often referred to as the gut–skin axis.
Importantly, gut imbalance isn’t the sole cause of eczema. Eczema is multifactorial and can involve genetics, skin-barrier dysfunction, immune activity, allergens and environmental irritants. However, when eczema is persistent — particularly alongside digestive symptoms — investigating gut health may provide another piece of the puzzle.
What might we look for?
When interpreting a paediatric microbiome test, some areas I may consider include:
Low beneficial bacteria – particularly patterns involving Bifidobacterium and Lactobacillus species, which interact with the immune system.
Low or altered microbial diversity – a resilient gut generally contains a broad community of microorganisms.
Opportunistic or pathogenic organisms – certain organisms may become more relevant when elevated alongside gastrointestinal symptoms.
Short-chain fatty acids – compounds such as butyrate are produced when beneficial bacteria ferment fibre and help support the intestinal environment and immune signalling.
Secretory IgA (sIgA) – provides insight into immune activity at the gut lining.
Gut inflammation and digestive markers – helping us understand whether further investigation or support may be warranted.
When might microbiome testing be useful?
I may consider investigating the gut when eczema is persistent or recurrent, particularly when a child also experiences tummy aches, bloating, constipation, loose stools, food reactions, recurrent infections or has a history of frequent antibiotic use.
Paediatric Microbiome Mapping
As part of my Little Eczema Warriors treatment package, paediatric microbiome testing can be used where appropriate to gain a deeper understanding of a child’s gut environment.
Rather than searching for one bacteria to blame for eczema, the goal is to identify patterns that may be contributing to the child’s gut, immune and overall health picture.
The results are then interpreted alongside their eczema presentation and used to help create an individualised treatment plan, while also addressing the foundations of skin-barrier care, food and lifestyle.
Eczema isn’t always just a skin problem — sometimes looking a little deeper can help us understand more of the picture.
Microbiome testing does not diagnose the cause of eczema, and persistent, severe or infected eczema should always be appropriately medically assessed.