New Eczema Trigger May Pave the Way for New Treatments

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Key Takeaways

  • A recent study further explains how staph is an important causative factor in eczema.
  • Eczema is a complex condition that there is no known cure for.
  • While there is hope that this new finding could pave the way for new non-steroidal treatments, when used appropriately, topical steroids can be very safe and effective.

Researchers have discovered groundbreaking insight into the mechanism of how bacteria can contribute to eczema flares—an important finding for the roughly 31 million Americans that have some form of the skin condition. 

Scientists from The University of Manchester identified "second immunoglobulin-binding protein"—also known as "Sbi"—as the unique protein that can trigger eczema by Staphylococcus aureus (staph). Staphylococcus aureus is a type of bacteria found on human skin, often referred to as golden Staph.

“We've known for some time that staph bacteria has the ability to flare eczema. This study is important because it defines more specifically how it does that," Ingrid Polcari, MD, FAAD, a pediatric dermatologist at the Masonic Children's Hospital in Minneapolis, Minnesota, tells Verywell. Polcari was not involved with the study. "Perhaps there will be more focus on methods of addressing the presence of this particular bacteria on the skin."

The decade-long study was published in a pre-proof of the Journal of Allergy and Clinical Immunology last month. It could lead to new treatments for the often-debilitating skin condition, which impacts up to 20% of children. While eczema typically begins in childhood, it can develop at any stage in a person’s lifetime. 

Although specialists have known about the role of staph in eczema for years, there is still so much to learn about this complicated disease and how it works.

“The truth is that it still likely does not explain everything, as eczema is a complex and heterogeneous disease," Peter Lio, MD, FAAD, a clinical assistant professor of Dermatology and Pediatrics at Northwestern University Feinberg School of Medicine, tells Verywell. "Even if we could find the magic bullet to stop this toxin from staph, it is very likely that it would not help everyone with eczema equally. Some might totally clear, but others may see little effect, since staph may be only one [eczema-causing] factor present with others."

What Is Eczema?

Eczema, also known as atopic dermatitis, is an inflammatory skin condition that causes a scaly, inflamed, itchy rash.

One of the most common medications for eczema is topical steroids, which are used to reduce inflammation and itching in order for the skin to begin healing, according to the National Eczema Association

“Now, our aim is to learn more about Sbi in order to lay the groundwork for future non-steroid treatments,” Joanne Pennock, PhD, one of the study’s lead investigators from The University of Manchester, stated in a press release

Although there are already a few non-steroid treatments used for eczema, they tend to work best for mild eczema. According to Polcari, “steroids remain the strongest topical treatment that we have.”

Parents of children with eczema have long worried about the use of steroids and their side effects. Some research states it could lead to thinning of the skin, white spots, temporary blisters, and increase the risk of skin infections among other things.

“[Steroids] are immunosuppressants, so you're suppressing the immune system locally in the skin," Doris Day, MD, FAAD, MA, a Manhattan-based dermatologist and clinical associate professor of dermatology at the New York University Langone Medical Center, tells Verywell. "Then there’s systemic absorption over time that can lead to things like cataracts and glaucoma and other issues of the eyes."

What this Mean For You

Researchers have identified a new cause of eczema, indicating new treatments may be next as a result. They plan to explore non-steroidal options that may be more appropriate for children.

If you use steroids for a long period of time, you can also develop tolerance to them, which will make the medications less effective.

“If we can understand more about this pathway, what this really means, how it affects eczema, how to address it, then I think we’re on the path to having a long-term safer solution for our patients that have chronic and severe eczema,” Day says. “I’m hopeful that they can come up with treatments to match that are safe and effective for all age groups that can be used in a long-term basis because it’s a chronic problem. You’re not curing the problem—you're helping to suppress it.”

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  1. National Eczema Association. An Overview of the Different Types of Eczema.

  2. Kindi AA, Williams H, Matsuda K, Alkahtani AM, et al. Staphylococcus aureus Second Immunoglobulin-Binding Protein drives atopic dermatitis via IL-33. J Allergy Clin Immunol. September 23, 2015. doi:10.1016/j.jaci.2020.09.023

  3. Avena-Woods C. Overview of Atopic Dermatitis. AJMC. June 20, 2017:3(8).

  4. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Eczema: Steroids and other topical medications. 2017 Feb 23.