Eczema and gut health: Is there a link?

The microbiome is the collection of bacteria, fungi, and other microorganisms that live in and on the body. While many of these organisms live in the intestines, their impact extends beyond digestion.

Some research suggests many skin disorders occur alongside an altered gut microbiome. This includes atopic dermatitis, which is a specific type of eczema.

The body contains many species of microorganisms, including bacteria, fungi, and viruses. These organisms have different effects on human health.

Most of these microbes live inside the gut, particularly the large intestine. However, some also live on the skin. Scientists have discovered that the gut microbiome and skin microbiome influence each other.

When there is an imbalance in the gut or skin flora, it is known as dysbiosis. This can happen if there:

• are too many “bad” species
• are not enough “good” species
• is not enough diversity of species

In people with atopic dermatitis (AD), which is a type of eczema, dysbiosis may play a role in the development of the disease.

Here is what researchers know so far about the connection.

Studies have shown that, in people with AD, there is often a compromise to the health of their gut microbiome.

The 2021 review notes that AD is associated with lower bacterial diversity and lower levels of beneficial species, such as Bacteroidetes, Akkermansia, and Bifidobacterium.

People with AD may also have higher levels of bacteria that can contribute to inflammation, such as:

• Faecalibacterium prausnitzii
• Clostridium
• Escherichia

Research in a 2024 review suggests no difference in the overall diversity of gut bacteria between people with and without AD. However, some bacteria, including Bacteroidales, Enterobacteriaceae, and Clostridium perfringens, were more common in people with AD.

More research is still necessary to understand the link between eczema and dysbiosis.

The immune system plays a role in AD symptoms. When the immune system perceives a threat on the skin, it creates inflammation, causing the itchy rash.

Scientists believe dysbiosis in the gut and on the skin may cause this. The immune system may be detecting harmful levels of “bad” microbes on the skin and reacting to them.

Dysbiosis and eczema may then create a cycle of inflammation that perpetuates symptoms.

According to the 2021 review, changes in the microbiome may also alter the immune response, causing it to dysregulate.

A 2024 review suggests some researchers believe there is an association between AD and intestinal barrier dysfunction.

Some beneficial bacteria species produce byproducts that help the intestinal barrier work more effectively. These include some species people with AD may have less of, such as Bifidobacteria.

However, more research on this is necessary to fully understand the connection.

There is currently no way to test if someone’s eczema is gut-related. Measuring gut health is complicated. Tests to measure the gut microbiome are available, but the data can be confusing, and it is unclear if people can change their microbiome.

Despite this, a doctor may use the following tests to assess overall gut health in someone with eczema:

• a gut microbiome test
• a Calprotectin test, which measures gut inflammation
• tests for celiac disease, which can occur alongside AD

It is also worth noting that microbiome tests cannot measure every species because there are so many species in the microbiome.

Research into the link between the gut microbiome and eczema is ongoing. More research is necessary to understand whether changes in diet will affect this relationship.

A 2021 study examined the effect of different foods on the composition of the gut microbiome. The authors associated a certain diet with higher amounts of microbial species that have anti-inflammatory effects.

• fruits
• vegetables
• beans and peas
• nuts
• low fat fermented dairy foods, such as yogurt
• fish

• alcohol
• sodas
• high fat processed meats

However, it is important to note that this is not a cure for eczema. Instead, dietary changes may support overall health. This can have a knock-on effect on the skin and reduce symptoms for some people.

Probiotics are another name for “good” microorganisms that are part of the microbiome. People can get them from food or supplements. The research so far on whether probiotics help with eczema is mixed.

The 2021 review notes that a number of studies have shown Lactobacillus and Bifidobacterium to be helpful for atopic dermatitis. They may also have a protective effect on the microbiome when a person has to take antibiotics, which may reduce the risk of dysbiosis.

A 2025 meta-analysis suggests that probiotics are a promising alternative therapy for children with AD. Although, the results note that they may only be effective for people with moderate to severe symptoms, not mild symptoms.

Probiotics may not be suitable for everyone and can have side effects and risks. Speak with a doctor before trying any new supplement or major dietary change.

The link between eczema and gut health lies in the gut-skin axis, which refers to how intestinal flora influences the microbes on the skin. An imbalanced microbiome may play a role in the inflammation and immune response that causes eczema.

Microbiome imbalance, or dysbiosis, is when someone has too many “bad” species of microbe, not enough “good” species, or a general lack of diversity.

More research is necessary to understand how the microbiome may be relevant to eczema treatment. People can speak with their doctor for more information if they believe their gut is influencing their eczema symptoms.