Why Eczema Skin Is Vulnerable to Staphylococcus aureus Infection
- Marcelline Goyen
- Mar 20
- 6 min read
Eczema is a common skin condition that affects millions worldwide, often complicated by infections that worsen symptoms and delay healing. One of the key players in these infections is Staphylococcus aureus, a bacterium that thrives on the skin of many eczema patients. Understanding the eczema infection microbiome—the complex community of microorganisms living on and in the skin—can shed light on why these infections occur and how they might be prevented or treated more effectively.
This article explores the relationship between eczema, the skin microbiome, and Staphylococcus aureus infections. We will discuss how imbalances in the skin’s microbial community contribute to infection risk, the role of the gut microbiome in skin health, and practical steps to support a healthy microbiome to reduce eczema flare-ups and infections.
Table of Contents
What Is Eczema and How Does It Affect the Skin?
Eczema, also known as atopic dermatitis, is a chronic inflammatory skin condition characterized by dry, itchy, and inflamed skin. It often appears in childhood but can persist or develop at any age. The skin barrier in eczema patients is compromised, making it more vulnerable to irritants, allergens, and infections.
The damaged skin barrier allows microbes to penetrate more easily, which can trigger immune responses and worsen eczema symptoms. This weakened defense also creates an environment where harmful bacteria like Staphylococcus aureus can colonize and cause infections.
Understanding the Skin Microbiome in Eczema
The skin microbiome consists of diverse microorganisms, including bacteria, fungi, and viruses, that live on the skin’s surface. In healthy skin, this microbial community maintains balance and protects against pathogens by competing for resources and producing antimicrobial substances.
In eczema, this balance is disrupted. Studies show that eczema skin often has reduced microbial diversity and an overgrowth of Staphylococcus aureus. This imbalance, known as dysbiosis, contributes to inflammation and infection risk.
Skin microbiome, Eczema and skin acidity (pH)
One of the main causes of S. aureus infections may lie in the change in the acidity of the skin (pH). In most skin conditions, the skin pH has risen, and this has direct consequences for the maintenance of the microbiome and its diversity. You can read more about the role of the skin acidity (pH) and changes in the skin microbiome in my BOOK.
Key Points About the Eczema Skin Microbiome
Reduced diversity: Healthy skin hosts many microbial species, but eczema skin shows fewer types like a reduction of the bacteria S. epidermidis, weakening natural defenses.
Increased Staphylococcus aureus: This bacterium can dominate eczema skin, producing toxins that damage skin cells and trigger immune responses.
Increased Staphylococcus epidermidis: Although S. epidermidis is a resident skin bacterium that contributes to a healthy skin defense, this bacterium can also multiply in some cases and cause an infection; consider, for example, antibiotic-resistant MRSE.
Microbial shifts during flare-ups: The microbiome changes dynamically, with S. aureus levels rising during eczema exacerbations.
The Role of Staphylococcus Aureus in Eczema Infections
Staphylococcus aureus is a common bacterium found on the skin and in the nose of many people. While often harmless, it becomes problematic in eczema due to the skin barrier’s weakness.
How S. aureus Affects Eczema
Colonization and infection: Up to 90% of eczema patients have S. aureus colonization on their skin, compared to 5-30% in healthy individuals.
Toxin production: S. aureus releases toxins that act as superantigens, overstimulating the immune system and worsening inflammation.
Barrier disruption: The bacterium damages skin cells and impairs healing, prolonging eczema flare-ups.
Antibiotic resistance: Some strains are resistant to common antibiotics, complicating treatment, like the antibiotic-resistend MRSA.
Managing S. aureus colonization is crucial for reducing eczema infections and improving skin health.
Interaction between bacteria S. aureus and S. epidermidis
S. aureus and S. epidermidis are two resident skin bacteria that keep each other in check by, among other things, producing antimicrobial peptides (AMPs), or defense proteins. They are, as it were, a kind of colleagues in the skin's defense. When one bacterium increases in number, the other bacterium faces more problems due to its AMPs. Read about this in my 2nd book (2023, 2024, 2025).
How the Gut Microbiome Influences Skin Health
The gut microbiome, the community of microbes in the digestive tract, plays a significant role in immune regulation and inflammation, which directly impacts skin conditions like eczema.
Gut-Skin Axis Explained
Immune system modulation: A balanced gut microbiome supports a healthy immune response, reducing skin inflammation.
Barrier function support: Gut microbes produce metabolites that strengthen the skin barrier.
Dysbiosis link: Imbalances in gut bacteria have been linked to increased eczema severity and susceptibility to infections.
Research suggests that improving gut health through diet, probiotics, or prebiotics may help manage eczema symptoms and reduce infection risk.
Strategies to Support a Healthy Eczema Infection Microbiome
Supporting a balanced skin and gut microbiome can reduce Staphylococcus aureus colonization and lower the risk of eczema infections. Here are practical steps:
Skin Care Practices
Gentle cleansing: Use mild, fragrance-free cleansers to avoid disrupting the skin microbiome.
Moisturizing regularly: Keeps the skin barrier intact and supports beneficial microbes.
Avoid harsh antibiotics: Overuse can kill good bacteria and promote resistant strains.
Topical probiotics: Emerging treatments use beneficial skin bacteria to restore microbial balance.
Gut Care Practices
Gut therapy: find a professional gut therapist to help you to work on your gut health and improve skin microbiome and skin health by working from the inside: improving the gut microbiome.
: Keeps the skin barrier intact and supports beneficial microbes.
Avoid harsh antibiotics: Overuse can kill good bacteria and promote resistant strains or combine with prebiotics and probiotics during therapy to avoid a decrease of the gut microbiome as much as possible.
Oral prebiotics: a healthy diet with plenty of beneficial vessels as food for your gut bacteria.
Oral probiotics: Emerging treatments use beneficial gut bacteria to restore microbial balance.
Diet and Lifestyle
Balanced diet rich in fiber: Supports gut microbiome diversity.
Probiotic and prebiotic diet / foods: Yogurt, kefir, sauerkraut, and fiber-rich vegetables promote gut health.
Stress management: Stress can disrupt the gut-skin axis and worsen eczema.
Avoid triggers: Identify and minimize exposure to allergens or irritants.
Medical Interventions
Targeted antibiotics: Used cautiously to treat infections without harming beneficial microbes and focus on improving skin parameters like skin pH (acidity) and skin microbiome.
Immunomodulatory treatments: Help control inflammation and improve skin barrier function.
Microbiome-based therapies: Research is ongoing into treatments that restore healthy microbial communities.
Frequently Asked Questions (FAQ)
What causes eczema infections?
Eczema infections often result from a weakened skin barrier and microbial imbalance, allowing bacteria like Staphylococcus aureus to colonize and cause infection.
How does Staphylococcus aureus worsen eczema?*
This bacterium produces toxins that trigger immune responses and damage skin cells, increasing inflammation and prolonging eczema flare-ups.
Can improving gut health help eczema?
Yes, a healthy gut microbiome supports immune regulation and skin barrier function, which can reduce eczema severity and infection risk.
Are probiotics effective for eczema?
Some studies suggest probiotics may help by balancing gut and skin microbiomes, but more research is needed to confirm their effectiveness.
How can I prevent Staphylococcus aureus infections in eczema?*
Maintaining good skin hygiene, moisturizing regularly, avoiding unnecessary antibiotics, and supporting gut health are key strategies.
Thank you for reading my blog post. If you'd like to learn more about the skin-gut-microbiome connection and its relationship to skin problems like acne, rosacea, and eczema, check out my book. Now available in Dutch, English, and German!
Marcelline Goyen BSc Skin Therapy and author in the Netherlands
Summary and Next Steps
Understanding the eczema infection microbiome reveals how imbalances in skin and gut microbes contribute to Staphylococcus aureus infections and eczema flare-ups. Supporting a healthy microbiome through gentle skin care, balanced nutrition, and mindful lifestyle choices can reduce infection risk and improve skin health.
If you or a loved one struggles with eczema and recurrent infections, consider consulting a healthcare professional about microbiome-friendly treatments. Exploring the connection between your gut and skin health could be a valuable step toward lasting relief.
For more insights on skin and gut health, visit Skin-GUT-Axis.com to explore research-backed information and practical advice.
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