Is ‘leaky gut’ or ‘leaky skin’ is the new culprit in eczema?

Many of us are now familiar with the term ‘leaky gut’ but have you heard of the term ‘leaky skin’?  Essentially both terms are referring to the same process which involves a break down in barrier function.   The function of the gut and skin barrier is to protect us against all sorts of nasties, including pathogens, chemicals, pollution and toxins.  When a break down occurs, the body is exposed to a plethora of insults, which can over-excite the immune system and cause inflammation.  

So is leaky gut or leaky skin the issue with eczema?

The answer is it can be both!  For many eczema patients, the skin becomes leaky due to a genetic trait which results in loss of function in the filaggrin (FLG) gene.  This gene is responsible for keeping skin cells tightly packed together.  When the FLG gene is not functioning, the skin becomes more permeable, not only letting water out but also letting uninvited guests in, including microbes and allergens.  Recent studies have shown that sensitization to allergens such as foods, dust mites and pollens may first occur through the broken skin barrier.  Furthermore, the itch-scratch cycle in Atopic dermatitis (AD) can also disturb the skin barrier due to the tears created in the skin.  This leads to a vicious cycle of re-flaring that AD sufferers are all too familiar with.

Having a leaky gut means that the intestinal barrier is compromised and substances that are not meant to penetrate the gut wall are able to, which can result in reactions to foods and immune over stimulation. Key markers of a ‘leaky gut’ have also been found in eczema sufferers and correlate with severity of the disease.  However, treatments targeting ‘leaky gut’, such as elimination diets and probiotic supplementation, have yet to demonstrate significant improvements in eczema skin. 

The good news is that treatments which target ‘leaky skin’, such as daily emollients, have shown benefit and can reduce the risk of allergen sensitization and water loss, helping to reduce inflammation and improve skin texture.

How will your PEC practitioner know if you have leaky skin or leaky gut?  Your practitioner is qualified to assess your skin condition and identify the underlying triggers causing your skin to flare.  Leaky skin can be effectively treated using our topical emollient formulations specifically compounded to suit your skin.  If leaky gut is suspected, your practitioner may refer you for further testing if required.

Practitioner – Jessica Simonis – Psoriasis Eczema Clinic

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