Bacteria found in thermal spring water could help treat eczema when applied directly to the skin, new research in the British Journal of Dermatology will reveal.
Atopic eczema is a common skin disorder that is often accompanied by allergies and hay fever, and affects one in 10 children. Atopic people have an overactive immune system and their skin easily becomes inflamed. Additionally their skin ‘barrier’ does not work well, so that their skin may become dry and prone to infection.
‘Vitreoscilla filiformis’ is a type of harmless (non-pathogenic) bacteria found in the water of sulphurous thermal springs. Benefits of visiting thermal spas have previously been reported by eczema patients, but changes to the skin following spa retreats are hard to assess as they could also be due to changes in diet and reduced stress. Scientists in France and Germany therefore studied the effects of V. filiformis on atopic eczema, to see whether this might be the cause of reported improvements.
51 patients with mild or moderate atopic eczema were divided into two groups – one receiving treatment with the bacteria applied to the skin in a cream, and the other with a similar cream containing no bacteria, over a one month period.
The researchers compared the patients by means of a clinical evaluation, the patients’ experiences of itching, and the presence of harmful (pathological) bacteria on the skin at the start of the study, after two weeks and again after four weeks.
Using SCORAD, a clinical evaluation tool that scores how severe a person’s eczema is, they found that clinical symptoms improved significantly in the V. filiformis group only, and this improvement could be noticed as early as two weeks after the start of treatment. In contrast, no significant difference could be observed in the control group.
The same was true for itching, which decreased significantly in the V. filiformis group, after just two weeks, compared to no significant improvement in the control group.
Improvement of eczema lesions in the V. filiformis group was also detectable by visual inspection. While the control cream did not improve lesions, the eczema lesions in the V. filiformis group cleared or showed marked improvement.
At the start of the study, a quarter of volunteer patients were found to have staphylococcus aureus on their skin, a bacterium that is commonly found in eczema patients and can cause skin infections. 12 percent were found to have Streptococci and/or E. coli on their skin. This is actually a low frequency of bacterial colonisation to start with, however, the levels reduced more significantly in the V. filiformis group than in the control group.
After a month, S. aureus was reduced by 30 percent and Streptocci and E.coli by 15 percent in the V. filiformis group, compared to 12 percent and four percent respectively in the control group.
Improved barrier function of the skin, measured according to water loss from the skin, was found equally in both groups and is thought to be due to the use of a cream alone, regardless of any bacterial content, which helps to moisturise the skin and keep it hydrated.
Dr Tilo Biedermann, dermatologist at Eberhard Karls University Tübingen in Germany and one of the researchers, said: “From our study there is clear evidence that V. filiformis is highly effective, significantly improving not only clinical symptoms but also reducing itching and consequently sleep loss. As only mild eczema was studied, sleep loss was not a frequent complaint of the volunteers, indicating that a study population with more severe eczema may reveal even more dramatic changes.”
As improvements were found in skin that was not colonised with harmful bacteria, it is thought that its effects are not purely antimicrobial (fighting harmful bacteria). The researchers believe that V. filiformis contains compounds that regulate the immune system.
“The improvement demonstrated in our study may be in part due to reduction of S. aureus, but seems to relate in most parts to a direct effect on skin-associated immune responses”, Dr Biedermann added.
The study was short term, but if the results are confirmed and consistent over a longer time, this may have direct clinical relevance.
Nina Goad of the British Association of Dermatologists said: “Dermatologists are at the forefront of eczema treatment and, if further studies suggest that this bacterium does indeed provide clinical results, would welcome the potential for new topical treatments to help combat this distressing disease.”
Non-pathogenic bacteria are already used to confer health benefits. One popular form is pro-biotics, live microorganisms which are thought to offer health benefits when ingested and are used as oral supplements to support gut health.
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