Eczema update

Pediatrics for Parents, June, 2003 by Richard J. Sagall

The number of children with atopic dermatitis, commonly called eczema, has doubled in the last few generations. One explanation of the phenomenon, the hygiene hypothesis, states that this increase, which has occurred only in children in developed nations, is due to "reduced early life exposure to microbes." In other words, the children's home is too clean, and that's not good for developing immune systems.

Two recent studies evaluated the effectiveness of two different ways of stimulating the infant's immune system, The first, from Finland, looked at 62 mother-infant pairs. All the mothers had a family history of atopic dermatitis. Half received regular doses of Lactobacillus during the last four weeks of pregnancy and for the first six months of breast-feeding. For those mothers who didn't breast-feed, the Lactobacillus was given to the infants as a supplement in their formula. The other half of the mother-infant pairs didn't receive the Lactobacillus.

By age two, only 15% of the infants in the test group had eczema compared to 47% in the control group. That's a 68% reduction.

The second study, from the University of Manchester, England, studied 41 children ages 5-18 years with moderate to severe atopic dermatitis. Half were immunized with a single injection of a killed Mycobacterium vaccae vaccine. The other half received a placebo injection.

Three months after the injection all the children were evaluated. Those who received the vaccine had an average 48% reduction in the skin surface area affected by eczema. This compares to a 4% reduction in the placebo group.

If the hygiene hypothesis is accurate, and these two studies lend support that it is, then much of the eczema now afflicting our children may be the result of our obsession with cleanliness and our efforts to create a germ-free environment.

Family Practice News, 8/1/02.