Diet and eczema: a review of

dietary supplements for the

treatment of atopic dermatitis
Megan J. Schlichte, Abbey Vandersall, Rajani Katta
Dermatol Pract Concept 2016;6(3):6
Introduction
Epidermal
barrier
dysfunction

Atopic
Dermatitis
Pathogenesis

Immune Enviromental
dysregulation factors
Probiotics
Gut floral in healthy children Gut floral in allergy-prone children
Probiotics in treatment for AD
• Recent meta-analysis  treatment
with probiotics significantly decreased
the SCORAD index in children over the
age of 1 year.
• 25 randomized controlled trials
(RCTs), with 1599 subjects, found that
treatment with a mixture of different
bacterial species or Lactobacillus
species showed greater benefit than
those with Bifidobacterium species
alone
Side effect
• Limited side effects
• While most of the studies have
reported no increased incidence of
side effects as compared to
placebo, there have been scattered
reports of side effects  increased
incidence of wheezing bronchitis,
infections, and bowel ischemia
• the source of infections has not
been proven with certainty
Prebiotics
Prebiotics in the treatment of AD
• Prebiotics have not been
extensively studied in the
treatment of AD.
• One small RCT  prebiotics
alone lowered the SCORAD index
in children with AD.
• Minimal evidence exists to
support the use of prebiotics as
a stand-alone therapy.
Synbiotics
• A combination of prebiotics and probiotics
• Recently published meta-analysis examined all published RCTs of
synbiotics for the treatment of AD, using the SCORAD index to
evaluate efficacy.
• The authors concluded that the use of synbiotics for at least 8 weeks
with mixed-strain bacterial species had a significant effect on
improving the SCORAD index.
• This effect held only for children aged 1 year or older.
• Probiotics containing single strains of bacteria did not show a
significant effect.
Conclusions
• While further studies are needed to clarify strains, dosing, and
targeted populations, the use of probiotics and prebiotics in
combination appears to hold promise in the treatment of AD.
• Based on the results of meta-analysis, the use of synbiotics appears
most promising when given for at least 8 weeks to children over the
age of 1 year, and with the use of probiotics that contain mixed
strains of bacteria.
• Given the mounting interest in their use, as reflected by their growing
popularity in current food advertising, probiotics and prebiotics will
likely become an increasingly common topic of conversation in clinical
settings.
Vitamin D
Background
Serum levels of vitamin D and correlation with Atopic
Dermatitis prevalence and severity
Serum levels of vitamin D and correlation with subgroups of
Atopic Dermatitis patients

Group 1 Group 2
Trials of supplementation for the treatment of Atopic Dermatitis
Supplementation may help those with frequent bacterial skin
infections
Conclusion
Fish Oil Supplements
BACKGROUND
IgE
ω-6 AA
Th2
PUFA

ω-3
Is Fish Oil Effective for AD?
Conclusion
Evening primrose oil
and borage seed oil
Background

GLA Inflammation
Are EPO and BO Effective for AD?
Conclusion
Chinese Herbal Medicine
Why choosing CHM ?
Chinese Herbal
Medicine

COMBINATION
 Effective for Atopic Dermatitis ?

Some studies reported that CHM was superior than conventional drugs
Conclusion

Need further well designed and

implemented studies for :
-Standarized dosing
-Comparable herbs
-Standarized formulas
CONCLUSION
Has promising result in RCT
Significant Variability
Need further studies to :
-Determine target population, strain, and types
of probiotics and prebiotics
-Optimal dosing regimens

Not recommended
Has promising preliminary results
Need larger and controlled studies
Cont,

Need further studies to particular subsets of

patient

Not recommended
Need further well designed and implemented
studies for :
-Standarized dosing
-Comparable herbs
-Standarized formulas
Cont,
No significant improvement in AD compared to
placebo
Not recommended