Two of Eczema's Biggest Troublemakers - Staph and Malassezia

By Diane Angela Fong, ND

Eczema isn’t just a surface-level skin issue—it’s a reflection of deeper imbalances within the skin’s microbiome. Our skin is home to a complex ecosystem of bacteria, fungi, and viruses that, much like the gut, requires balance to maintain healthy function. When this delicate equilibrium is disrupted, it can lead to or exacerbate eczema, resulting in uncomfortable flare-ups.

Two key players in microbiome imbalances associated with eczema are Staphylococcus aureus, a bacterium, and Malassezia, a type of yeast. These microorganisms disrupt skin health in different ways, often leading to persistent inflammation, itching, and discomfort. Understanding how they affect the skin can be crucial in developing effective treatment strategies for managing eczema.

Staphylococcus aureus: The Overgrowth in Eczema

Staphylococcus aureus is a common bacterium found on the skin, but its overgrowth is strongly linked to eczema. Research shows that up to 90% of eczema patients have an overgrowth of this bacterium on their skin. In individuals with eczema, the skin’s barrier is often compromised, providing an ideal environment for this bacterium to thrive.

Staphylococcus aureus can exacerbate eczema by inducing inflammation through the production of toxins that damage skin cells. Additionally, it can form biofilms, protective layers that shield the bacteria from the immune system and antibiotic treatments, making it difficult to eliminate. This overgrowth is a common reason why eczema patients struggle to manage their symptoms effectively.

Malassezia: A Hidden Fungal Trigger in Eczema

While Staphylococcus aureus is well-known for its role in eczema flare-ups, Malassezia, a genus of yeast, also plays a crucial part in certain cases, particularly in head and neck dermatitis. Malassezia thrives in lipid-rich environments, making it a common factor in conditions like seborrheic dermatitis and eczema, especially in patients who experience persistent or severe lesions in the head and neck area.

Overgrowth of Malassezia on the skin can trigger an allergic response, leading to inflammation, itching, and worsening of eczema symptoms. In these cases, an immune response to Malassezia can be tested by measuring Malassezia-specific IgE antibodies. Studies have shown that 5%–27% of children and 29%–65% of adults with eczema test positive for these IgE antibodies, indicating an immune reaction to this yeast.

Clinically, a Malassezia allergy may be suspected in patients with eczema who exhibit the following characteristics:

1. Lesions in the head and neck area.

2. Exacerbations during adolescence or young adulthood.

3. Severe, treatment-resistant lesions that do not respond to conventional eczema treatments.

4. Other associated atopic diseases, such as asthma or allergic rhinitis.

Additionally, Malassezia thrives in warm, moist environments, such as those created by sweating. This makes managing sweat crucial for eczema sufferers, especially those who exercise frequently or live in humid climates. Excessive sweating can create an environment that promotes yeast growth, leading to flare-ups. Therefore, taking measures to manage sweat, such as showering after exercise or using antimicrobial products (CleanSKIN Topical Kit), can help reduce flare-ups caused by Malassezia overgrowth.

How Does Staphylococcus aureus and Malassezia Overgrowth Happen?

Overgrowth of Staphylococcus aureus and Malassezia occurs for several reasons:

1. Compromised Skin Barrier: Eczema patients often have a weakened skin barrier that allows harmful microorganisms to thrive. Without this protective layer, bacteria and fungi can more easily penetrate the skin’s deeper layers.

2. Antibiotic Use: While antibiotics can treat bacterial infections, they can have unintended effects on the skin microbiome. Overuse of antibiotics can kill beneficial bacteria, allowing harmful organisms like Staphylococcus aureus and Malassezia to dominate. This imbalance can lead to recurring eczema flare-ups.

3. Diet High in Sugar and Inflammatory Foods: Diet plays a critical role in skin health. High sugar intake can fuel yeast overgrowth, including Malassezia, as yeast thrives on sugar. Similarly, diets high in inflammatory foods, such as processed foods and trans fats, can worsen skin inflammation. Eating an anti-inflammatory diet rich in whole foods, fiber, and healthy fats helps maintain a balanced skin microbiome.

4. Sweat and Warm Environments: Malassezia thrives in warm, moist environments, making sweat management crucial. Eczema sufferers should shower or cleanse their skin after sweating to prevent yeast overgrowth. Immediate use of treatments like the CleanSKIN Topical Kit can reduce the risk of microbial imbalances triggered by sweat.

Testing for Staphylococcus aureus and Malassezia at Cleanbody

Identifying the presence of Staphylococcus aureus and Malassezia is crucial to developing an effective eczema treatment plan. At Cleanbody, we offer testing to identify microbiome imbalances, including IgE (immunoglobulin E) responses to Malassezia. IgE testing helps determine whether your immune system is reacting to Malassezia, allowing for targeted treatment.

Additionally, we focus on identifying Staphylococcus aureus colonization through skin cultures or swabs. Once the presence of these microorganisms is confirmed, a personalized treatment plan is created to restore balance to your skin microbiome.

The CleanSKIN Topical Kit: Your Defense Against Staph and Malassezia

CleanSKIN Topical Kit (3-Step System)

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To help restore balance to the skin microbiome and reduce overgrowth of Staphylococcus aureus and Malassezia, we recommend the CleanSKIN Topical Kit:

1. CleanSKIN Calm (Hypochlorous Acid): Hypochlorous acid is a powerful antimicrobial agent that helps reduce Staphylococcus aureus colonization while soothing inflammation. It's gentle on the skin yet effective at restoring balance to the microbiome.

2. CleanSKIN Restore (Probiotic Spray): Probiotics help replenish beneficial bacteria on the skin, promoting a healthy microbiome. This spray introduces good bacteria to the skin’s ecosystem, crowding out harmful microorganisms like Staphylococcus aureus and promoting better skin health.

3. CleanSKIN Protect (Barrier Repair): This product is designed to strengthen the skin barrier, which is crucial in preventing microbial overgrowth and maintaining a balanced microbiome. A healthy skin barrier protects against external irritants, helps retain moisture, and creates an environment where both harmful bacteria and yeast are less likely to thrive.

By using all of these products together, you can manage both bacterial and fungal imbalances that contribute to eczema. After sweating, we recommend applying CleanSKIN Calm and CleanSKIN Restore immediately to prevent microbial overgrowth.

If immune reactions to Malassezia are identified through testing, we may consider additional anti-fungal support, including products with anti-fungal ingredients such as tea tree oil or grapefruit seed extract, such as the Skin & Wound Spray with GSE.

Managing Skin Microbiome Imbalances in Eczema

Restoring balance to the skin microbiome is essential for managing eczema. Here are strategies to reduce Staphylococcus aureus and Malassezia overgrowth:

1. Antimicrobial and Antifungal Treatments: Use antimicrobials like CleanSKIN Calm for bacterial overgrowth, and antifungal products like Skin & Wound Spray with GSE for Malassezia.

2. Probiotic Skincare: Probiotic treatments, such as CleanSKIN Restore, introduce beneficial bacteria that help restore the skin’s natural balance.

3. Dietary Changes: Reducing sugar and inflammatory foods while focusing on an anti-inflammatory diet helps prevent Malassezia overgrowth and supports a balanced microbiome.

4. Sweat Management: If you sweat frequently, shower or cleanse your skin and apply CleanSKIN Calm and CleanSKIN Restore immediately afterward to prevent yeast and bacterial overgrowth.

5. Barrier Repair: Strengthening the skin barrier with CleanSKIN Protect from the CleanSKIN Topical kit helps reduce both bacterial and fungal colonization, preventing eczema flare-ups.

The skin microbiome plays a significant role in eczema, with Staphylococcus aureus and Malassezia as key triggers. Addressing these imbalances through testing, targeted treatments like the CleanSKIN Topical Kit and Skin & Wound Spray with GSE, and lifestyle changes can prevent flare-ups and restore your skin’s health.

For personalized treatment plans, testing, and product recommendations, book a consultation, take our free Eczema Assessment, or Join our Free Eczema Relief Workshop to start your journey to healthier skin.

GOT QUESTIONS?

Dr. Fong is going live to discuss this topic on Wednesday, September 25, at 12:00 PM PST! Watch the live or check out the replay here:

References:

Leung AD, Schiltz AM, Hall CF, Liu AH. Severe atopic dermatitis is associated with a high burden of environmental Staphylococcus aureus. Clin Exp Allergy. 2008 May;38(5):789-93. doi: 10.1111/j.1365-2222.2008.02964.x. Epub 2008 Mar 13. PMID: 18341620.

Saunte DML, Gaitanis G, Hay RJ. Malassezia-Associated Skin Diseases, the Use of Diagnostics and Treatment. Front Cell Infect Microbiol. 2020 Mar 20;10:112. doi: 10.3389/fcimb.2020.00112. PMID: 32266163; PMCID: PMC7098993.

Glatz M, Bosshard PP, Hoetzenecker W, Schmid-Grendelmeier P. The Role of Malassezia spp. in Atopic Dermatitis. J Clin Med. 2015 May 29;4(6):1217-28. doi: 10.3390/jcm4061217. PMID: 26239555; PMCID: PMC4484996.

Kamruz Darabi, Sarah Grim Hostetler, Mark A. Bechtel, Matthew Zirwas, The role of Malassezia in atopic dermatitis affecting the head and neck of adults, Journal of the American Academy of Dermatology, Volume 60, Issue 1,2009, Pages 125-136, ISSN 0190-9622, https://doi.org/10.1016/j.jaad.2008.07.058.

About the Author:

Dr. Diane Angela Fong, ND, is the CEO and founder of Cleanbody, a wellness company dedicated to treating and preventing chronic disease. She is the creator of the Cleanbody Method, which follows a three-step process: Evaluate (digging into the root causes of chronic disease using lab testing and other evaluation tools), Optimize (enhancing health foundations by addressing nutrition, lifestyle, and toxic exposures), and Support (optimizing organ functions through healing protocols).

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