Eczema, also known as atopic dermatitis, is more than just dry, itchy skin. It is a chronic condition that affects millions of people worldwide. Recent research suggests that a surprising treatment could come from nature. A friendly skin bacterium might help rebalance the skin and improve symptoms.

Understanding Eczema

Atopic dermatitis is caused by multiple factors.

The first is barrier dysfunction. People with eczema have a weakened skin barrier. Lipids and proteins like filaggrin are disrupted, which makes the skin more susceptible to irritants and allergens.

The second factor is immune dysregulation. The skin inflammation in eczema is driven by an overactive immune system. Specific immune molecules such as interleukins IL-4, IL-13, and IL-31 become too active, causing redness, itching, and swelling.

The third factor is microbial imbalance. Healthy skin hosts a diverse community of microbes. In eczema, harmful bacteria like Staphylococcus aureus often dominate while beneficial bacteria decrease.

These three elements create a cycle of barrier damage, inflammation, and microbial imbalance, which reinforces each other and triggers flare-ups.

The Roseomonas mucosa Study

In 2018, researchers led by Ian Myles published a study in JCI Insight testing whether Roseomonas mucosa, a bacterium commonly found on healthy skin, could help people with moderate eczema.

They cultured strains of Roseomonas mucosa from healthy volunteers and applied them to the skin of participants a few times per week in the form of a spray.

Many participants experienced improvements. Eczema severity scores decreased, itching improved, and patients were able to reduce the use of steroid creams. On a microbial level, the harmful Staphylococcus aureus decreased in many participants. Some of the beneficial bacteria appeared to persist on the skin for months.

No major safety issues were reported. This approach attempts to restore balance by adding helpful bacteria that compete with harmful microbes and support the skin barrier and immune system.

Why the Study Is Important and Why Caution Is Needed?

This study is exciting but it is still early research.

The study was small and open-label, meaning it was not placebo-controlled. This makes it hard to know whether improvements were entirely due to the bacteria or other factors such as psychological interference.

Not all strains of Roseomonas mucosa are the same. The study used strains from healthy individuals. It is unclear whether other strains would be equally safe or effective.

Maintaining live bacteria in a spray is challenging. Ensuring stability, potency, and safety on a large scale is not simple.

Long-term effects are also unknown. How long colonization lasts and what immune effects it might have are still being studied.

Related Research and the Skin Microbiome

This study is part of a larger field investigating the role of the skin microbiome in eczema. Other research has shown that topical probiotics and live bacterial therapies can reduce eczema severity in some patients. Laboratory studies suggest beneficial bacteria produce metabolites that support barrier repair and reduce inflammation.

Researchers are also testing combinations of bacteria and natural ingredients, such as cardamom, which has anti-inflammatory and antioxidant properties. These combinations are still under investigation in clinical trials.

The skin microbiome is increasingly recognized as an important part of eczema. Healthy microbial diversity supports the barrier and modulates immune responses. Restoring this balance could become a central strategy in eczema management.

Current Treatments and Limitations

Today, eczema is treated with several approaches.

Emollients and moisturizers help restore the barrier but do not address inflammation or microbial imbalance.

Topical steroid creams are effective for flare-ups but can cause skin thinning if used long-term.

Topical calcineurin inhibitors reduce inflammation without steroids but can be irritating and are not always used consistently.

Targeted biologics and JAK inhibitors are highly effective for severe cases but are expensive and require careful monitoring.

Phototherapy can help some patients but requires clinic visits, alters the skin microbiome and carries UV exposure risks.

While these treatments manage symptoms, they do not fully address the underlying microbial and barrier dysfunction.

Looking Forward

The Roseomonas mucosa study suggests a new approach: instead of only suppressing inflammation or killing harmful bacteria, we could restore a healthy microbial balance. This could reduce steroid use and provide a more natural, self-sustaining therapy.

However, larger, controlled trials are needed to confirm effectiveness and safety. Quality control and strain selection are crucial.

Patients should not attempt to use live bacteria at home. Clinical-grade therapies are being developed carefully for safety and consistency. In the meantime, following established eczema care plans, maintaining the skin barrier, and consulting a dermatologist remain essential.

Further Reading

• The role of the skin microbiome in atopic dermatitis (Clinical and Translational Allergy)

• Skin-gut crosstalk and atopic dermatitis (PubMed review)

• Molecular mechanisms of atopic dermatitis pathogenesis (MDPI review)

• Human microbiota and atopic dermatitis therapy (MDPI review)