Eczema: Much More than a Skin Condition

Eczema is a skin condition in which the skin is itchy, dry, rough, red, and inflamed. Over 12% of American children suffer from eczema at an annual cost of $3.8 billion. Many parents wonder if there is a root cause of eczema, and if so, how to treat it.

My conventional medical training taught me to use steroid creams of varying potencies along with antihistamine medications to keep inflammation and itching at bay. The conventional approach to eczema explains why many parents also see eczema as a problem that is skin deep.

As an integrative pediatrician I have learned that the root cause of eczema is a complex interplay between our genetics, immune system, skin integrity, and the microbiomes of the skin and the gut. Learning how to treat illness using the best of both conventional and integrative medicine has absolutely transformed the way I am able to help kids with eczema.

The video below is from a talk I recently delivered at a global conference on skin conditions. In it you’ll learn about the gut and skin microbiomes and see that almost everything—including sleep—is a factor in whether a child can overcome eczema. I go much deeper in my online course, but this video is a good start.

Dr. Kilbane explains understanding eczema’s root cause in disturbed cellular health

Eczema and cellular health

My medical training (circa 1998) didn’t include two significant factors I needed to understand and treat eczema at the cellular level. First, information about the triggers of inflammation. Second, the understanding that our skin, gut, and other body systems are teeming with their own ecosystems of microorganisms called microbiomes. I discussed microbiomes in the video above so now let’s get on the same page with the relationship between the skin, gut, and immune system.

You may have learned in high school that the gut regulates the breakdown and absorption of food, as well as waste removal, and detoxification. What’s not as well known is that roughly 70% of our immune system resides there and that much of our health is connected to the gut. Therefore, how do we protect the gut so that it can protect us?

To answer that question we must start with anatomy. We have a single layer of cells along our GI tract. Each of these cells needs to be cemented to their adjacent neighbor  by tight junctions. If we do something to disturb those junctions, the gut becomes permeable and start leaking into the bloodstream that don’t belong there. These runaway molecules that belong in the gut then set off a cascade of inflammation, as the body knows the molecules aren’t supposed to be there and it tries to ward them off.

Leaky Gut and Eczema

In our current era of processed, highly refined, sugar-laden foods, many children live in a state of excess inflammation because their cellular junctions are constantly disturbed.

You may already be familiar with this cycle, which is commonly called “leaky gut syndrome.” The medical term is permeable intestine. Leaky gut is also why many children with eczema have either constipation or loose stools. 

Excessive inflammation can show up in a number of diagnoses, from chronic runny nose to reflux and chronic ear and sinus infections. When excess systemic inflammation shows up as eczema, it is often accompanied by severe itching and sleepless nights. Without addressing the inflammation, the patient may spend weeks, months, or years using topical steroids and antihistamines, which only manage the symptoms (with varying degrees of success).

A two-way street between the gut and skin

A two-way street of inflammation exists between the excess staph bacteria on the skin and the cells along the GI tract. I explain the relationship between the gut and skin in this video from my recent talk.

Dr. Kilbane explains how the Skin and Gut Microbiomes interact in Eczema patients

Believe it or not, addressing the microorganisms living on the skin and gut play a crucial role in our ability to treat eczema and see long lasting improvements. Upwards of 80% of kids with eczema have excess staphylococcus bacteria on their skin. Taking it further, this staph bacteria secretes a delta toxin, which in turn, contributes to eczema flares.1, 2 Once the staph bacteria is addressed on the skin and the skin begins to heal, this also facilitates gut healing. 3

Topical steroids alone do not address the root cause of the eczema. The steroids decrease inflammation, but once they are stopped, the skin often flares up again if the staph and gut issues have not been addressed as well. I treat eczema from the outside in and the inside out by also supporting the beneficial bacteria in the gut using nutrition and supplements, as well as medications when needed. By taking a comprehensive approach, we gradually decrease the child’s overall systemic inflammation.

For many of my patients, the results can be astounding, quick, and long-lasting.

Case study: Rocky

I have included photos of Rocky, who had severe eczema when he first came to see me. You can see how quickly his skin began to turn around when we addressed the skin and gut together, and optimized cellular health. He showed a decrease in systemic inflammation and experienced long-lasting improvements. You can see the timeline of Rocky’s improvements below. 

You can watch the full story of Rocky’s eczema healing journey as documented by his parents. 

Video #1 (Before we started working with them) 

Video #2 (after he started seeing results)

Video #3 (one year later)

See Rocky’s final transformation and how much he enjoys taking his supplements

The immune system of a child whose body is unburdened by inflammation has an immune system that is working optimally and better able to handle infectious diseases without symptoms, while a child whose system is already overworked cannot. This concept illustrates why decreasing systemic inflammation and restoring proper digestion, are the bedrock of my Healthy Kids, Happy Moms Program. Inflammation is the number one root cause of eczema.

Takeaway tips for treating the root cause of eczema

We know several things about treating eczema at the cellular level. I discuss them all in my book and go into more depth in my online course. The most important first step is identifying and addressing common eczema triggers:

  • Food: one-third of eczema cases are triggered  by food allergies and food sensitivities. The two big culprits are dairy and eggs 
  • Environmental allergies: Dust mites and other environmental allergens also contribute to eczema
  • Environmental toxins: For example, mold from a water-damaged building
  • Infectious Diseases:
    • Excess staph bacteria on the skin (dysbiosis of the skin microbiome)
    • Excess amounts of harmful bacteria in the gut or a deficiency of beneficial bacteria  (dysbiosis of the gut microbiome) 
  • Stress (physical or emotional): Poor sleep can be a source of stress so making sure your child is getting into a deep, restful sleep is so important! Discover a refreshing way to alleviate stress and unwind by immersing yourself in the captivating world of sip777, where every game offers a chance to relax and rejuvenate.


There is so much more information I would like to share with you about eczema and the ways to lessen its impact on your child’s life. I have created several resources to support you on your healing journey including:

  • I use a topical product in my practice that requires a prescription. It addresses the excess staph bacteria on the skin, the inflammation, and the dry, disrupted skin barrier in kids with eczema. I used this product for Rocky, but we also have a wonderful non-prescription option for less severe cases. 

While addressing the triggers of inflammation, we work to optimize the gut microbiome using my Seven-Step Program. This helps your child heal from the inside out and the outside in.  

Let’s Get Your Child Thriving Again!


  1. https://www.termedia.pl/Staphylococcus-aureus-an-underestimated-factor-r-nin-the-pathogenesis-of-atopic-dermatitis-,7,35797,0,1.html
  2. https://pubmed.ncbi.nlm.nih.gov/24172897/
  3. https://onlinelibrary.wiley.com/doi/10.1111/j.1365-2133.1974.tb06447.x


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What If You Could Break Your Child's Sick Cycle?

Discover 7 Steps to Heal and
Prevent Common Childhood Illnesses

Online Course

The Healthy Kids, Happy Moms Companion Course is a physician-led, parent-centered, time-tested online course that includes assessments, workbooks, recipes, and illness-specific recommendations.

Become a Patient

 Dr. Kilbane’s private practice, Infinite Health, is based in Charlotte, North Carolina. She is currently accepting new patients

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What You Get With The Eczema Jump Start Guide:

Dr. Kilbane’s approach is universal and can be used by both children and adults who have eczema. Here’s what’s included: