Diet & Nutrition for Eczema

How are eczema and diet connected?

Diet is linked to so many aspects of our health, including our skin. Though there is still a lot to learn about the role of food and nutrition when it comes to eczema, determining how different diets affect your skin can help reduce your symptoms.

Research has shown that people with atopic dermatitis (the most common type of eczema) have a higher risk for food allergies. Those with more severe atopic dermatitis are more often diagnosed with food allergies compared to the general public without atopic dermatitis.¹

While people with atopic dermatitis may be more prone to food allergies, that does not mean food is the cause of atopic dermatitis. This is a common misconception. Food can be a part of your atopic dermatitis symptoms, but it is rarely the root cause of the disease.

Is there a special diet for people with eczema?

No, in general, there is not an “eczema diet.” There is no special diet that you should follow once you’re diagnosed with eczema. The connection between diet and eczema is incredibly complex. Currently, doctors recommend that people with eczema eat a healthy diet (like everyone else), including avoiding processed foods and sugary foods. Processed foods and sugary foods can cause inflammation in the body in general, so it’s best to lessen your chances of inflammation.

If you think a specific food is repeatedly causing your eczema to flare, talk to your doctor about it so they can help you figure out a diagnostic and treatment plan.

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Diet and Eczema

Dr. Peter Lio, clinical assistant professor of dermatology and pediatrics at Northwestern University, discusses diet and eczema, including how researchers have uncovered a new understanding of the connection between eczema and food allergies.

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Is there a link between food allergies and eczema?

Food allergies are a known comorbidity (or related health condition) of atopic dermatitis, the most common type of eczema. Food allergies, along with asthma and allergic rhinitis, are a common set of allergic conditions that often affect people with atopic dermatitis called the atopic march.² The atopic march (asthma, allergic rhinitis and food allergies) typically comes on in a sequence one after another usually after being diagnosed with atopic dermatitis.² In general, if you have one of these four conditions — atopic dermatitis, asthma, allergic rhinitis or food allergies — the likelihood of developing one of the other three allergic conditions increases.

Children with atopic dermatitis are six times more likely to develop a food allergy than those without atopic dermatitis.³ There are a few food allergies that tend to be more common for those with atopic dermatitis. These include milk, eggs, fish, shellfish, tree nuts, peanuts, wheat and soybeans.⁴ Doctors do not recommend that you avoid these foods just because you have eczema. If there is a concern for a potential food allergy, you should consult with an allergist.

Symptoms of food allergies typically appear within 30 minutes of eating or breathing in a food allergen and can include:

• Itchy mouth and swelling of the lips
• Vomiting, diarrhea, painful stomach cramps
• Hives, rash or reddening of the skin
• Blood pressure drop

What’s the difference between food allergies and food sensitivities?

Knowing the difference between food allergies and food sensitivities or intolerances can help you understand the correlation between eczema and diet.

A food sensitivity, or food intolerance, happens when someone has difficulty digesting certain foods, which can lead to gas, bloating, abdominal pain or diarrhea. It can also trigger a rash, but this is a different reaction than atopic dermatitis.⁵ Food sensitivity can happen when the skin or gut comes into contact with a specific food.

A food allergy provokes an immune system reaction that affects several organs in the body, called an immunoglobulin E (IgE) reaction. It can lead to a variety of symptoms, and some are life-threatening. In most cases, food allergies spark an immediate reaction, within minutes of consuming the food. Common ones include hives, itchiness, swelling, vomiting or diarrhea. Anaphylaxis reactions can include difficulty breathing, dizziness or loss of consciousness. Food allergies trigger this IgE reaction every time the person is exposed to the food.⁵

How do you know if you have a food allergy?

To test for a food allergy, allergists use the skin prick test or test for a specific antibody reaction. However, these tests are not always accurate and both can have false positives. A strong option for diagnosing a food allergy is for the medical professional to do a food challenge and monitor the reaction. An allergic food causes an immediate rash every time.

For those with inflammatory diseases, such as eczema, the line between food allergies and food sensitivities is less clear. Though certain foods may not cause anaphylaxis or organ failure, they can still lead to a reaction from the immune system. Reactions can range, but they can take anywhere from a few hours to days to occur, which makes them harder to diagnose. Making it even trickier, though some foods can trigger an allergy-like reaction, they do not show up on allergy tests. It is believed that when skin is already very inflamed, it makes a flare more likely to happen.

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Should you eliminate or cut out certain foods from your diet if you have eczema?

If people with atopic dermatitis (the most common type of eczema) are more likely to be allergic to wheat and eggs, should you cut them from your diet? No, it’s not that simple. Remembering that food is not the root cause of atopic dermatitis is important.

It is always best to consult with your healthcare provider before making any major changes to your diet. If a true food allergy is suspected, a patient should be tested by an allergist, and then the food can be removed from their diet after an allergy is confirmed. It is highly recommended that patients have a give and take discussion with their healthcare provider about food in their eczema management plan.

Food elimination diets for atopic dermatitis are currently not recommended and they come with risks. In some cases, patients will try to “cure” their eczema with such a severe elimination diet that it can lead to other health issues without helping their eczema at all. Eliminating certain foods from your diet can actually increase the risk of developing food allergies. Additionally, if atopic dermatitis goes untreated or undertreated, it can lead to a risk of developing more food and other allergies because the skin barrier is not functioning properly and the immune system is overreacting.

However, some eczema patients have found it helpful to cut dairy products, simple carbs and/or gluten from their diet, since they are all linked to inflammation. More research and controlled studies on diet and atopic dermatitis need to be done to better understand how these are connected. There currently is not enough research on the topic.

The general public is advised to eat as healthy as possible, eating mostly plant-based foods and vegetables, with some fish and meat, which can improve health overall. This applies to people with eczema as well.