Brenda Khan
Eczema is a common inflammatory skin condition characterised by itchy, dry, scaly, and inflamed skin. While the exact causes of eczema are unclear, genetics and immune function are known to play a role. There is a complex relationship between diet and eczema, with certain foods potentially triggering or exacerbating symptoms. Although there is no specific eczema diet, anti-inflammatory diets that avoid processed foods and emphasise whole, antioxidant-rich foods may help manage symptoms. Probiotics, prebiotics, and omega-3 fatty acids have also been linked to potential eczema relief. Determining individual food triggers through elimination diets can be a strategy to identify and avoid specific trigger foods.
| Characteristics | Values |
|---|---|
| Diet's role in eczema | Most experts say diet has little effect on eczema, but some studies have found that certain foods may trigger eczema symptoms. |
| Foods that may trigger eczema | Processed foods, sugary foods, acidic foods (for those with dyshidrotic eczema), foods containing nickel and cobalt (for those with hypersensitivity to these metals) |
| Foods that may reduce eczema symptoms | Anti-inflammatory foods (e.g. nuts, grains, fish, turmeric, ginger), omega-3 fatty acids, probiotics, tea |
| Identifying food triggers | Elimination diet: temporarily avoid suspected food triggers, monitor symptoms, and gradually reintroduce foods to identify specific triggers |
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What You'll Learn
Food allergies and eczema
While most experts say that diet has little effect on eczema, there is a link between food allergies and eczema, particularly in children. Research has shown that people with atopic dermatitis, the most common type of eczema, have a higher risk of food allergies.
Up to 30% of people with atopic dermatitis also have food allergies, compared to only 10% in the general population. Scientists have found that children with both atopic dermatitis and food allergies have structural and molecular differences in the top layers of healthy-looking skin near the eczema lesions, whereas children with atopic dermatitis alone do not. These differences may help identify children at a higher risk for developing food allergies.
Food allergies can sometimes cause eczema in young children. An allergic reaction to dairy products, eggs, nuts, soy, or wheat may cause hives or other skin problems that look like eczema, but they are not the same. Food allergies are considered an official comorbidity (related health condition) of atopic dermatitis, alongside asthma, allergic rhinitis (hay fever), and depression.
While food allergies can trigger eczema, they are rarely the root cause of the disease. People with atopic dermatitis may be more prone to food allergies, but food is not the cause of the condition. It is important to consult with a healthcare provider before making any drastic changes to your diet.
Some studies have found that probiotics and teas may help relieve eczema symptoms. An anti-inflammatory diet that avoids added sugars, simple carbs, and highly processed foods may also be beneficial. This diet includes lean proteins, fresh fruits, vegetables, leafy greens, and healthful oils. Omega-3 fatty acids, found in fatty fish like salmon, sardines, and mackerel, may also have a beneficial effect on eczema.
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Anti-inflammatory diets
While there is no specific eczema diet, certain foods can either calm or irritate eczema. Adjusting your diet can help manage flare-ups and improve skin health over time.
For those with inflammatory diseases, such as eczema, the line between food allergies and food sensitivities is less clear. Although certain foods may not cause anaphylaxis or organ failure, they can still trigger a reaction from the immune system. Reactions can take anywhere from a few hours to days to occur, making them harder to diagnose.
An elimination diet is a technique that can help determine what foods may be causing the reaction. This diet involves temporarily avoiding a food or food group for several weeks and then gradually reintroducing it. If the food coincides with an increase in eczema symptoms, it is possible that it is a trigger.
An anti-inflammatory diet avoids foods that may cause inflammation when consumed in excess. It includes foods with anti-inflammatory properties, such as:
- Lean proteins
- Fruits and vegetables (especially colourful ones)
- Whole grains
- Leafy greens
- Healthful oils
- Nuts
- Fish (salmon, sardines, mackerel, and shrimp)
- Flaxseed
- Fermented foods and yogurt
- Tea (black, green, or oolong)
Some research suggests that omega-3 fatty acids, found in fish and fish oil, may help with inflammation. Probiotics, prebiotics, and flavonoids are also being studied as a potential avenue for eczema relief.
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Omega-3 fatty acids
While there is no specific eczema diet, some studies have shown that omega-3 fatty acids can help manage eczema symptoms. Omega-3 polyunsaturated fatty acids (PUFAs) are composed of 18 or more carbon chains, with a double bond three atoms away from the terminal methyl group. They are mainly classified into three representative lipids: α-linoleic acid (ALA), docosahexaenoic acid (DHA), and eicosapentaenoic acid (EPA). ALA is enzymatically converted to EPA and then to DHA, primarily in the liver, but these conversions are limited due to enzyme concentration in the human body.
Some studies suggest that dietary supplementation with omega-3 fatty acids can help manage symptoms of atopic dermatitis (AD) by reducing lesion severity, skin inflammation, dryness, and itching. A 2012 review of three studies on fish oil supplements and eczema found that treatment with fish oil improved quality of life and itchiness in people with eczema. Additionally, a 2002 study of 22 hospitalized individuals with eczema found that infusion therapy with fish oil significantly improved eczema severity compared to soybean oil. Another 16-week study showed that daily supplementation with omega-3 fats, along with omega-6 fats, zinc, vitamin E, and a multivitamin, reduced eczema severity by over 50% in more than 80% of participants.
In a randomized, placebo-controlled trial, AD patients who received daily omega-3 fatty acid supplementation (fish oil, 10%; 200 mL) showed high serum EPA concentration and reduced disease severity of AD. A separate double-blind, randomized, multicenter trial found that daily intake of an omega-3 fatty acid supplement (Omegavenous; 200 ml/day with 4.2 g of EPA and DHA) decreased the Psoriasis Area Score Index (PASI) score without serious side effects.
Furthermore, animal studies have shown positive results. A rodent study found that oral supplementation with fish oil for 30 days resulted in improved skin hydration and reduced scratching behaviour. Similarly, a study in mice revealed that treatment with DHA and EPA decreased eczema scores and reduced levels of inflammatory proteins and immunoglobulin E (IgE), an antibody associated with eczema.
While most supplements on the market contain about 1,000 mg of fish oil concentrate per serving, the Food and Drug Administration (FDA) recommends keeping the combined intake of DHA and EPA below 3,000 mg per day, with no more than 2,000 mg from supplements. However, it's important to note that the link between diet and eczema is complex, and food is rarely the root cause of eczema.
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Probiotics and prebiotics
Probiotics are live microorganisms (bacteria or fungi) that are consumed or applied to the skin to improve health. They can be found in a range of products, from live yogurt and other fermented foods to dietary supplements. The most common types of probiotics are Lactobacillus and Bifidobacterium.
Probiotics are gaining popularity as a potential treatment for eczema, also known as atopic dermatitis. Eczema is a chronic inflammatory skin condition that affects approximately 20% of children and 10% of adults worldwide. It is characterised by dry skin, intense itching, and eczematous cutaneous lesions. The cause of eczema is a faulty immune response, which leads to skin inflammation, dryness, and cracking.
Probiotics may help treat eczema by strengthening the immune system. They provide good bacteria that support a healthy digestive system and improve intestinal barrier function, which can help reduce allergic reactions and atopic dermatitis severity. Probiotics can also be applied topically to the skin to relieve eczema symptoms. A recent discovery by scientists at the National Institute of Allergy and Infectious Diseases (NIAID) found that a specific strain of bacteria, Roseomonas mucosa (R. mucosa), reduced eczema-related skin inflammation and enhanced the skin's natural barrier function in both adults and children. This R. mucosa-based probiotic, called Defensin, has been made available over the counter.
While probiotics show promise in preventing and treating eczema, it is important to note that they are not a cure. Research suggests that probiotics can help prevent eczema from developing in babies who are predisposed to it. However, there is insufficient evidence to support the use of probiotics as a direct treatment for eczema in those who already have the condition. The current research on the use of probiotics for eczema is mixed, and more studies are needed to determine their effectiveness.
Prebiotics are non-digestible ingredients that benefit the host by selectively stimulating the growth of "good" bacteria in the gut, such as Bifidobacterium and Lactobacilli. Prebiotics can be found in dietary fibre. The International Scientific Association for Probiotics and Prebiotics recommends a daily intake of 5 grams of prebiotics for gut health, which can typically be achieved through a diet containing sufficient fibre. While prebiotics have not been specifically studied in the context of eczema, their role in promoting a healthy gut microbiome may indirectly support skin health and reduce eczema symptoms.
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Elimination diets
While there is no specific eczema diet, some people with eczema may find that certain foods trigger flare-ups. An elimination diet can help identify these trigger foods.
To begin an elimination diet, a person removes a suspect food from their diet. After a period of time, the food is gradually reintroduced. If the reintroduction coincides with an increase in eczema symptoms, the food may be a trigger.
Some common food triggers for eczema include milk, eggs, peanuts, wheat, and fish. However, it is important to note that a true food allergy should be confirmed by an allergist before removing any foods from the diet.
There are potential downsides to elimination diets, including the risk of malnutrition, delaying proper eczema treatment, and the possibility of developing food intolerances. Elimination diets can also be time-consuming and expensive.
Some healthcare professionals advise against long-term elimination diets, as there is no evidence that they change the underlying disease process. Instead, it is recommended to explore other treatment options, such as topical medications, before removing foods from the diet.
It is always best to consult with a healthcare provider before making any significant changes to the diet.
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Frequently asked questions
No, diet does not cause eczema. However, certain foods may trigger eczema flare-ups in some people.
There is no one-size-fits-all answer to this question. The best way to identify your trigger foods is to adopt an elimination diet under medical supervision.
An elimination diet involves temporarily avoiding a food or food group for several weeks, monitoring your symptoms, and then gradually reintroducing the food to see if symptoms reappear.
There is no specific diet that can help with eczema. However, some diets, such as the Mediterranean diet, may help reduce eczema symptoms by emphasizing whole and antioxidant-rich foods.
Yes, anti-inflammatory foods like nuts, grains, and fatty fish may help reduce eczema symptoms. Probiotic foods and teas may also be beneficial.
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