Plant-Based Diet: Eczema's Natural Remedy?

Eczema is a common skin condition that affects about 10% of children and young adults and 2-5% of the general population. While there are many treatments for eczema, they don't always work, and people may turn to alternative treatments, lifestyles, and diets.

Some evidence suggests that a plant-based diet may help with eczema. A 2018 study found that the greatest benefits were reported by those who added vegetables, especially organic ones, to their diets. Another study from 2001 showed that a strict plant-based diet reduced inflammation and immune response markers in participants with eczema.

However, there is no conclusive evidence that a plant-based diet can help everyone with eczema. Experts recommend that people with eczema eat a diet rich in nutrients that support gut and immune health, which can come from plants or a mix of plant- and animal-based foods.

Overall, a plant-based diet may be worth considering for those looking to manage their eczema, but individual results may vary.

Dairy and eggs as common triggers

Dairy and eggs are common triggers for eczema. People with eczema are often told to avoid dairy, and many choose to do so before an allergy or intolerance is confirmed. This is because dairy is a common allergen, and consuming it may worsen symptoms for those who are allergic.

Dairy foods are also often restricted or avoided by people following an anti-inflammatory diet, as many believe that dairy foods cause inflammation. However, new research suggests that dairy and milk proteins do not cause inflammation and can be included in an anti-inflammatory diet.

For example, a 2018 study found that those who went on a vegan diet for eight weeks had lower levels of inflammation compared to those on a regular heart-healthy diet. Additionally, foods in the dairy group are important because they provide vital nutrients for overall health, such as calcium, potassium, vitamin D, and protein. Vitamin D, in particular, is important for helping the body absorb calcium, which is needed for strong bones.

Eggs are also common triggers for eczema. According to the National Eczema Association, eggs are among the foods that tend to top the "do not eat" list for people with atopic dermatitis, along with dairy, seafood, peanuts, sugar, alcohol, and gluten.

It is important to note that food allergies are considered an official comorbidity (related health condition) of atopic dermatitis, and researchers have found that up to 30% of people with this condition also have food allergies. Therefore, eliminating potential food allergens such as dairy and eggs may help reduce eczema symptoms for some people.

However, it is always recommended to consult with a trusted healthcare provider before making any drastic changes to your diet, as eliminating certain food groups can lead to nutrient deficiencies.

The role of vitamin D

Vitamin D is an essential nutrient for immune function, bone and heart health, disease prevention, and more. It is believed that vitamin D plays a role in eczema due to its immune-regulating properties and ability to affect gene expression.

Vitamin D has been found to protect the skin's barrier function, which helps to prevent infections. Additionally, it suppresses skin inflammation by regulating immune cells. Vitamin D also influences gene expression, and some research suggests that a lack of it in utero may predispose a person to eczema.

Vitamin D Deficiency

Vitamin D deficiency is common among those with eczema, and it is believed to be due to various factors such as dietary factors, decreased time spent outdoors, living in regions with limited sunlight, air pollution, and not consuming enough vitamin D-rich foods.

Vitamin D Supplementation for Eczema

While there is no conclusive evidence, experts are increasingly suggesting vitamin D supplements for their eczema patients. Vitamin D supplementation has been found to improve eczema symptoms in some individuals. However, it is important to consult a healthcare professional before taking any supplements, as excessive vitamin D can be dangerous.

Recommended Dosage

For adults, a dosage of 4,000 IU per day is typically recommended. For infants and toddlers, vitamin D drops designed for babies, generally 400 IU per day, are suggested. Older children are advised to take 1,000 IU per day.

The role of vitamin E

Vitamin E is an essential nutrient with antioxidant and anti-inflammatory properties. It is a naturally occurring antioxidant that can be consumed from foods like seeds, nuts, and some vegetables. It is also available in topical and supplement form.

Vitamin E is known to provide benefits to heart health, liver health, and the immune system. Due to its anti-inflammatory and antioxidant properties, it helps combat free radicals that can cause damage to the skin cells. It also helps regulate the immune system, which may help minimize outbreaks of eczema.

A 2016 study found that patients with atopic dermatitis, a type of eczema, who were treated with oral vitamin E for eight months saw significant improvement and near remission in symptoms by the end of the study. A separate 2015 study of 70 participants with mild to moderate eczema found that treatment with vitamin E showed greater improvement in symptoms such as itching, redness, swelling, excoriation, and skin thickening compared to a placebo.

Evidence suggests that vitamin E is a safe and effective way to minimize or significantly reduce eczema flare-ups. Both topical and oral vitamin E seem to have beneficial effects on symptoms. Vitamin E can be consumed naturally from foods, including seafood, seeds, nuts, and green vegetables. It can also be applied topically in the form of creams, serums, and oils.

However, it is important to note that consuming large quantities of vitamin E supplements can cause potential health issues, such as excess bleeding or intracranial hemorrhages. Therefore, it is recommended to speak with a medical professional to determine if taking vitamin E supplements is suitable for your specific needs.

The gut-skin axis

An imbalance in either the skin or gut microbes often affects the other. People with eczema have some distinct differences in their microbiomes, and alterations in the microbiome are seen in various health conditions, including eczema. Treatment for eczema is therefore not just about targeting the skin; changing your gut microbiome may also improve your skin health.

The makeup of the microbiome starts from birth and is influenced by factors such as birth method, infant feeding type, location, and medication use. There is no one "healthy" microbiome—each healthy person will have a unique microbiome. However, research has noted distinct differences in the microbiomes of people with certain diseases.

In babies and children, eczema can be an early sign of allergy risk, as both eczema and allergies are triggered by an abnormal immune response. The immune system usually only responds to true threats such as viruses or harmful bacteria, but with allergies or eczema, the immune system is triggered by something benign. Babies with eczema are more likely to develop food allergies or asthma, and removing any allergens from the diet often improves the skin.

Children with eczema have different skin bacteria compared to children without eczema. Studies show that children without eczema have a more diverse gut microbiome, which is often a sign of better health. As children with eczema tend to have less diverse microbiomes, supporting greater diversity within the microbiome may be beneficial.

There are several ways to support greater diversity within your microbiome:

• Eating a high-fibre diet, with fibre sources such as whole grains, nuts, seeds, beans, vegetables, and fruits
• Incorporating fermented foods such as yogurt, kefir, tempeh, kimchi, and sauerkraut
• Limiting alcohol intake, as alcohol can change the gut microbiome and lead to gut dysbiosis
• Managing stress, as research suggests this may also change our microbiome

While there is no conclusive evidence that a vegan diet can help manage eczema, some people with eczema have reported improvements in their symptoms after switching to a plant-based diet. A well-planned vegan diet can provide essential nutrients that may be beneficial for skin health, such as vitamins A, C, and E, zinc, and omega-3 fatty acids. Additionally, the high fibre content in a vegan diet supports a healthy gut microbiome and promotes healthy digestion and regular bowel movements.

The leaky gut theory

The "leaky gut" theory of eczema suggests that defects in the connections between cells in the intestines allow food allergens and other irritants to enter the bloodstream, causing widespread inflammation. This theory is supported by research that shows that people with atopic eczema also have a leaky gut or increased intestinal permeability.

The outer layer of skin in eczema patients can have defects in its barrier function, causing the skin to lose too much moisture and become "leaky". Similarly, a leaky gut allows unwanted compounds to enter the bloodstream, triggering inflammation in the body, including the skin. This is thought to be why leaky gut is connected to eczema and other dermatitis conditions.

According to research in Clinical Reviews of Allergy and Immunology, most autoimmune conditions, including eczema, are related to leaky gut. The skin reflects our diet and digestive health, and a compromised intestinal barrier can cause an overreaction in the immune system, making the skin and gut leaky.

Food allergies are present in most people with atopic eczema and can worsen symptoms. The root cause of this may be a leaky gut. An elimination diet may be helpful for reducing leaky gut symptoms and gastrointestinal issues, but it should be done under the supervision of a medical professional.

To improve a leaky gut, it is recommended to minimize or eliminate sugar and processed foods, as these are inflammatory and can cause surges of insulin that are highly inflammatory for the skin and digestive tract. Instead, focus on consuming nutrient-rich foods like extra-virgin olive oil, broccoli sprouts, and superfood powders.

Additionally, adding fermented foods or probiotics can help restore healthy bacteria in the gut, which may reduce leaky gut symptoms. Probiotics can also help increase the diversity of gut bacteria in children. Specific strains like Lactobacillus and B. Longum may be particularly beneficial for reducing leaky gut symptoms.

In summary, the leaky gut theory proposes that defects in the intestinal barrier allow allergens and irritants to enter the bloodstream, triggering widespread inflammation. This can affect the skin, potentially leading to or exacerbating eczema. Addressing leaky gut through dietary changes, such as reducing sugar and processed foods and increasing nutrient-rich and probiotic-rich foods, may help improve eczema symptoms.

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