Keto Diet: Friend Or Foe For Eczema Sufferers?

Eczema is an inflammatory skin disease that affects an estimated 1 in 10 people, causing itchy skin and rashes that can significantly impact quality of life. While the exact cause of eczema is unclear, it is believed to be linked to a combination of environmental triggers, genetics, and immune system dysfunction. In recent years, there has been growing interest in the potential benefits of the keto diet for managing eczema. The keto diet is a low-carb, high-fat, moderate-protein eating pattern that has gained popularity for weight loss and improving certain health conditions. While there is limited scientific evidence specifically linking the keto diet to eczema improvement, some individuals have reported significant reductions in eczema symptoms after adopting this diet.

Keto diet and eczema success stories

May's story

May, a Diet Doctor member, shared how a low-carb keto diet helped her daughter finally find relief from eczema. After years of discomfort, May decided to let her daughter follow a keto diet together with her. The daughter's skin became less itchy and gradually healed. Not only did the rashes on her hand improve, but so did the flares on her neck, leg, and face.

Other success stories

There are countless stories and anecdotal evidence of how going keto significantly improved eczema and other skin issues. Many people tried everything to no avail before stumbling into the ketogenic lifestyle and finding success in treating eczema.

Eczema is an inflammatory skin disease, and a ketogenic diet is proven to decrease inflammation. Low-carb diets have also shown promise for a range of autoimmune diseases, where the body is attacking its own tissues.

Sugar and refined carbs can hike up inflammation in the body but going low-carb means leaving all that inflammatory sugar behind. Most of the opportunistic bacteria in your gut feed off sugar. Reducing sugar consumption can assist in bringing your gut microbiome back into balance.

Fats and oils like MCTs (medium-chain triglycerides) are easily and promptly converted to ketones in your body. Ketones lower inflammation and fuel your cells.

Precautions

It is important to note that a keto diet can also produce other skin rashes, as eliminating certain necessary foods from your diet can cause deficiencies that impact your skin health.

Additionally, while a keto diet may help with eczema, it is not a "one-size-fits-all" solution. Every individual is unique, and their treatment needs to be tailored to their specific needs. It is always best to consult a dermatologist or healthcare practitioner if you are unsure or have questions about eczema or considering diet and lifestyle changes.

The link between keto and prurigo pigmentosa

Prurigo pigmentosa, also known as Nagashima disease or "keto rash", is a rare inflammatory skin condition associated with ketosis. It is characterised by a recurrent itchy rash with netlike hyperpigmentation. The condition has been increasingly associated with ketotic states brought on by diabetes, fasting, and post-bariatric surgery.

The exact role of the exclusion of carbohydrates and ketosis in the development of prurigo pigmentosa is not yet fully understood. However, there is a growing body of evidence and success stories that suggest a link between the ketogenic diet and the development of prurigo pigmentosa.

A review of the literature identified 19 cases of prurigo pigmentosa induced by a ketogenic diet from 2015 to 2021. Patients ranged in age from 16 to 43 years, with a mean age at diagnosis of 24 years. The majority of patients were female (79%) and Asian (32%) or Middle Eastern (32%). The onset of the rash ranged from six days to four months after starting the diet, with an average of 31 days. The skin lesions predominantly occurred on the trunk and neck, with some cases involving the face, scalp, and suprapubic region.

Treatment for prurigo pigmentosa includes cessation of the ketogenic diet, with the addition of carbohydrates to the diet possibly being beneficial. Oral antibiotics such as doxycycline or minocycline are often used, as well as topical steroid treatments. The prognosis is excellent after resuming a normal diet and beginning treatment, typically resolving within two weeks.

Given the growing popularity of the ketogenic diet, cases of prurigo pigmentosa appear to be on the rise. Dermatologists should be aware of the timing of rash onset and resolution in relation to the diet and consider prurigo pigmentosa as a possible diagnosis for patients presenting with a cutaneous eruption after initiating a ketogenic diet.

While the ketogenic diet has been found to be beneficial for some people with eczema, it is important to note that it can also trigger the development of prurigo pigmentosa in some individuals. This rare skin condition is characterised by an itchy rash and is often mistaken for eczema. Topical and systemic steroids are not effective treatments for prurigo pigmentosa, but breaking ketosis typically leads to improvement.

Eczema and food allergies

Eczema, also known as atopic dermatitis, is a chronic inflammatory skin condition that affects roughly 20% of children. It is characterised by redness, itching, and sometimes infections. People with eczema often have other allergic conditions, including food allergies. However, food allergies do not cause eczema. Instead, common triggers for eczema flares include dry climates, overheating, exposure to irritants (e.g. sand or dirt), scratching, allergens (e.g. dust mites), and bacterial skin infections.

Food allergies are considered a comorbidity of atopic dermatitis, with up to 30% of people with AD also having food allergies. Some common food allergies among people with AD include seafood, peanuts, dairy, eggs, sugar, alcohol, and gluten. While there is a correlation between eczema and food allergies, the relationship is not fully understood.

The ketogenic diet has been anecdotally linked to improvements in eczema and other skin issues. Some people report that their skin became less itchy and gradually healed after adopting a keto diet. However, there is currently a lack of strong scientific evidence to support this claim.

The ketogenic diet is high in fat, moderate in protein, and low in carbohydrates. This type of diet has been shown to decrease inflammation and improve the gut microbiome, both of which may contribute to managing eczema. Additionally, keto diets typically include omega-3 fats, which have anti-inflammatory effects and may improve eczema symptoms.

While the keto diet may help manage eczema for some people, it is important to consult with a trusted healthcare provider before making any drastic changes to your diet.

Eczema triggers

Eczema is a skin condition that causes dry, itchy, and bumpy patches of skin. It is a type of dermatitis, which is a group of conditions that cause skin inflammation. While the exact cause of eczema is unknown, it is believed to be caused by a combination of genetic and environmental factors. Here are some common triggers that can cause an eczema flare-up:

Irritants:

Common irritants include soaps, detergents, shampoos, washing-up liquid, bubble bath, and other household cleaning products. These can strip away natural oils from the skin, leading to dryness and irritation. Even natural substances like fruit or vegetable juices can irritate the skin.

Environmental factors:

Dry and cold weather, as well as dampness, can trigger eczema. Specific environmental allergens such as house dust mites, animal dander, pollen, and moulds can also cause flare-ups. Living in extreme climates, whether very cold or hot and humid, may increase the risk of eczema.

Food allergies:

While the connection between food allergies and eczema is not fully understood, certain foods can trigger eczema symptoms. Common food allergies that may contribute to eczema include cow's milk, eggs, peanuts, soy, and wheat.

Materials and fabrics:

Certain materials and fabrics can irritate the skin and trigger eczema. Wool and synthetic fabrics like polyester and latex are common triggers. Rough organic materials, such as wool, can also irritate affected areas.

Hormonal changes:

Hormonal fluctuations, especially in women, can affect eczema symptoms. Many women report worsening symptoms before their period or during pregnancy.

Stress and emotional triggers:

Emotional stress and mental health conditions like depression or PTSD can cause eczema flare-ups. This is likely due to the physical reaction of the body to stress, which includes increased inflammation.

It is important to note that triggers can vary from person to person, and identifying specific triggers can help individuals with eczema avoid or manage their symptoms effectively.

Eczema treatments

Eczema is a skin condition that causes dry, itchy, and bumpy patches of skin. While there is no cure for eczema, there are a variety of treatments available to help manage the symptoms. Here are some detailed methods to treat eczema:

Lifestyle Changes

A regular bathing and moisturizing routine is essential for managing eczema. Use gentle, sensitive skin moisturizers throughout the day, especially after a bath or shower when your skin is damp. Look for moisturizers that are hypoallergenic, fragrance-free, and contain petroleum jelly or mineral oil. Additionally, identify and avoid triggers that cause eczema flare-ups, such as certain fabrics, allergens, or stress. Maintaining a healthy gut microbiome by consuming probiotics and fermented foods can also help improve skin health.

Over-the-Counter (OTC) Remedies

Topical and oral medications are available without a prescription to help alleviate eczema symptoms. These include antihistamines, such as diphenhydramine (Benadryl) and cetirizine (Zyrtec), which can reduce itching and inflammation. Oral pain relievers like acetaminophen (Tylenol) and ibuprofen (Advil) can address common symptoms such as pain and inflammation. Topical hydrocortisone, a low-potency steroid, can also be used to reduce irritation and itching.

Prescription Medications

For more severe cases of eczema, prescription medications may be necessary. Topical treatments, such as steroids, calcineurin inhibitors, PDE4 inhibitors, and Janus kinase (JAK) inhibitors, are applied directly to the skin to reduce inflammation and manage symptoms. Prescription injectables, such as biologics, are targeted treatments that use human DNA to suppress the immune system and reduce inflammation. Immunosuppressant drugs are also prescribed to help regulate the immune system and control symptoms.

Phototherapy (Light Therapy)

Phototherapy involves treating the skin with different wavelengths of ultraviolet (UV) light, either UVB or UVA light. This treatment helps reduce itchiness and inflammation and is often used for widespread eczema or localized eczema that has not responded to topical treatments.

Alternative Therapies

Some people explore alternative and natural therapies to treat eczema. This includes the use of natural moisturizers like sunflower oil or coconut oil, which can help retain moisture in the skin. Additionally, addressing stress through mind-body medicine, such as exercise and meditation, can help reduce inflammation and improve overall skin health.

Frequently asked questions