Eczema and Diet: The Foods to Eat and Avoid to Prevent and Manage Flare-Ups

The National Eczema Association estimates that over 31 million Americans have a form of eczema, such as atopic dermatitis, contact dermatitis, or seborrheic dermatitis. (1) Scientists do not know the exact cause of eczema, but they believe genetics plays a role, increasing sensitivity to irritants, allergens, and environmental factors. (2)

Eczema triggers can include shampoo, body washes, laundry detergent, food, fragrances, pollen, dust mites, pet dander, as well as weather shifts, hormones, and even stress. (3)

First-line treatments for eczema include emollients to moisturize, protect, and relieve itchy skin; corticosteroid creams to control and minimize inflammation; and, if the skin doesn’t respond, oral corticosteroids or an injectable biologic.

But traditional therapies might not be the only way to manage eczema flares: Diet may also help.

Can a Special Diet or Eating Style Help Get Rid of Eczema?

While there is no cure for eczema, eczema flares are sometimes triggered by an allergic reaction to specific foods, suggesting some people with eczema can benefit from following diets tailored to their allergies. (4)

Study Suggests Eczema Subtype Tied to Food Allergies

Other dietary interventions, such as regularly drinking water to keep the body and skin hydrated, may also reduce eczema flares and symptoms. (5)

Food Allergies, Diet, and Different Eczema Types

In 2018, 6.5 percent of American children (4.8 million children) reported having food allergies in the previous 12 months, according to the National Center for Health Statistics at the Centers for Disease Control and Prevention (CDC). (6)

Food allergies are the result of an abnormal immune system response. The body reacts to a certain food as if it were harmful or dangerous, which triggers symptoms such as hives, itching, swelling, tingling in the mouth, coughing, and vomiting. (7)

A severe food allergy can cause anaphylaxis, a life-threatening reaction in which the throat swells and blocks the airway.

Interestingly, food allergies are more common among people with eczema — as many as 30 percent of children under age 5 with eczema may also have at least one food allergy. (4)

But researchers evaluating the skin of children with both conditions have found “structural and molecular differences in the top layers of otherwise healthy- looking skin near eczema lesions.” The skin was also more prone to water loss and had a greater presence of staph bacteria. Researchers also found evidence that the skin barriers were “immature.” (9)

More research is needed to fully understand these changes. But scientists believe that these differences could help identify children at risk for food allergies.

In addition to eczema flares, food allergies may cause gastrointestinal issues and shortness of breath. If your child experiences such reactions after eating food, he or she should be tested for food allergies.

A blood test can check for antibodies that may indicate an allergic reaction to a specific food. An allergist may also use a skin test to diagnose a food allergy. This involves exposing skin on their back or forearm to small amounts of an allergen, and then waiting a few minutes to see if the skin develops a reaction. (10)

The most common food allergies among children are from eggs, milk, peanuts, wheat, and soy. (4) Tree nuts, fish, and shellfish also commonly cause allergic reactions. (10) This doesn’t mean you should ban these foods from a young child’s diet, though.

In fact, introducing common allergens like peanut butter and shellfish as early as 4 to 6 months may help prevent a food allergy. (11) To be safe, ask your doctor about allergy testing prior to the exposure.

Consider introducing new foods a few days apart from each other. This way, if a reaction occurs, it’ll be easier to identify the problem food.

Can Elimination Diets Help Treat Eczema?

An elimination diet involves removing certain foods from your diet to help identify the cause of an allergic reaction or other food-related symptoms. You’ll avoid a particular food or ingredient for a few weeks, and then monitor your skin for any changes. (12)

If symptoms improve, slowly reintroduce the food into your diet over a few days. If symptoms return, you’ve likely found a trigger.

An elimination diet isn’t only effective for eczema. It’s also helpful for identifying foods that may trigger other conditions, like celiac disease, a gluten intolerance, a lactose intolerance, and irritable bowel syndrome.

Research suggests that people with specific food allergies may find some eczema relief by avoiding those foods. But there isn’t much evidence showing that so- called elimination diets — those in which people completely stop eating certain food groups — are effective for eczema relief in general.

In 2008, researchers from the Cochrane Collaboration conducted a literature review to see if elimination diets had any effect on eczema symptoms. In eight of the nine studies reviewed, people with eczema who followed elimination diets showed little to no improvement in symptoms — but these people weren’t tested for food allergies beforehand.

In the last study, babies known to have an allergic reaction to eggs experienced fewer eczema rashes after going on an egg-free diet. (13)

Most children eventually outgrow their allergies to milk, eggs, soy, and wheat, allowing them to eat these foods without experiencing eczema flares. (4)

Special Diets for Contact Eczema

Contact eczema is a specific type of eczema in which localized skin reactions arise from direct contact with something in the environment, including allergens such as pollen, nickel, and latex. (14)

Balsam of Peru comes from the tree Myroxylon balsamum pereirae and contains a mixture of potential allergens, such as cinnamates and vanillin, chemicals commonly found in flavorings, spices, and certain foods.

If you have a contact eczema related to balsam of Peru, you may find some eczema relief by avoiding:

• Citrus fruits
• Tomatoes
• Certain spices, including cinnamon, vanilla, and cloves, which are related to balsam of Peru
• Chocolate
• Colas

Nickel is the most common cause of metal allergies and causes more cases of contact eczema than all other metals. Scientists don’t fully understand why, but it could be due to sweat leaching nickel from earrings and other jewelry. The nickel then absorbs into skin, causing a rash. (16)

It’s also found in a wide range of foods, including grains, shellfish, processed meats, canned food, black tea, nuts, and seeds. Vegetables with especially high nickel content include beans, lentils, peas, and soybeans. (15)

Research suggests that a low-nickel diet may improve dermatological symptoms in people with nickel-related contact eczema.

The diet may also improve symptoms in people with hand eczema and dyshidrotic eczema, also known as foot-and-hand eczema. (15,17) This is a type of eczema on the fingers, toes, and soles of feet. It’s more common in women between ages 20 and 40, but can develop in men and children, too. Having another type of eczema or a family history of foot-and-hand eczema also puts you at risk. (18)

8 Surprising Triggers for Contact Dermatitis

Foods aren’t the only thing that can set off an eczema flare-up. Be aware of these other common yet unexpected factors that may worsen your symptoms.

How to Follow an Anti-Inflammatory Diet for Eczema

As eczema is an inflammatory skin condition, following an anti-inflammatory diet may help relieve symptoms.

This diet involves eating less of foods that may trigger inflammation in the body, and more of foods that help fight inflammation. (19)

For this diet, it’s important to pay close attention to dietary fats, which can influence the overall amount of inflammation in the body.

In particular, trans fats, which include hydrogenated oils, some margarine brands, french fries, and other fried foods; and saturated fats, which are found in red meats, full-fat dairy foods, butter, and poultry skin; promote inflammation and therefore may potentially worsen eczema symptoms.

Large quantities of foods rich in omega-6 fatty acids, including vegetable oils, may also promote inflammation. (20)

On the other hand, the three main omega-3 fatty acids — alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) — also have anti-inflammatory properties. EPA and DHA are in fatty fish like salmon, sardines, mackerel, herring, and tuna. Meanwhile, ALA is in flaxseed, canola oil, and soybeans. Other sources of omega-3s include walnuts and green leafy vegetables, like kale, mustard greens, and spinach. (21)

Monounsaturated fats, including olive oil and canola oil, may also be anti- inflammatory.

Aside from these dietary fats, other foods and drinks that may exert anti- inflammatory effects include:

• Fruits (cherries, blackberries, strawberries, and blueberries)
• Vegetables (spinach, kale, broccoli, onions)
• Whole grains (brown rice, quinoa, whole-wheat flour, whole-wheat bread)
• Limit alcohol consumption to one drink per day for women, and two drinks per day for men. A standard drink is 14 grams of alcohol, which is about 12 ounces (oz) of beer; 5 oz of wine; 8 oz of malt liquor; or a 1.5 oz shot. (22)
• Coffee and tea, especially green tea (contains polyphenols, an antioxidant with an anti-inflammatory effect) (23)
• Turmeric
• Ginger

For an anti-inflammatory diet, make sure to avoid refined carbohydrates and sugar, which may stimulate inflammation. (24) Refined carbohydrates have had most of their nutritional value removed. These include white rice, white bread, and white pasta. Also, be on the lookout for hidden sugar. These can be found in cereals, ketchup, and other condiments, sauces, granola bars, and yogurt.

How Do You Tell the Difference Between Good and Bad Carbs?

The healthy type is packed with nutrients and can help you slim down.

Supplements for Relief of Eczema Symptoms

Although more research is needed, a wide range of supplements may help reduce eczema symptoms, including:

• Probiotics (25)
• Fish oil (25)
• Vitamin D (25)
• Vitamin C (26)
• Vitamin E (27)
• Vitamin B6 (pyridoxine) (28)
• Bromelain (an enzyme derived from pineapple) (29)
• Flavonoids (30)
• Evening primrose oil and borage oil (25)
• Sea buckthorn seed oil (and sea buckthorn pulp oil) (25)
• Hempseed Oil (31)
• Sunflower Oil (32)

While individual studies may suggest some of these supplements work for eczema, reviews of past research suggest there is no strong evidence to recommend people with eczema use these products.

Be sure to discuss with your doctor any supplements, vitamins, or home remedies before you try them.

Additionally, some of these supplements may have dangerous side effects or drug interactions, including vitamin D (in high doses), evening primrose oil, borage oil, bromelain, and probiotics. (29,33,34)

A Final Word on Eating to Help Manage Symptoms of Eczema

There’s no cure for eczema, but treatment can help you manage symptoms and reduce flares. (1) While topical ointments and oral medications are effective, identifying and avoiding triggers that irritate your skin — such as certain foods — is also helpful for calming itching, redness, and rashes.

So if you haven’t already, talk to your dermatologist about an elimination diet. And if you suspect a food allergy, talk to your doctor about allergy testing.

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