How The Keto Diet May Help or Harm Eczema

The Effects of the Keto Diet on Skin Are Unclear, but There Are Some Known Risks

A keto diet is a high-fat, moderate-protein, and very-low-carb eating plan. This shift of macronutrients drives your body into ketosis, or a state where you burn fat as your main energy source, rather than its preferred fuel, carbohydrates. It’s a profound metabolic shift.

With regards to treating eczema, it’s important to point out that there’s a distinct lack of medical literature proving the keto diet is helpful. Yet clinicians have an idea of how this diet approach may affect your skin. “In the world of dermatology, keto is actually problematic for the skin. There are multiple reports that show it causes dermatitis,” meaning inflammation of the skin, says Vivian Shi, MD, an assistant professor of medicine in dermatology at the University of Arizona in Tucson and director of the Eczema and Skin Barrier Clinic.

Another potential downside: nutrient deficiencies. “Your skin is one of the most metabolically active organs in the body, and it’s constantly requiring nutrients,” says Dr. Shi.

People who jump to a keto diet for weight loss are usually pleasantly surprised by how quickly they shed pounds, and that’s largely due to water weight from severe carbohydrate restriction. This purging of body water can also worsen skin dryness and itchiness for those with eczema, she says.

One example is pellagra, a disease that results from vitamin B3 (niacin) deficiencies and often affects underserved countries where malnourishment is a problem, says Shi. Skin symptoms including a scaly rash is one sign of pellagra, notes MedlinePlus. When it comes to prurigo pigmentosa, Shi says, it’s less common in the Western world and seen more often in Asia. Yet blogs such as Ruled.Me have described this as the “keto rash,” so there are some signs that more people are developing it.

Could Keto, as a Form of the Elimination Diet, Offer Advantages for Eczema?

An elimination diet of any form isn’t a cure for eczema, according to the National Eczema Association. Yet for some people with this skin condition, food sensitivities may contribute to flare-ups, says Robin Foroutan, MS, RD, an integrative dietitian at the Morrison Center in New York City and spokesperson for the Academy of Nutrition and Dietetics.

Some of the foods that keto eliminates, like wheat, most dairy, added sugar, and citrus, could potentially help improve skin if you have a sensitivity to those foods. But, she says, some of the foods allowed on keto, such as eggs or tomatoes, may also exacerbate problems.

It’s no guarantee that minding potential food sensitivities will soothe your skin. “Because the research on this is dicey, even some people with severe cases who avoid food triggers don’t see a difference,” says Angela J. Lamb, MD, an associate professor of dermatology at the Ichan School of Medicine at Mount Sinai in New York City.

What to Eat for Better Skin and Potentially Improved Eczema

Inflammation plays a role in the development of both acne and eczema. As the National Eczema Association points out, when the immune system is triggered, it produces inflammation, which gives rise to red, itchy, and scaley flare-ups. Likewise, there’s evidence of increased levels of inflammatory cells in skin during the early stages of acne.

Taking a cue from that research, avoiding low-fat dairy and foods high on the glycemic index (white bread, white potatoes, processed snack foods, high- sugar foods) may be helpful in clearing skin, says Lamb. Above all else, an anti-inflammatory diet is a good first step to see if it makes a notable difference in flare-ups, says Foroutan. That can take many different forms — from a vegetarian to traditional (but well-planned) low-carb diet — but you’d be focusing on whole foods in a Mediterranean diet. The National Psoriasis Foundation says an anti-inflammatory diet limits fatty red meats, refined sugar, processed foods, and dairy, and emphasizes fatty fish, nuts, seeds, olive oil, and fruit and vegetables. (While eczema and psoriasis are two different conditions, inflammation is a common thread that underlies both and triggers symptoms.)

The Bottom Line on Following Keto to Treat Eczema

Keto can’t cure eczema. In fact, because this eating plan may cause a red, itchy rash itself, it may worsen eczema symptoms.

On the other hand, a diet that focuses on eliminating potential triggers for your flares may help.

The best way to approach your eczema treatment is by working with your healthcare team to come up with an individualized game plan. “A specific diet definitely wouldn’t cure someone’s eczema — nor is there any cure we know of right now,” says Shi.

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