Eczema And Nutrition

Introduction

Itchy, red patches on the skin could be caused by something relatively harmless, such as a mosquito bite. However, sometimes these are caused by a chronic skin condition known as eczema. Many people have eczema when they are young but eventually grow out of it. However, some people still experience eczema flare-ups into adulthood.

Besides genetic factors, environmental factors including lifestyle and diet can contribute to the severity of eczema. ‘You are what you eat’ is true in this regard, as the balance of your diet can influence the health of your skin. This article will help you find out how eczema and nutrition are related, and what foods to avoid to prevent eczema flare-ups.

What is eczema?

Eczema, also known as atopic dermatitis, is an inflammatory skin condition which presents with patches of skin that feel itchy and dry. Eczema tends to occur more frequently among children than among adults. In recent years, it has become more prevalent, with approximately 15-20% of children suffering from eczema, which can sometimes be debilitating.¹

Both genetic and environmental factors can contribute to eczema. If your family members have eczema, you may have an increased chance of suffering from it as well. This is because some genes associated with defects in the skin’s structural proteins could be passed down in families. People with these genetic factors may have impairments in the skin barrier, which allows pathogens, chemicals, and allergens to enter the body through the skin more easily. This can trigger immune responses and inflammation, which both contribute to eczema.

Similarly, exposure to these environmental factors can also contribute to or trigger eczema:²

• Heat and sweat
• Allergies
• Infections
• Psychological distress
• Air pollution

Symptoms

Some common symptoms that you may experience if you have eczema include:

• Dry skin
• Itchiness
• Reddening of the skin
• Rashes, blisters or swelling
• Oozing of serum

These symptoms typically appear at flexures (where you bend and fold, such as your elbows and knees), hands, neck, face, and feet. For many people with eczema, these symptoms often recur.

Eczema often causes an irritating itch and the urge to scratch, which can lead to secondary injuries to the skin. This can cause:³

• Hyperpigmentation - darkening of patches of skin
• Thickening of the skin
• Exaggerated skin lines
• A balanced diet often helps manage eczema
• The connection between the skin and the stomach

The negative effects due to infections by microorganisms like bacteria and viruses are well known. However, did you know that there are microorganisms that are living within our gut and our skin at all times? These are known as the gut microbiota and skin microbiota, respectively.

Gut microbiota are a collection of microorganisms in the gut that are essential in maintaining our health, especially through regulating our immune and metabolic functions. Think of the gut microbiota as a small but diverse ecosystem, which consists of viruses, bacteria, fungi, and other single-celled organisms. We have a mutually beneficial relationship with these microorganisms, and they need to be in balance to maintain our health. Our diet is one of the main factors that can affect the composition of the gut microbiota.

Our gut and skin microbiota can interact with each other to help with our bodily functions. Our gut microbiota produces molecules such as proteins, fatty acids, and vitamins, all of which are important in maintaining skin health. These get released into the bloodstream and transported to the skin. Also, certain gut microorganisms release molecules that help accumulate immune cells that prevent inflammation, while some do the opposite and promote inflammation. An imbalance in the composition of gut microbiota can tip the scales and can end up causing inflammation.⁴

Gut bacteria, inflammation, and the skin

Eczema has been found to be associated with a decreased diversity in the gut microbiota. One study suggested that infants with lesser diversity in gut bacteria lack certain bacterial proteins that help their immune systems to mature. This was shown to increase the likelihood of developing eczema.⁵

Besides that, gut bacteria also help break down certain nutrients that we consume, and can help us release end-products that are beneficial to our body. For example, gut bacteria help break down dietary fibres and resistant starch into short-chain fatty acids (SCFAs). These SCFAs produced in the gut can be transported to the skin and other parts of the body, where they play an important role in preventing inflammation and improving defences against allergens. Eczema was found to be associated with a lower SCFAs production by gut bacteria.⁶

What foods can flare up eczema?

As mentioned above, food can be one of the triggers for eczema. Normally, eczema is triggered by foods you are allergic to or have an underlying hypersensitivity to. When you eat these foods, your immune system triggers immune and inflammatory responses, both of which contribute to eczema flare-ups.

Food allergies and hypersensitivity may trigger eczema symptoms in a range of several hours to several days.⁷ Avoiding food allergens in your diet could be one way to prevent eczema flare-ups, but this course of action is mainly recommended for people who suffer from both food allergies and eczema, respectively. If you have eczema, but no known food allergies, you may want to consult your GP or nutritionist before cutting out certain foods from your diet completely.⁷

Simple carbohydrates

Simple carbohydrates are carbohydrates which are more easily broken down by our bodies. Some examples are glucose, fructose, and lactose. These simple carbohydrates could be present naturally in fruit and dairy products, but are also found in processed and refined foods such as sweets, syrups, and sodas.

Simple carbohydrates can contribute to inflammation and trigger eczema flare-ups. Therefore, it is recommended to reduce the consumption of processed and refined foods and opt for a more balanced diet.

Dairy

Dairy products like cow’s milk can cause flare-ups in people with eczema, especially among people who are lactose intolerant. This could be due to immune responses triggered by proteins within cow’s milk.

Some studies reported that participants with eczema who were asked to follow diets that did not contain eggs and milk reported reduced itching and improvements in their eczema symptoms. However, these studies were not able to conclude that avoiding milk completely had significant benefits for all eczema patients in the long term.8 If you know that you’re lactose intolerant and suffer from eczema, it is best to avoid milk and dairy products.

Soy products

Despite being a good source of protein, some people are allergic to proteins in soybeans. Soy protein allergy can in turn trigger eczema. You might want to avoid soybean and soy products, such as soy milk and tofu, if you suffer from a soy allergy and eczema.

Conclusion

Eczema is a chronic skin condition that can be really debilitating. Although mainly children are affected, adults can also suffer from eczema. People with eczema normally present with patches of dry and itchy skin which can appear red and swollen. Our diet can actually influence the risk of getting eczema, as our diet determines the balance of our gut microbiota, which is important in regulating immune responses and our skin health. Some food allergies can be major culprits of eczema flare-ups, and you should avoid foods you are allergic to if you have eczema. Examples of common food allergies that could cause eczema flare-ups are, simple carbohydrates, dairy products, and soy products.