Top 5 Eczema Food Triggers
Get the scoop on how foods may impact eczema
Edited By:Alexandra Vaughn , MD
Itching to know more about eczema? So am I. If you are one of the 31.6 million people in the US (that’s 10% of our population!) who suffers from eczema, you may already know that your body is prone to sensitivities. But what actually causes eczema? The mystery is still being unraveled, but scientists are now identifying a variety of different factors that may be playing a role in you or your child’s discomfort. In addition, identifying potential dietary triggers may serve as a means to limit the severity of flares.
What Is Eczema?
Eczema is an inflammatory skin condition characterized by red, itchy skin. The term is actually a blanket category for a variety of different rash conditions that are classified by the pattern and location of inflamed skin. Examples include atopic dermatitis, contact dermatitis, dyshidrotic eczema, as well as lichen simplex chronicus. Scientists have discussed a multitude of different reasons for the causation of eczema, and different manifestations may have different associated triggers. Stress, weather changes, smoking, genetics, and certain foods can all increase the severity of eczema.
Atopic dermatitis specifically, is the most common type of eczema and is commonly diagnosed in early childhood. Approximately 13.1% of all children in the U.S. under the age of 18 are diagnosed with atopic dermatitis, and it is estimated that 1/3 of those children also have co-existing food allergies or sensitivities. It is important to note that an allergy is different from an intolerance. Both can cause eczematous symptoms, but only true allergies will demonstrate specific signs and symptoms that can be screened for, immediately after specific food exposure. Regardless, here are the five most common food triggers associated with atopic dermatitis.
Cow’s milk protein has been cited as the most common food allergy and intolerance for children with atopic dermatitis. Both cow’s milk protein allergy and intolerance have also been noted to further increase the severity of atopic dermatitis flares. Interestingly enough, many children outgrow their allergy or intolerance by ages 3-6 years. There remains significant debate about whether to completely eliminate dairy products from the diet for atopic dermatitis flares. For infants who cannot breastfeed and who suffer from a dairy allergy, scientists have investigated the benefits of supplementing the infant’s diets with donkey milk, due to its low protein content and similar composition to human milk.
Atopic dermatitis symptoms have also been associated with the second most common childhood allergy, eggs. Recently, a study published in Allergology International indicated that treating pre-existing atopic dermatitis early on in infancy might assist in reducing egg sensitivity. Another randomized, controlled trial demonstrated that early introduction of eggs between ages 4-6 months may promote “reduced incidence of egg allergy.” This information promotes early treatment of existing eczema symptoms along with early prevention of egg allergy. For atopic dermatitis patients with a known egg allergy, elimination of egg products is encouraged. Egg substitution ingredients can be found here, compliments of the Asthma and Allergy Foundation of America.
The same idea behind egg allergies and eczema symptoms may apply to peanuts. Severe allergic reactions are most common with peanuts, but scientists have indicated that early exposure to peanuts may prevent the development of an allergy later in life. The Journal of Allergy and Clinical Immunology published a study in 2015 where children with preexisting atopic dermatitis flares demonstrated an increased sensitivity to peanuts found in household dust. It appears that the dysfunction of the skin barrier plays a role in further promoting a sensitivity to peanuts in the future.
Wheat and cereal products containing gluten have been demonstrated to provoke flares of a unique skin condition called dermatitis herpetiformis, rather than atopic dermatitis. Dermatitis herpetiformis is a skin manifestation of celiac disease or a permanent intolerance to gluten proteins found in wheat and other grain products. Many times, patients are diagnosed with atopic dermatitis, but actually, go undiagnosed with celiac disease. While a strict gluten-free diet has been proven to improve dermatitis herpetiformis, the evidence is not as strong for the treatment of atopic dermatitis. More long-term studies need to be conducted regarding gluten-free diets and flares.
There is limited evidence indicating a true soy allergy for patients suffering from atopic dermatitis. In a recent study, only a minor fraction of atopic dermatitis patients demonstrated aggravated symptoms after consuming soy or products containing soy. It is estimated that approximately 20-30% of these patients will have a soy sensitization with no clinical symptoms. Much like wheat, soy may or may not aggravate flares in a select group of individuals.
Food Allergy vs Food Sensitivity
The central issue with eczema-related food triggers centers around food intolerances versus true food allergies. Currently, the gold standard for diagnosing allergies is a random controlled oral food challenge, but this should be done under the guidance of a physician such as an allergist.
Diet Restriction Can Cause More Bad Than Good: Be Careful
A correct diagnosis is essential because allergists report that young children who are placed on restrictive diets for treatment of atopic dermatitis may actually develop a more severe allergic reaction to those same foods when re-introduced later in life. Another caveat is that many children can outgrow food allergies in their late teens, depending on the type and severity. Restrictive diets for the treatment of eczema can do more harm than good, so diet should be discussed with a healthcare practitioner before restricting nutrition.
Finally, the emerging evidence of eczema and skin dysfunction/allergen sensitization may provide an explanation for other common symptoms that atopic dermatitis patients experience. Those with moderate to severe atopic dermatitis commonly experience food allergies, allergic rhinitis, and asthma. This triad of atopic symptoms is labeled as the atopic march. Eczema is complex, and the quest for precise treatment remains. Those who suffer from eczema are encouraged to continue to work with a medical team to find the best individual treatment. For more information, download Integrative Approaches to Eczema, a free e-book compiled by Dermveda with a team of medical professionals.
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