An estimated 1 in 10 people will develop eczema during their lifetime. But how do you combat it? Sometimes all you need is a change of diet. Nutritionist Ro Huntriss explains.

Eczema, or atopic dermatitis, is a common inflammatory skin condition that usually appears during infancy or childhood. The condition causes the skin to become dry, itchy, cracked and sore. It is often a long-term condition but can improve significantly, or even completely clear, as people get older.

It is not entirely clear what causes eczema however it is thought that genetics may play a large role. The immune system is also thought to be involved and the inflammation of the skin may occur due to over-activity or a misdirection of the immune system, whose usual role is to defend the body against infection and protect the body's own cells.

For some people, symptoms can occur in response to certain triggers such as soaps, detergents, stress, the weather, or even food.

Can diet play a role?

While certain foods do not cause eczema, sometimes certain foods can make symptoms of eczema worse through an immune reaction. Keeping a food diary is one way that people who suffer from eczema can identify food triggers for an eczema flare.

Common food allergies have also been linked to eczema in children and consuming these foods may serve as triggers for some people.

Diet has also been linked to eczema through its role in modulating inflammation and immune responses and a dietary pattern that is pro-inflammatory (fewer vegetables, fruits and nuts, and more meat/sausages and more sweets/snacks) may worsen the symptoms of eczema.

Can an elimination diet help?

An elimination diet for eczema often sees the exclusion of certain foods that are associated with eczema in people who don’t have a food allergy. These foods can include eggs, milk, fish and peanuts.

Research has shown that dietary elimination may lead to a slight improvement in eczema severity, itching, and sleeplessness in patients with mild to moderate eczema.

If considering an elimination diet, there are some important considerations.

• Create a list of possible trigger foods and work through it systematically.
• Try one food at a time - this will help you to identify exactly what may be a trigger.
• Avoid each potential trigger food for a significant amount of time e.g., 3 weeks.
• Don't eliminate lots of foods as this could increase your risk of deficiencies in certain nutrients.
• Be mindful that there are other factors outside of diet that can contribute to an eczema flare eg stress and the weather, incorporate this into your diary.
• Don’t stop other treatments for eczema which may be more effective.

Don't just consider foods to exclude, consider your overall dietary pattern and what it is like. For example, some eczema patients have reported skin improvements when adding vegetables, organic foods and fish oil to their diets.

Eczema and gut health: Is there a link?

Research has shown that the gut microbiome may play a crucial role in the development of eczema, through its role in regulating the immune system. So the answer is yes there is a link. Changes in the amount of individual bacteria from the different bacterial species present in the gut has been linked with the development of skin conditions such as atopic dermatitis.

Although research looking at the links between the gut microbiome and eczema are in the early stages, there is some evidence to support the use of live bacteria (probiotics) for the treatment of atopic dermatitis.

Can going gluten-free help with eczema?

Gluten is one of the foods that people commonly believe can worsen symptoms of eczema. The link between gluten and eczema isn't fully clear and currently there is no evidence to show that gluten causes eczema.

Having said that, some studies have shown that people with atopic dermatitis can experience improvements when removing gluten from their diets whereas others have found that gluten is not a risk factor for atopic dermatitis so we aren't entirely sure yet what role it may play.

When it comes to removing gluten from our diet, it is not recommended to do this without consulting a healthcare professional as it is important to plan a gluten free diet correctly to ensure nutritional adequacy. If you think that gluten is leading to problems and eczema flares, have a chat with your doctor.

Key takeaways

While diet may play a role in eczema it is important to remember that diet may be just one of a number of factors that can influence eczema severity. Identifying any trigger foods can be one way to support eczema symptoms, however keep in mind that other treatments for eczema are also available and may be more effective than dietary changes.

If you are considering your diet in relation to eczema here are the key things to bear in mind.

• Consuming more anti-inflammatory foods and less pro-inflammatory foods could be useful.
• Identifying food triggers using a food diary can be useful.
• If considering an elimination diet, consult with a healthcare professional and don’t eliminate more than one food at a time.
• Going gluten-free could be beneficial for some people but not everyone and should only be done after consulting with a healthcare professional.
• Support your gut health by consuming plenty of fibre rich foods and a diverse range of foods.

Words: Ro Huntriss