What Research Says About Gluten and Eczema

Eczema, as atopic dermatitis is more commonly known, is a skin condition that causes an itchy, scaly skin rash. The exact cause is unknown, but research suggests that gluten may be a culprit in some cases, as the protein (found in certain grains) can trigger an inflammatory response in certain individuals. This classically presents with gastrointestinal symptoms, but that same response may affect the skin as well.

This gives color to the fact that eczema is more common in people with celiac disease than those who don't have these issues. Non-celiac gluten sensitivity or intolerance may even be enough to make eczema worse.

It's well known that people who have eczema, especially those who develop the skin condition before age 2, are more likely to have food allergies as well. But even without a true food allergy, it's possible for certain foods to worsen eczema in sensitive individuals.

Although you are not technically allergic to a food, it may trigger a T-cell (inflammatory) response in the body. This, in turn, could give rise to or worsen eczema.

Eggs, milk, nuts, and dairy are foods that are commonly linked to eczema flareups even in those who are not allergic to them. Gluten—a naturally-occurring protein in certain grains, namely wheat, barley, and rye—may do the same.

The idea that gluten affects the skin is not an obscure one. For example, gluten can cause a rash called dermatitis herpetiformis in certain individuals with celiac disease, and going gluten-free completely clears it up.

It's important to note that gluten will not have the same effect on everyone with eczema. Food triggers are different for different people.

It's not clear what causes eczema, but the skin condition appears to result from a combination of genetic predisposition and environmental factors.

People with eczema seem to have both lower levels of a type of protein that's associated with a healthy immune system plus higher levels of a protein that's involved in allergic reactions. Some physicians consider eczema an autoimmune condition, meaning your immune system attacks your own body by mistake.

Researchers have compared the prevalence of eczema in people who also have celiac disease to eczema prevalence in control subjects.

Non-celiac gluten sensitivity is not as well understood as celiac disease. However, researchers who are studying it say that symptoms include digestive issues, such as diarrhea, constipation, pain, and bloating plus other symptoms, including brain fog and skin conditions.

Eczema has been associated with gluten sensitivity. Specifically, one 2015 study looked at 17 people with non-celiac gluten sensitivity who had skin problems, including rashes that looked like eczema, dermatitis herpetiformis, and psoriasis. The study found that participants' skin improved significantly within about one month when they adopted a gluten-free diet.

It's possible that a strict gluten-free diet could help treat some cases of eczema, both in those with celiac disease and in people with gluten sensitivity.

In a 2017 piece published in the Journal of Dermatological Treatment, 169 people with eczema were surveyed. More than half of those who cut gluten from their diets reported seeing an improvement in their eczema symptoms.

A 2013 study found that among 149 participants, 80% saw an improvement of their eczema symptoms when following a hypoallergenic diet (which included cutting out gluten).

The main drawback of these studies is the small sample size. Also, in these studies, the gluten-free diet helped some, but not all, eczema patients control their symptoms. Others have found a gluten-free diet not to create any significant improvement in eczema.

If you've just been diagnosed with celiac disease and you also have eczema, you may find that you resolve some or all of your eczema symptoms with a gluten-free diet.

If you have eczema along with celiac disease symptoms, you should get tested for celiac disease, since you're already at a higher risk for the condition. This is especially true if you also have relatives with celiac disease. Again, if you do turn out to have celiac disease, as a bonus, you may find that the gluten-free diet helps ease eczema symptoms.

If you're concerned you may have food allergies or sensitivities, you should bring this up with your physician. Keeping a food diary can be very helpful to see if eczema flares correlate with any specific foods.

If you've finished with all the medical testing you wish to have for celiac disease (regardless of whether you've been diagnosed with the condition), you might want to consider trying the gluten-free diet on a trial basis for several months to see if it helps with your eczema. Just remember, for the diet to work, you'll need to follow it strictly without cheating.

Making the switch to gluten-free is most appropriate if you also have other symptoms of gluten-sensitivity, have been diagnosed with celiac disease, or if your eczema is not well-controlled with conventional treatment.

Any time you restrict your diet, there are possible risks. Gluten-free foods are generally low in fiber, so those following a gluten-free diet must take care to get enough fiber daily.

Long-term, people who are on a gluten-free diet are at risk of nutritional deficiencies, specifically B vitamins, but also iron, calcium, and vitamin D.

Also, remember that a gluten-free diet is not a substitute for eczema treatment. Consider dietary changes as complementary to your current eczema treatment routine.

If you believe gluten, or any other food, is contributing to your (or your child's) eczema flare-ups, it's important to let your doctor know. Your physician may recommend keeping a food diary, eliminating gluten for a short period while watching for improvement of symptoms, or even recommend further testing. And remember: So far, there is no proof that eliminating any food will completely clear up eczema on its own. It's important to continue with your regular eczema treatments.