What to Eat When You Have Eczema

Dietary Recommendations for Bettter Management

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Eczema, or atopic dermatitis (AD), is an inflammatory condition characterized by dry, itchy patches of skin. Various types of triggers can cause a flare, including certain foods. While there is no diet to cure eczema, some people with eczema find relief in following a diet that is rich in fruits, vegetables, healthy fats, such as omega-3 fatty acids, and probiotics.

The theory behind this type of eating plan is to reduce the inflammatory response which occurs due to an overactive immune system.

Some people who have moderate to severe eczema may also have food allergies, and therefore can potentially find relief after eliminating the offending foods. Other people may try an elimination diet to see if removing foods that they are sensitive to provides relief. The exact diet for someone with eczema should be individualized.

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Benefits

In some sensitized patients, particularly infants and young children, food allergens can induce hives, itching, and eczematous flares, all of which may aggravate eczema.

The National Institute of Allergy and Infectious Diseases (NIAID) Food Allergy Expert Panel suggests considering food allergy testing of cow's milk, eggs, wheat, soy, and peanut in a child 5 years of age and under with moderate to severe eczema and one or both of the following:

  1. Persistent disease in spite of optimized management and topical therapy
  2. A reliable history of an immediate allergic reaction after ingestion of a specific food

If a food allergen is discovered, elimination may provide relief of eczema, but the amount of relief varies from person to person.

Even if a food allergy is present and the offending foods are limited, one of the most important components to eczema relief is adequate skincare including applying hydrating moisturizing creams and ointments. Sometimes prescription topical anti-inflammatory creams may be necessary. Many patients with eczema should be seen by a dermatologist to devise a skincare regimen.

How It Works

Rather than following a specific diet, focus on filling your plate with whole, unprocessed foods, such as fruits and vegetables, plus foods rich in omega-3 fatty acids, such as flaxseeds, walnuts, and fish.

Some research has shown that supplementing with vitamin D can also provide relief. Additionally, if you have any known food allergies, or are sensitive to certain foods, eliminating those foods can help.

Duration

There is no set time for how long you should follow this diet because the specific diet should be individualized, and severity of eczema varies from person to person.

If you are someone with food allergies, depending on the severity of your allergy, you may need to eliminate the offending food altogether. Much of the time, children with food allergies can grow out of them, but work with an allergist to develop a plan of action that makes sense.

If you suspect you have food sensitivities and are attempting to eliminate certain foods, keeping a food journal that logs your symptoms can be helpful. Try not to eliminate too many foods at once, and if you notice that cutting out a particular food is not yielding any results, add it back in.

For parents who are trying to help their children with eczema, working with a registered dietitian will be important to ensure your child is receiving adequate nutrition.

What to Eat

Eating whole foods and reducing your intake of processed foods is a healthy way to eat regardless of whether you have eczema. Choosing a whole foods diet that is rich in non-starchy vegetables, fruits, whole grains, nuts, seeds, omega-3 fatty acids, and vitamin D may help reduce inflammation, which can boost immunity and potentially improve the inflammatory skin response.

If you have allergies or food sensitivities, removing those foods may help to reduce symptoms. For example, some people with eczema benefit from following a gluten-free diet, but there is no scientific evidence to support this to be a universal dietary recommendation.

Sometimes people with eczema benefit from taking certain supplements. There is also some evidence to suggest that for those with a family history of eczema, taking certain supplements earlier in life can help to prevent eczema. One study found that infants who took probiotics during their first year of life had a reduced risk developing eczema.

Before beginning any supplements, you should always discuss it with your physician.

Compliant Foods
  • Fruit (fresh and frozen, no sugar added)

  • Vegetables (fresh and frozen)

  • Herbs (fresh and dried): Basil, parsley, oregano, turmeric, cinnamon, cumin, corriander, etc.

  • Nuts and seeds: Walnuts, ground flaxseed, chia seed, hemp seed, almonds, cashews (all unsalted)

  • Fatty fish like salmon, tuna, and sardines

  • Foods rich in vitamin D: mushrooms, organic milk and yogurt, egg yolks, fortified whole-grain cereals

  • Whole grains

  • Probiotics—yogurt, kefir, fermented foods

  • Certain supplements when recommended by a doctor

Non-Compliant Foods
  • Processed foods: Fast food, frozen pre-made meals, packaged foods, sweets, and snack foods like chips and cookies

  • Allergenic foods (as applicable), such as cow's milk, soy, egg, peanut, tree nuts, shellfish

  • Gluten (in some)

Probiotics/Prebiotics

It is believed that there is an imbalance of good bacteria versus bad bacteria in the gut of a person with eczema. Because the health of the gut has been linked to immune function, supplementing with a probiotic may help reduce the risk or treat eczema by storing healthy flora and modulating the immune response.

Many studies have shown that giving a mother probiotics containing strains of Bifidobacterium during gestation and lactation, and providing her baby the same, can prevent eczema in infants and children.

On the other hand, the use of probiotics in the treatment of eczema is less convincing. According to the National Eczema Association, more studies evaluating single and multiple strain probiotics and exact dosing are needed to confirm most beneficial bacterial species.

If you are interested in beginning a probiotic supplement, consult with your physician. Different strains do different things and the type and amount needed varies from person to person.

Other Dietary Supplements

In addition to probiotics, there are several other supplements that have been studied in relation to eczema.

Vitamin D

Vitamin D is a fat-soluble vitamin that is otherwise known as the "sunshine vitamin." Its main job is to aid in the absorption of calcium and phosphorous.

The role of vitamin D in eczema is not clearly understood, but researchers have found that supplementing with vitamin D may be helpful in the treatment of eczema, especially for those children who have worsening eczema in the winter months.

In addition, a study examining the severity of eczema and vitamin D deficiency in children suggests that vitamin D deficiency can result in more severe eczema. Certain subsets of people with eczema (for example those who are vitamin D deficient or those with frequent bacterial infections) may benefit from vitamin D supplementation, but more studies need to be conducted.

The amount of vitamin D a person needs varies based on age. Because it is a fat-soluble vitamin, you can take too much. Therefore, it's important to discuss supplementation with a medical professional first. It is not recommended to put vitamin D formulations directly on the skin.

Vitamin E

Vitamin E is a fat-soluble vitamin that is a potent antioxidant and has been found to have a protective effect for common health problems, such as heart disease, cataracts, cancer, and stroke. Some studies have shown that it also reduces the level of IgE antibodies in people with eczema, which may help to reduce eczema flares and provide relief.

While some studies suggest promising results, supplementing with vitamin E is not recommended for everyone. Larger well-designed, double-blind, randomized control trials are required before its integrated into clinical guidelines for the treatment of eczema.

Omega-3 Fatty Acids

Omega-3 fatty acids are essential fatty acids that need to be consumed through the diet because the body is unable to make them. These long-chain fatty acids are needed for a variety of reasons, including normal skin function. Therefore, it has been speculated that a deficiency of essential fatty acids in the skin can play a role in eczema.

It has been suggested that fish oils, which are particularly rich in n-3 fatty acids, compete with n-6 fatty acids in a manner that reduces the inflammatory components eczema. In reviewing the literature, promising results have been seen in improved daily living for those supplementing with fish oils vs. placebo, but longer randomized clinical control trials need to be done.

Therefore, no general recommendations can be made. Before supplementing with fish oil, be sure to discuss intake with your physician or your child's pediatrician.

Omega-6 Fatty Acids

Certain types of omega-6 fatty acids have been linked with inflammation, but gamma-linolenic acid (GLA), has been thought to reduce inflammation.

Supplementation of evening primrose oil and borage oil, both high in GLA, have been studied in the treatment of eczema. Unfortunately, clinical research has not shown promising results. In a review of 27 studies, it was found that treatment with either supplement failed to significantly improve global eczema symptoms as compared to placebo.

Cooking Tips

Eczema treatment and care can be overwhelming at times; therefore, it's important to reduce stress wherever and whenever possible.

Start simplifying in the kitchen by using cooking methods that are basic and uncomplicated. Keep to whole foods recipes that require few steps.

Baking and sautéing are good choices. Using a slow cooker or pressure cooker may be an easier way to make one-pot nutritious meals. Lastly, sheet-pan meals are another way to add variety quickly and easily.

Considerations

As mentioned, there is no one-size-fits-all diet for dealing with eczema, but following a plan that is rich in whole foods and lower in processed foods can be helpful in treating this skin condition.

General Nutrition

Eating a whole foods diet, rich in fruits, vegetables, whole grains, and healthy fats will ensure that you are receiving adequate vitamins, minerals, and fiber. Fruits, vegetables, and healthy fats, like omega-3 fatty acids, are also rich in antioxidants which can help to reduce the inflammatory response and successfully treat eczema.

Unless you are eliminating specific foods due to allergy or sensitivity, such as dairy or gluten, a diet for eczema provides the same basic recommendations as the USDA MyPlate.

A restricted diet should be evaluated by a registered dietitian to ensure all nutrient needs are being met. For example, if you are eliminating certain foods, particularly for your child, it's important that they find substitutions for certain nutrients like iron, vitamin D, calcium, and B12.

Sustainability

An eczema diet should be individualized, taking into consideration the severity of eczema, likes, dislikes, food allergies, and sensitivities. Once the diet has been established, it should be sustainable.

Given that most people, even those with food allergies, still have access to a wide variety of healthy foods, this type of diet can be followed for the long haul. You'll find more incentive to follow this diet if dietary interventions provide symptom relief.

On the other hand, for those with multiple food allergies (particularly children), this diet may seem restrictive. Working with an allergist will help to identify the allergy and the severity. The good news is that much of the time, children can grow out of certain allergies and eventually they'll be able to add these foods back into the diet.

Safety

Eating a whole foods diet is not only safe, it's recommended. In fact, the 2020-2025 USDA Dietary Guidelines note that the key recommendations for a healthy eating pattern include:

  • A variety of vegetables from all of the subgroups-dark green, red and orange, legumes, beans and peas
  • Fruits, especially whole fruits
  • Grains, at least half of which are whole
  • Low-fat dairy
  • A variety of lean protein
  • Healthy fats, like oils

They also recommend limiting saturated fats, trans fats, sugars, and sodium.

While these recommendations may not be made specifically for eczema, eating this way can be helpful for overall health and hopefully provide eczema relief.

Flexibility

This diet is flexible in that there are lots of foods one can eat, however, it may be harder when eating out and on-the-go, especially if you have food allergies. The good news is that most restaurants have allergy-friendly menu options and can add food items or take food items out based on request.

Cost

Eating a whole foods diet can be expensive, but you can save money by buying local and seasonal fruits and vegetables. You can also save money by purchasing frozen fruits and vegetables.

If you are taking different types of supplements, this can also be pricey. You reap some savings by buying your supply in bulk.

A Word From Verywell

Treating eczema is complex and involves monitoring and controlling potential triggers, including food. In addition, reducing itchiness, improving sleep, addressing mental health issues, and adequate skincare are very important aspects of management. Unfortunately, there is no one-diet-fits-all for eczema. But, if you suspect that you or your child has food allergies and have not received relief with adequate eczema care, then testing for food allergies may be necessary. If food allergies are identified, eliminating these foods may help to provide relief.

Even if you or your child do not have food allergies, eating a whole food, nutrient-rich diet, dense in antioxidants is important for health and longevity, as well as adequate development in children. Focus on simple, nutrient-dense foods, and easy recipes to minimize stress. In some instances, probiotic supplementation, omega-3 fatty acids, and vitamin D may be helpful. Before starting yourself or your child on supplements, discuss it with your physician or pediatrician.

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