What to Eat When You Have Eczema

Dietary Recommendations for Bettter Management

In This Article

Eczema, otherwise known as atopic dermatitis (AD), is an inflammatory skin condition characterized by dry, itchy patches of skin. The exact cause of eczema is hard to determine because different types of triggers can cause a flare, including household products, environmental allergens, fabrics, soaps, and food. 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, probiotics, and vitamin D supplementation. 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.

Benefits

In some sensitized patients, particularly infants and young children, food allergens can induce hives, itching, and eczematous flares, all of which may aggravate atopic dermatitis (eczema) The National Institute of Allergy and Infectious Diseases (NIAID) Food Allergy Expert Panel suggests considering limited food allergy testing (of cow's milk, eggs, wheat, soy, and peanut) if a child less than 5 years of age has moderate to severe AD and: 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; or 3) both. If a food allergen is discovered, elimination may provide relief of eczema, but the amount of relief varies from person to person.

It has been said that even if food allergy is present and the offending foods are limited, one of the most important components to eczema relief is adequate skin care including adequately hydrating the skin and topical therapies. Most people who have eczema should be seen by a dermatologist to devise a skin care routine.

The American Academy of Asthma, Allergy and Immunology, suggests that atopic dermatitis (eczema), "is now thought to be due to 'leakiness' of the skin barrier, which causes it to dry out and become prone to irritation and inflammation by many environmental factors."

How it Works

There is no specific diet for eczema; rather there's a theory that eating whole foods, like fruits, vegetables, foods rich in omega-3 fatty acids may provide relief. Sometimes, supplementing with vitamin D and probiotics can also provide relief. Additionally, if you have any 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 working with a licensed allergist will be important to developing 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 remove too many foods at once, and if you notice that a food you've eliminated 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.

Recommended Timing

Regular meals and snacks should be consumed, especially for children. There is no specific timing of meals or snacks.

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 to 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. 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)

  • Omega-3 fatty acids—fatty fish like salmon, tuna, sardines, and omega-3-rich nuts and seeds like walnuts, ground flaxseed

  • Foods rich in vitamin D—salmon, mushrooms, halibut, sardines, organic milk, and yogurt, egg yolks, fortified whole-grain cereals

  • Whole grains

  • Probiotics—yogurt, kefir, fermented foods

  • Certain supplements when recommended by a doctor-primrose oil, borage oil, omega 3 fatty acids, probiotics, vitamin d and e

Non-Compliant Foods

  • Processed foods—fast food, frozen pre-made meals, packaged foods, sweets, and snack foods like chips and cookies

  • Allergens—if you are allergic to certain foods you will need to avoid them. Most common foods include: cow's milk, soy, egg, peanut, tree nuts, shellfish

  • Gluten—this is not for everyone, but some people may find relief avoiding gluten

Probiotics/Prebiotics

It is believed that the bacterial flora in the gut of a person with eczema is very different than those without. The idea is that there is an imbalance of good bacteria verse bad bacteria. Because the health of the gut has been linked to immune function, supplementing with a probiotic may help to reduce the risk or treat eczema by modulating the immune response.

Many studies have shown that using probiotics containing strains of Bifidobacterium given to both the mother during gestation and lactation, as well as to the infant, can prevent eczema in infants and children.

On the other hand, the use of probiotics in the treatment of eczema is more mixed. The amount of probiotic and the strain of probiotic used needs to be studied further in order to determine which types and how much can provide relief. 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 they type and amount you need will vary from person to person.

Other Dietary Supplements

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 before doing so. 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 integration in 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 sauteing can be easy cooking methods. Using a slow cooker (crock pot) may also be an easier way to make one pot nutritious meals that are delicious.Consider using an instant pot, a multipurpose electric pressure cooker, as another one pot cooking tool to make breakfast, lunch, or dinner. Lastly, one 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 eating a diet 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 relief. On the other hand, for those with multiple food allergies, this diet may seem restrictive, particularly for children. 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 2015-2020 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, we do know that eating this way can be helpful for overall health and hopefully provides 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, however, 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, but if they are working, they will likely be worth the cost.

A Word From Verywell

Treating eczema is complex and involves monitoring and controlling potential triggers, including environmental and food. In addition, reducing itchiness, sleep, addressing mental health issues, and adequate skin care 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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Article Sources

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