Is There a Link Between Diet and Atopic Dermatitis?

Eczema (atopic dermatitis) affects more than 230 million people worldwide. There is no single cause of eczema. There is also no diet that works for everyone with the condition. However, an anti-inflammatory diet can support overall health for people with eczema. Identifying and avoiding any food allergies may also reduce eczema symptoms.^1,2

What is an anti-inflammatory diet?

Anti-inflammatory diets focus on fresh fruits and vegetables, lean meats, leafy greens, and healthier oils. Fruits and vegetables contain flavonoids, which are chemical compounds thought to have anti-inflammatory, antiviral, and anti-cancer properties.^2-6

Anti-inflammatory diets also limit sugar, simple carbohydrates, and processed foods. The Mediterranean diet is 1 popular anti-inflammatory diet. Mediterranean foods are also rich in vitamin D, which helps strengthen immunity.^2-5

Many spices and herbs also have anti-inflammatory properties, including:^2-6

• Turmeric
• Black pepper
• Fenugreek
• Cinnamon
• Ginger

Food allergies and eczema

The connection between eczema and food allergies is a complex one. A food allergy may trigger eczema, but it is not the cause of this chronic skin disease. In fact, some research suggests that eczema leads to food allergies, not the other way around.¹

Between 30 and 80 percent of people with eczema have a food sensitivity. Food sensitivity means the person has a positive result on diagnostic tests. But having a food sensitivity does not mean you have symptoms of a food allergy. And between 20 and 30 percent of people with eczema have neither a food sensitivity nor a food allergy. People with mild eczema are less likely to have a food sensitivity or allergy.¹

However, people with eczema do have more food allergies than the general population. Having a food allergy can result in poor eczema control over time. This is especially true in cases of severe eczema. For example, if a child is allergic to milk and drinks it daily, their eczema may be harder to manage.¹

The gut-skin connection

Inside your intestines are trillions of microscopic organisms. These microorganisms include more than 1,000 species of viruses, bacteria, and parasites. When the relationship between these microorganisms and your immune system is out of balance, it can affect your skin's health. The imbalance may result in inflammatory diseases such as eczema.⁷

Eating a diet rich in fruits, vegetables, and fermented foods rich in probiotics like yogurt, kimchi, kefir, and sourdough bread can help you maintain a healthy gut and improve eczema. Researchers have shown probiotics to be beneficial in reducing eczema severity.^8-10

As researchers continue to study the gut-skin connection, they may find new ways to treat skin diseases.^8-10

Diagnosing a food allergy

There is no single test that will confirm that you have a food allergy. Your doctor will look at multiple factors, including:⁸

• Your family history
• Your symptoms
• The results of your physical exam
• Your environment

Your doctor may also perform different types of allergy tests, including a skin prick test, blood test, or elimination diet.⁸

Skin prick testing for food allergies

A skin prick test can show how you react to a certain food. In this test, the doctor puts a small amount of that food allergen on your back, upper arm, or forearm. Then, they prick your skin with a sharp tool to get a bit of the substance beneath the skin's surface. After about 15 minutes, the doctor will check to see if there is a reaction.⁷

A positive reaction to the allergen is called a "wheal." A wheal is a raised red bump with a white center. The wheal is surrounded by an area of redness called a "flare." The size of the wheal determines if you have an allergy.⁸

Blood testing for food allergies

Blood tests for allergens involve testing for allergen-specific immunoglobulin E (IgE). IgE are antibodies produced by the immune system that begin the process of an allergic reaction.⁸

Negative test results can be helpful to rule out specific allergies, like food allergies. But positive test results show only that someone is sensitive to the allergen. More testing is needed to confirm the allergy.⁸

Elimination diet

Food elimination diets remove a certain food to see if it may be the cause of an allergy. But according to a 2022 study, elimination diets offer limited benefits. They can even cause harm in the treatment of eczema.¹

Eliminating a food that was previously tolerated might create a life-threatening allergy when the food is reintroduced. Restricted diets can also lead to nutritional deficiencies. Any attempt at a food-elimination diet must be based on strong evidence and approached with caution. Do not eliminate foods from your diet without first talking to your doctor.¹

Should people with eczema take dietary supplements?

Dietary supplements remain an area of research in eczema. Vitamin D is sometimes recommended for people with eczema. Not only does vitamin D boost immunity, but many people are deficient in this vitamin. Prebiotics also may be beneficial because they act as food for the good bacteria in your gut.^3,4,7

However, there is no specific supplement routine for people with eczema. A well-balanced diet remains the best way to get vital nutrients. And supplements are not regulated by the US Food and Drug Administration (FDA) the same way other drugs are. This means that no outside agency confirms the ingredients or suggested dose. Tell your doctor before beginning a new supplement for eczema.^3,4,7

If you have questions about how your diet or certain foods may be impacting your eczema symptoms, talk to your doctor.