Is There a Link Between Diet and Atopic Dermatitis?

While there is no single “atopic dermatitis diet” that works for all people with atopic dermatitis (AD), a healthy diet that contains a variety of foods can provide proper nutrition to support the overall health of the body. It can be helpful to keep a food journal for a couple weeks to share with your doctor if you suspect food allergies. People with AD who have a known food allergy that exacerbates their skin condition should avoid those foods that trigger an allergic reaction.

Food allergies

A significant number of people with AD have food allergies. Food allergies are more common in children with AD, with an estimated 20-40% of children with AD having food allergies. A smaller number of adults with AD have food allergies. The most common food allergies that worsen AD include cow’s milk, eggs, fish, peanuts, soy, tree nuts, and wheat. Children with food allergies often outgrow their sensitivity, developing a tolerance over time, and the American Academy of Dermatology recommends retesting as the child ages.1,2

Testing for food allergies

People that have symptoms of allergies or whose AD is persistent or difficult to treat may receive additional testing for allergens. Blood tests for allergens involve testing for allergen specific IgE (Immunoglobulin E, antibodies produced by the immune system that begin the process of an allergic reaction). Negative test results can be helpful to rule out specific allergies, like foods, but positive test results only identify sensitization and require additional information to confirm.2

Skin prick testing involves applying a diluted allergen with a prick or puncture on the surface of the skin. The skin is observed for approximately 15 minutes to see if a reaction develops. A positive reaction to the allergen is a “wheal,” a raised, red bump and a surrounding “flare,” or area of redness.3

Another alternative for testing for food allergies is food elimination diets, however, excessively restrictive diets can lead to weight loss, poor growth, calcium deficiency, and other complications in children. People considering food elimination diets should talk with their doctor.1

Elimination diets

Even if someone tests positive for food allergies, it does not mean that those foods are relevant to their AD. Food allergies are only triggers in a small number of people with AD, and food elimination diets, where certain foods or food groups are completed avoided or not included in the diet, are generally not recommended as a treatment for AD as research has not demonstrated that they provide an improvement in symptoms.

Elimination diets may be helpful for a small group of people with AD who have food allergies that worsen their symptoms. Clinical studies have found that people who are allergic to eggs may benefit from egg restriction, and a small group of people with AD who are sensitive to food additives had improvement with restricting preservatives such as sorbic acid and coloring agents such as tartrazine.4 However, anyone considering a food elimination diet should talk with their doctor before attempting.

Dietary supplements

Dietary supplements, ingestible products that contain ingredients that are intended to add nutritional value to the diet, are a continued area of research for their benefit in AD. Several studies have evaluated the potential benefits of various dietary supplements on people with AD, including probiotics, evening primrose oil, docosahexaenoic acid (DHA), and various vitamins.

It is generally recommended that people aim to obtain the needed nutrients through healthy eating that includes a variety of foods, but supplements are available and may be used to support nutrition. Limited data is available showing a benefit to any dietary supplement and at present, no recommendations exist.2,5

Emily Downward | June 2017
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