The Role of Nutrition & Lifestyle in Managing Eczema
What is Eczema?
Eczema (atopic dermatitis) is a common inflammatory skin condition that causes areas of skin to become dry, itchy, cracked, and irritated. Often, elevated IgE levels are present in those with eczema along with associations with other atopic conditions such as allergic rhinitis and asthma (Pizzorno & Murray, 2012). Eczema can be challenging and significantly impact quality of life; however, it is possible to reduce symptoms through diet and lifestyle changes.
What are the possible root causes of eczema?
Genetic variants, dysbiosis (imbalance of gut bacteria), leaky gut, immune insufficiency, food allergies, stress, and exposure to environmental triggers such as mould, dust mites, cosmetic products. Usually, it is a combination of these factors that leads to the development of eczema. Compromised gut health and reduced microbiome diversity has been identified among those with eczema. Research has demonstrated that sufferers showed decreased levels of butyrate and propionate (Song, 2016). These bacteria-derived short chain fatty acids have anti-inflammatory effects and play important roles in health and disease. It is suggested that poor skin barrier function and poor intestinal mucosal barrier integrity cause inflammatory responses both in the skin and in the gut, therefore reinforcing the importance of gut health in managing skin conditions (Johnston, 2014). Working with a nutritional therapist can help to identify your own personal triggers and put in place a structure to best improve your symptoms long term.
Which foods to include to help reduce symptoms of Eczema?
Omega 3 rich foods such as salmon, mackerel, herring, as well as plant-based sources like chia, flaxseed, and walnuts can help modulate inflammation, benefiting skin conditions that are characterised by redness and irritation.
Quercetin containing foods such as apples, cherries, berries, and broccoli. This flavonoid is a powerful antioxidant and has been shown to reduce lesions in atopic dermatitis (Beken, 2020).
Anti-inflammatory foods such as leafy greens, olive oil, green tea, turmeric, and avocados to help combat oxidative stress associated with inflammatory skin conditions.
Zinc is essential for wound healing and skin integrity. Incorporate foods containing zinc such as chickpeas, pumpkin seeds, and lean meats.
Vitamin D foods like fortified mushrooms, fatty fish, eggs, as well as adequate sun exposure to help support normal immune function. Vitamin D therapy has been shown to reduce clinical signs of dermatitis (Samochocki, 2013).
Probiotic and prebiotic foods can help support a balanced gut environment which may help reduce eczema symptoms (Pachacama, 2021). Include probiotic foods such as kefir, sauerkraut, yogurt as well as prebiotic foods such as asparagus, garlic, and banana. *Caution as fermented foods are a trigger for some eczema sufferers.
Which foods trigger Eczema flare ups?
Not everyone will have issues with the following but common dietary triggers include:
Cow’s milk (A1 casein)
Eggs
Nuts
Soy
Gluten
Shellfish
Tomatoes
Pro inflammatory foods such as processed meats, trans fats, fizzy drinks.
An elimination diet can help identify these triggers by removing potential culprits for a few weeks and gradually reintroducing them one at a time, observing any changes in the skin. This combined with keeping a food and symptom diary can help pinpoint reactions and assist in creating a personalised diet plan.
Lifestyle Factors
Lifestyle factors are also important when it comes to managing eczema. Excessive alcohol consumption, smoking, stress, and poor sleep can contribute to both development and flares. Reducing or moderating intake of substances like alcohol and caffeine which can irritate the gut lining and increase permeability may help support gut health and improve skin conditions such as eczema. Stress management is essential as chronic stress increases cortisol levels which over time can lead to dysregulated immune function and an impaired gut barrier. We often think only of external creams to help moisturise the skin but ensuring adequate internal hydration by drinking water throughout the day supports skin hydration and function, assisting in the natural repair of the skin barrier. Restorative sleep also supports immune health and skin repair, making it an essential lifestyle component for skin health.
In Conclusion
While eczema can be persistent and affect all areas of life, it is not a life sentence and symptoms can be improved. Working with a registered nutritional therapist can provide the personalised guidance that is required for complex conditions such as eczema. Clearing eczema through diet and lifestyle takes time and dedication. An initial positive difference may be seen after 4-6 weeks but symptoms improve gradually over a number of months depending on severity and triggers. The link between eczema and leaky gut reinforces that good gut health is foundational to skin health. A focus on nutrition to support gut barrier function, incorporating lifestyle changes, and managing stress can improve skin resilience and may help those suffering to find relief from symptoms. Every client is unique and has their own triggers and nutritional needs. There is no one-size-fits-all approach to healing so while following general guidelines and research is helpful, an in depth look into an individual’s health history and personal pathophysiology along with the necessary functional testing (if needed) is the best baseline to start from. From here we can create a tailored nutritional/lifestyle plan, supplement recommendations, and sustainable strategy to avoid further flare ups by addressing the cause.
References
Beken, B., et al., (2020). Quercetin Improves Inflammation, Oxidative Stress, and Impaired Wound Healing in Atopic Dermatitis Model of Human Keratinocytes. Pediatric allergy, immunology, and pulmonology, 33(2), 69–79. https://doi.org/10.1089/ped.2019.1137
Johnston, L. K., et al., (2014). The Immunology of Food Allergy. Journal of Immunology. 192(6):2529–2534
Pachacama López AF, et al., (2021) Probiotics to Reduce the Severity of Atopic Dermatitis in Pediatric Patients: A Systematic Review and Meta-Analysis. Actas Dermosifiliogr. Nov 1;112(10):881–90.
Pizzorno & Murray (2012) Textbook of Natural Medicine
Samochocki, Z., et al. (2013). Vitamin D effects in atopic dermatitis. Journal of the American Academy of Dermatology, 69(2), 238–244. https://doi.org/10.1016/j.jaad.2013.03.014
Song, H., et al. (2016). Faecalibacterium prausnitzii subspecies-level dysbiosis in the human gut microbiome underlying atopic dermatitis. The Journal of allergy and clinical immunology, 137(3), 852–860. https://doi.org/10.1016/j.jaci.2015.08.021