You have probably heard by now that what you put into your body impacts your health. But for some reason most people don’t think the same is true for their skin.
Do you have eczema? Skin rashes? Do you know someone who does? You might find it helpful to know that elimination diets don't necessarily improve eczema and may cause harm if not done the right way! But in some cases, people do experience benefit, especially when done in conjunction with a nutrition expert. This can be invaluable.
Food allergy may be a predictor of risk for eczema and sometimes eczema and food allergies go together. One does not necessarily cause the other. BUT, it is completely possible to notice a worsening of skin when eating certain foods, even when food allergy testing is negative. Eczema is really complicated. And so are our bodies.
I have often told my patients to keep a food diary like this one, but sometimes they want to know where to even start if they are on the hunt for their triggers. Do they have to give up their favorites? And can they even afford to make substitutions?
Food is sacred to us. It reflects how we experience life. In many ways it is life. Family traditions, holidays, celebrations, festivals, gatherings center on food.
The truth is, you don't have to give it all up. You just have to be smart about it. Learn what was helpful to others who suffer from eczema and see if it might also be helpful to you. Success leaves clues, as they say.
Over the last few years we have better data, some of it compiled by people who actually have eczema on what the most common triggering foods are.
I lament that in the clinic, this information makes it only to the ears of my patient. But here I am writing it out now for all of you.
Let’s just get right to it!
An article was published which revealed responses to a survey of 169 people with eczema, asking what made their skin worse and what foods they avoided in an attempt to make things better. Their responses are here just for you!
It's no surprise that junk foods make the list. These foods are often cooked in highly processed oils and syrups and have ingredients no one can pronounce. They line the pockets of the food giants and steal our health. Many people who struggle financially, deal with food insecurity and live in "food deserts" may feel they have limited options for better nutrition. They may feel junk food is all they can afford.
But unfortunately the cost of eczema is huge (some studies suggest at least $600 a year), when you factor in costs of creams, moisturizers, medications, not to mention the unseen costs of lost sleep, depression, poor quality of life, etc.
Junk foods are deceiving because though might seem cheap on face value, they certainly have innumerable downstream costs, including worsening of overall health.
Adding more whole foods to a diet can be done in an affordable way. Look to add in nourishing and filling foods such as beans and lentils. If you're in a position to take aim at food insecurity, check this out.
Eggs also made the list, which is not surprising. Egg allergy itself is not uncommon, and it has been strongly associated with atopic dermatitis flares for almost one hundred years. If your atopic dermatitis is flaring, look for ways eggs may be sneaking into your diet (think baked goods) and see whether there is any correlation.
But you can still find many beautiful ways to enjoy them! These were from our egg hunt last spring, I think! the decorating was the very best part!
Cow's milk is another common allergen which in some people may trigger flares of their atopic dermatitis. This is probably due to the cow's milk protein. Fortunately, cow's milk can easily be substituted for a plant based milk which can be so delicious. Have you checked out this site for ideas?
Just be sure to speak with your dermatologist or primary doctor about it and never ever substitute it in your baby or child without speaking to your child's physician. This can actually be dangerous! But in adults, it's usually an easy transition if you have the right tools!
Many people in the study found gluten to be a common trigger.
Though thankfully gluten intake does not seem to be a risk factor for atopic dermatitis/eczema, observational studies have linked atopic dermatitis to celiac disease, which is a serious autoimmune condition where people cannot safely eat gluten.
Once again, there are many substitutes for gluten now that people are more aware of inflammatory foods. (And don't judge the appearance of my strawberry rhubarb cake because it was actually quite delicious).
Sadly some of my very favorite foods made the list of common triggers. But don't throw the baby out with the bathwater!
Nightshades are a family of plants that include tomatoes, potatoes, eggplant, etc. Many of these plants have excellent nutritional benefits, but some have chemical compounds that are frankly carcinogenic. For instance, tobacco is also a nightshade.
Nightshades contain alkaloids which may have a medicinal or biological impact on the body. The alkaloid content may increase at times (eg when a potato turns green and sprouts). If my patients suspect they have an allergy to nightshades, I often recommend that food journal to see which of the many plants in this category may be the culprit.
Alcohol, sugar, and citrus were also reported triggers, as you can see here.
What are some other important things we can do when we have eczema?
Avoid chemicals in our cleaning products and personal care products!
Give your laundry an extra rinse and skip the fragranced fabric softener.
Wear gloves when cleaning and change them often!
Replace caustic and toxic compounds with more natural cleaning agents like this one.
Wash your hands immediately after and then apply a moisturizer.
Speaking of moisturizer, MOISTURIZE your skin at least once daily with an affordable, fragrance-free product such as shea butter or Vaseline (not just any old petrolatum). Do this immediately after getting out of the bath or shower and patting the skin dry. Think of it as sealing in the water and repairing your skin barrier.
Avoid harsh antibacterial soaps when possible which can strip the skin and cause breakdown of the delicate skin barrier.
Use lukewarm water in the shower or bath. I live up in the Northeast where the winters can be frigid, and a long hot shower can be tempting. But try to turn down the heat and keep it to just a few minutes. If you can tolerate, try making the last bit of the shower a cold one.
Add a humidifier to the bedroom if you can. These can be affordable because both the cool mist ones and the warm mist ones work at forcing moisture into the air, and the cool mist humidifiers are available in many pharmacies, supermarkets and drug stores. Just make sure to clean the filter often.
Paul Farmer once wrote, “Understanding more about the causes of the causes will help make medicine matter, help make it better, in part because it forces us to be better listeners.”
Though these reports of people's real world experiences with eczema certainly don't give us all the answers, they give us invaluable information still. I have personally found that listening to my patients gives me some of the best clues to help them figure out how to get better. And I think I get better that way too.
Many thanks to Dr. Paul Farmer for a legacy of inspiration, hope, dedication and courage. 1959-2022