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Lately, it seems like there’s a diet for everything that ails or irks you, and there’s certainly no shortage of trendy eating plans out there. But can a diet really help improve a chronic skin condition like eczema?
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What is eczema?
Otherwise known as atopic dermatitis, eczema is a term that describes several different types of skin inflammation. Most types of eczema cause dry skin and rashes or patches of itchy skin on the face, hands, and feet, as well as inside the elbows and behind the knees. Eczema isn’t contagious (MedlinePlus, n.d.).
It’s an allergic skin disease that usually involves the immune system being oversensitive to certain triggers. Eczema usually develops in early childhood, but adults can have it too. For some people, eczema is a result of a bacterial, fungal, viral, or yeast infection (AAAAI, n.d.). About 15% to 20% of children and 1% to 3% of adults worldwide have eczema (Avena-Woods, n.d.).
Recent research has indicated that children who have both atopic dermatitis and at least one food allergy may have differences in the structure and molecules of healthy-looking top layers of skin, near their eczema lesions. While these children had healthy-looking skin around their eczema patches, the patches were actually more prone to losing hydration, accumulating Staphylococcus aureus bacteria, and having gene expression that resembled an immature skin barrier.
Kids who just have eczema and don’t have food allergies don’t appear to show these microscopic differences. Researchers believe understanding this connection further may help them diagnose and treat eczema. By identifying kids who are most at risk for developing food allergies, experts can address eczema flares before they become severe and develop more effective, targeted treatment strategies (Leung, 2019).
Which foods should you eat on an eczema diet?
While there’s no single quick fix for eczema, some scientific studies have indicated that eating particular foods may help some people control their eczema flare-ups (AAD, n.d.). While the evidence is mixed, it may be worth considering experimenting with some of these edible options:
- Fatty fish: Because eczema is considered an inflammatory skin disorder, researchers have investigated whether fish oil may help tame symptoms since it’s rich in anti-inflammatory omega-3 fatty acids (NIH, 2019; Calder, 2013). A few small studies suggest that fish oil may help treat eczema, but more research is needed (Schlichte, 2016).
- Probiotics: Otherwise known as “good bacteria,” probiotic supplements and foods like yogurt and fermented vegetables have been touted as healthy digestive aids and illness fighters (MedlinePlus, n.d.). A 2010 study found that children with allergic diseases like eczema had significantly different intestinal flora from healthy children, which the researchers interpreted as a possible clue that probiotics could be helpful (Özdemir, 2010). A 2016 study found that probiotics can have positive effects on eczema, but the improvements really depend on the probiotic strain being used, the time of administration, the duration of exposure, and the dosage (Rather, 2016).
- Foods with quercetin: Quercetin is a natural pigment (or flavonoid) found in fruits and vegetables like apples, cranberries, onions, and kale, as well as other foods like wine and black or green tea (Andres, 2018). Some studies have shown that quercetin has anti-inflammatory properties and that adding it to a balanced, healthy diet through food or dietary supplements may help treat eczema symptoms (Karuppagounder, 2016).
What is eczema? The causes, symptoms, and treatments explained
Which foods should you avoid on an eczema diet?
Numerous studies have found that certain foods can exacerbate eczema in people who are sensitive to these foods or have food allergies. The most common food-related allergies in the United States are triggered by peanuts, tree nuts, cow’s milk, eggs, soy, wheat, fish, and shellfish.
While food elimination isn’t recommended for everyone, some people with eczema have shown improvements in their allergic reaction and eczema symptoms when they’ve eliminated the foods they’re sensitive to. One study found that children who had eczema in addition to an egg allergy showed a significant reduction in their eczema symptoms when they eliminated eggs from their diet (Lever, 1998).
Potential diets to follow or try with eczema
While there aren’t necessarily one-size-fits-all food choices for people with eczema, research has shown that certain eating plans may help control symptoms and allow people with eczema to better manage the inflammatory skin condition.
One study found that children who ate foods that are considered part of the Mediterranean diet (fruit, vegetables, olive oil, and fish) had a reduced risk of eczema while children who frequently ate fast food had an increased risk (Cepeda, 2015).
Some people with eczema have a form of the disease called dyshidrotic eczema or dyshidrosis. This type of eczema affects the hands and feet and can cause blisters and irritation on the hands and feet. There’s no single cause of dyshidrotic eczema, but experts believe some people who have it may also have an allergy to metals like nickel or cobalt.
For some people, making dietary changes to avoid foods that contain these metals and eating a low nickel diet or low cobalt diet can help relieve symptoms. People who are nickel-sensitive may find some relief if they avoid foods that may contain this metal, like canned foods, oysters, beans, tomatoes, whole grain flour, pears, and chocolate for 3–4 weeks.
Cobalt-sensitive people may try to avoid foods that contain this metal, like apricots, beer, cabbage, chocolate, coffee, and more. However, while some people find relief following these diets, improvement is actually rare, and the eating plans may be difficult to follow because of their restrictiveness (Amini, 2019; Lofgren, 2008; Stuckert, 2008).
7 Eczema triggers to know and how to avoid them
For some people, an elimination diet may be appropriate to help identify potential food triggers of eczema. In young children, this may involve temporarily eliminating dairy products, egg, peanut, and soy, and in older children, this may involve getting rid of wheat, fish, tree nuts, and shellfish for a period of time.
It’s always important to work with a medical professional before trying any specific diet or eliminating entire foods groups, so be sure to go over the pros and cons of any diet with a healthcare provider or nutritionist (Bergmann, 2013).
- American Academy of Allergy, Asthma, & Immunology (AAAAI). (n.d.) Eczema (Atopic Dermatitis) Overview. Retrieved from https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/eczema-(atopic-dermatitis)-overview
- American Academy of Dermatology Association (AAD). (n.d.). Can Food Fix Eczema? Retrieved from: https://www.aad.org/public/diseases/eczema/childhood/treating/food-fix
- Amini, S. (2019). Dyshidrotic Eczema (Pompholyx) Treatment & Management. Medscape. Retrieved from https://emedicine.medscape.com/article/1122527-treatment#d18
- Andres, S., Pevny, S., Ziegenhagen, R., Bakhiya, N., Schäfer, B., Hirsch-Ernst, K. I., & Lampen, A. (2017). Safety Aspects of the Use of Quercetin as a Dietary Supplement. Molecular Nutrition & Food Research, 62(1), 1700447. doi: 10.1002/mnfr.201700447. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/29127724
- Avena-Woods, C. (2017). Overview of Atopic Dermatitis. American Journal of Managed Care, 23(8). Retrieved from https://www.ajmc.com/view/overview-of-atopic-dermatitis-article?p=1
- Bergmann, M. M., Caubet, J.-C., Boguniewicz, M., & Eigenmann, P. A. (2013). Evaluation of Food Allergy in Patients with Atopic Dermatitis. The Journal of Allergy and Clinical Immunology: In Practice, 1(1), 22–28. doi: 10.1016/j.jaip.2012.11.005. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/24229818
- Calder P. C. (2013). Omega-3 polyunsaturated fatty acids and inflammatory processes: nutrition or pharmacology?. British Journal of Clinical Pharmacology, 75(3), 645–662. doi: 10.1111/j.1365-2125.2012.04374.x. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/22765297
- Cepeda, A. M., Del Giacco, S. R., Villalba, S., Tapias, E., Jaller, R., Segura, A. M., Reyes, G., Potts, J., & Garcia-Larsen, V. (2015). A Traditional Diet Is Associated with a Reduced Risk of Eczema and Wheeze in Colombian Children. Nutrients, 7(7), 5098–5110. doi: 10.3390/nu7075098. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26121530
- Karuppagounder, V., Arumugam, S., Thandavarayan, R. A., Sreedhar, R., Giridharan, V. V., & Watanabe, K. (2016). Molecular targets of quercetin with anti-inflammatory properties in atopic dermatitis. Drug Discovery Today, 21(4), 632–639. doi: 10.1016/j.drudis.2016.02.011. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26905599
- Katta, R., & Schlichte, M. (2014). Diet and dermatitis: food triggers. The Journal of Clinical and Aesthetic Dermatology, 7(3), 30–36. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3970830/
- Leung, D. (2019). Non-lesional skin surface distinguishes atopic dermatitis with food allergy as unique endotype. Science Translational Medicine, 11(480). doi: 10.1126/scitranslmed.aav2685 2019. Retrieved from https://stm.sciencemag.org/content/11/480/eaav2685.abstract
- Lever, R., Macdonald, C., Waugh, P., & Aitchison, T. (1998). Randomised controlled trial of advice on an egg exclusion diet in young children with atopic eczema and sensitivity to eggs. Pediatric Allergy and Immunology, 9(1), 13–19. doi: 10.1111/j.1399-3038.1998.tb00294.x. Retrieved from http://europepmc.org/article/MED/9560837
- Lofgren, S. M., & Warshaw, E. M. (2006). Dyshidrosis: Epidemiology, Clinical Characteristics, and Therapy. Dermatitis, 17(4), 165–181. doi: 10.2310/6620.2006.05021. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/17150166
- Medline Plus. (n.d.). Eczema. Retrieved from: https://medlineplus.gov/eczema.html
- National Center for Complementary and Integrative Health (NIH). (2019). Probiotics: What You Need To Know. Retrieved from https://nccih.nih.gov/health/probiotics/introduction.htm
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- Schlichte, M. J., Vandersall, A., & Katta, R. (2016). Diet and eczema: a review of dietary supplements for the treatment of atopic dermatitis. Dermatology practical & conceptual, 6(3), 23–29. doi: 10.5826/dpc.0603a06. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5006549/
- Stuckert, J., & Nedorost, S. (2008). Low-cobalt diet for dyshidrotic eczema patients. Contact Dermatitis, 59(6), 361–365. doi: 10.1111/j.1600-0536.2008.01469.x. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/19076887
- Tsakok, T., Marrs, T., Mohsin, M., Baron, S., Toit, G. D., Till, S., & Flohr, C. (2016). Does atopic dermatitis cause food allergy? A systematic review. Journal of Allergy and Clinical Immunology, 137(4), 1071-1078. doi: 10.1016/j.jaci.2015.10.049. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26897122
Dr. Mike is a licensed physician and the Director, Medical Content & Education at Ro.