Atopic dermatitis, also known as eczema, is the most common chronic skin condition in America.
It’s an inflammatory condition that affects around 10% of the population and is characterized by extremely dry, itchy skin that can progress into unpleasantly painful rashes and skin lesions.
Although it disproportionately affects children, there are still millions of adults across the world living with this condition.
Eczema is certainly not pleasant to deal with, something that those who live with it need no reminder of.
But once you have it, what tools do you have at your disposal to manage it?
Traditional treatment modalities include topical creams, oral steroids and a host of other pharmacological interventions that all bring with them a risk of side effects that lead some eczema sufferers to dabble in alternative or complementary management strategies.
Nutrition management and the role of diet is, of course, at the top of that list.
But is there any evidence that what you eat can affect your eczema?
My brand new writing & research intern Kat Durston and I took a good look at the evidence to find out in today’s co-written special feature.
Let’s get to the good stuff.
Eczema & Vitamin D
Vitamin D is increasingly identified as having a role to play in maintaining a healthy immune system, and so perhaps it comes as no surprise that certain studies have demonstrated a link between vitamin D status and risk of eczema.
A 2018 study out of the Allergy journal found that those with lower blood levels of Vitamin D were at a higher risk of eczema in an adult population.
A systematic review and meta-analysis conducted in 2019 out of the Nutrients journal found that supplementation of Vitamin D in the 1500-1600 IU range over a 3+ month period was effective at reducing symptoms of eczema sufferers.
Because Vitamin D is found primarily in fatty fish like salmon, trout and sardines, it can be very hard for people who don’t like fish to get enough from their diet.
This is especially true for those who live in northern climates with less annual sun exposure.
If you’d like to learn more about the challenges of getting enough vitamin D and the role of supplementation, please read my article on the topic.
The benefits of consuming fish extend beyond Vitamin D, however, as multiple studies (1,2) have demonstrated a potential benefit of omega-3 consumption on reducing the severity of eczema.Omega-3 fatty acids are also found in foods such as flax, chia, hemp seeds as well as walnuts and in smaller amounts in tofu, seafood and certain types of eggs.
You might consider a joint omega 3 + vitamin D supplement if you don’t consume these foods.
Eczema & Zinc
Zinc is another nutrient of interest in the world of eczema management because it has regularly been shown that individuals with eczema tend to have lower zinc levels.
In fact, it may be the case that the lower the level of dietary zinc one consumes, the more severe the eczema becomes.
While this is just observational evidence, it does makes sense for eczema sufferers to be aware of zinc containing foods and ensure they are part of their regular dietary pattern.
Zinc is well known to play a role in the human immune system, as well as cell growth and repair – which perhaps makes it unsurprising that is also connected to skin health.
With that in mind, here are a few examples of zinc-rich foods to add to your plate:
Oysters (which contain more zinc per serving than any other food), beef, pumpkin seeds, chickpeas, and cashews.
Eczema & The Gut (Probiotics/Prebiotics)
The effect of probiotics and prebiotics on eczema is a hot, yet controversial topic of research.
Let’s break it down.
Probiotics are live microorganisms found in certain foods and supplements that add to the good bacteria in your gut, whereas prebiotics are typically high fibre foods that essentially act as feed for the beneficial bacteria and help stimulate their growth.
Pre & probiotics work in harmony to support healthy digestive function, and this effect may spill over into the world of skin health and eczema.
A 2016 review out of the Dermatology Practical & Conceptual Journal caught my eye because some evidence was presented to suggest a connection between the state of the gut microbiome and eczema risk.
When I looked into it further, I found that the evidence was mixed and potentially inconclusive.
The strongest evidence exists for what are known as “synbiotics” – a supplement that contains a combination of both pre and probiotics.
As far as the actual probiotic strains that may be of benefit, it seems a combination of various strains from the Lactobacillus and Bididobacterium species may be best.
You can learn more about pre & probiotics here and also find “Synbiotic” supplements online and at your local health food store.
Please also note that the introduction of supplements, especially in children, should be reviewed and discussed with your healthcare team to ensure suitability.
Eczema & Veggie Intake
As a friendly reminder, vegetables are fundamental foods for good health.
Given their abundance of vitamins, minerals and anti-oxidants (in addition to gut healthy fibres) it should be largely unsurprising that improved skin health outcomes would arise from increasing vegetable intake.
In a survey of those living with eczema, nearly half of the respondents identified eating more vegetables as the dietary change that most positively influenced their eczema symptoms.
If you’d like to take a closer look at the survey, you can do so here.
As I’ve discussed in a previous article, antioxidant rich foods like veggies may also have a role to play in preventing skin cancer and delaying skin aging.
Bringing it all together, someone suffering from eczema and it’s aggravating symptoms could benefit from nutritional intervention strategies, such as the ones listed above.
Despite this, it is important to keep in mind that this is a growing body of research and we still do not understand the full picture when it comes to the effect our diet has on skin health.
Making sure your nutrient levels are meeting age and sex-specific requirements and consuming a variety of whole foods is almost always your best bet towards not only managing your skin condition, but living an overall healthier life.
Article co-written & researched by Andy De Santis RD MPH & Kat Durston