There’s a growing body of evidence linking eczema and gut health. While it’s a relatively new area of study, gut health is gaining traction as a root cause of many modern-day health issues.
So how can your gut health influence the health of your skin? The answer can only be seen under a microscope. You see, our gut plays host to trillions of microorganisms. These microscopic residents include bacteria, fungi and viruses. Collectively, these microorganisms are referred as the microbiome. The microbiome, or gut flora, plays a vital role in our immune system and changes to its composition can lead to the development of skin diseases, including eczema. A 2018 literature review provides compelling evidence of a correlation between the health of your gut microbiome and skin conditions.
Some say our skin is a direct reflection of what’s going on in our gut—the good and the bad. Before we explore this gut-skin connection, let’s first understand what eczema is and the important functions of our gut and its microbial composition.
What Is Eczema?
Eczema is an inflammatory skin condition, often associated with an allergic disease. It can cause dry, itchy, bumpy and cracked areas of skin on the body. The exact cause is unknown and there is no cure as of yet. It’s typically treated with topical steroid creams. Eczema has been linked to both genetic and environmental factors. It is not contagious and does not harm your body. With 15-20% of people experiencing eczema at some point in their lives, it’s a fairly common allergic disease. Those who do, endure discomfort and symptoms that may interfere with their day-to-day life, and even affect their mental health. There are several different types of eczema, and here’s a list of the four most common types:
- Atopic dermatitis is the most common type of eczema. It’s an autoimmune response that damages the skin. It typically begins in childhood and is a chronic condition. The itching is usually severe and can lead to sleep loss and greatly reduce one’s quality of living.
- Contact dermatitis results from exposure to an irritant or allergen, such as laundry detergent, jewelry, or perfumed body products. It is common amongst professionals who work with chemicals.
- Seborrheic dermatitis is what most people think of as dandruff, but it is usually due to the immune system attacking an overgrowth of a yeast that lives on the skin’s surface. It affects the sebaceous glands and is found on the scalp and other oil-producing areas of the body. It can overlap with atopic disease.
- Dyshidrotic eczema is extremely itchy and found only on the hands and feet as raised, small bumps or blisters. It’s common amongst people who have one of the other types of eczema.
What Is the Gut?
The gut is your gastrointestinal tract. It consists of several organs including your stomach, your small intestine and your large intestine. There are both friendly bacteria and harmful bacteria that reside in our gut. Their main job is to take the non-digestible components of the foods we eat and make them usable for us. They eat those undigested food particles and convert them into absorbable nutrients for our body. When this healthy gut bacteria becomes out of balance (gut dysbiosis) or isn’t diverse enough, a whole host of problems can result—including skin issues.
Eczema and Gut Health
Intestinal hyperpermeability, or Leaky Gut Syndrome, can result from gut dysbiosis, and is hypothetized to contribute to eczema, but this is still up for debate in the scientific community.
A review published in 2021 found a strong link between gut health and atopic dermatitis. This review revealed that consumption of “friendly” bacteria, otherwise known as probiotics, helped to improve and maintain gut health and the symptoms of atopic dermatitis, including:
- Enhanced shininess and thickness of fur in mice.
- Reduced water loss through the skin barrier, and reduced skin sensitivity in adult humans.
These findings suggest that probiotics could play a pivotal role in the treatment and prevention of atopic dermatitis through improved gut health.
Another study revealed a connection between changes in the early gut microbiome and early childhood eczema.
Also, Dr. Peter Lio, Assistant Professor of Dermatology and Pediatrics at Northwestern University in Chicago, Founding Director of Chicago Integrative Eczema Center, and member of NEA’s Scientific Advisory and Board of Directors, spoke to the correlation between diet and eczema with the National Eczema Association. Food allergies are considered a comorbidity of eczema and up to 30% of people with atopic dermatitis have one or more. The cause and effect is not that cut and dry, however. A food that triggers one person’s flare up doesn’t necessarily trigger someone else’s. Quantity of the food item and the person’s current level of skin inflammation may factor in as well. Overall, eating a cleaner diet seems to relieve many people’s symptoms, he noted.
The scientific evidence reveals that gut health correlates strongly with skin health. Given that bacteria in our gut consume the food we eat, diet plays an important role in gut health—which in turn may help with skin conditions such as atopic dermatitis and eczema.
Healing Foods for Eczema and Gut Health
There is not enough research to confirm any one, specific diet will help with eczema. Considering its inflammatory nature, consuming foods with anti-inflammatory properties may be helpful. Here’s a list of foods with anti-inflammatory properties that will improve gut health and may also keep eczema at bay:
Omega-3 Fatty Acids
Studies show fish oil reduces inflammation and has an effect on the diversity and abundance of the microbiota. Fish with the highest omega-3 fatty acid content include:
- Salmon (wild or farmed)
- Albacore tuna
Vitamin C can function like an antihistamine in the body and one study found a deficiency in it can aggravate symptoms of atopic dermatitis. More research is needed, but there’s no harm in adding fresh fruit and vegetables to your diet. Top food sources of vitamin C include:
- Citrus fruits (oranges, kiwi, lemon, grapefruit)
- Bell peppers
- Cruciferous vegetables (broccoli, Brussels sprouts, cabbage, cauliflower)
- White potatoes
Foods High in Flavonoids
Mount Sinai suggests foods rich in flavonoids for eczema and gut health. They are antioxidant agents with anti-inflammatory properties and can strengthen connective tissue. Flavanoids are found in many plant foods, but the richest sources are:
- Blueberries, cherries, and raspberries
- Citrus fruits
- Red cabbage
- Red wine
- Cocoa and chocolate products
A study published in 2016 proved a correlation between consuming fermented food and a reduced likelihood of eczema in adults. Many fermented foods contain probiotics, such as Lactobacillus bacteria, and can boost the friendly microbes in your gut. Per Medical News Today, the following foods are richest in probiotics:
- Non-dairy yogurts
- Fresh, sour dill pickles
- Water or brine-cured olives
- Aged cheeses, such as cheddar, gouda, or mozzarella
- Kefir, a probiotic milk drink
- Traditional buttermilk
Foods That Can Trigger Eczema Flare Ups
Food allergies or food sensitivities can directly impact eczema and gut health. The most common allergens to cause skin reactions are:
- Cow’s milk
- Tree nuts
- Fish and shellfish
Pro-inflammatory foods will lead to an unbalanced microbiome, strengthening the link between eczema and gut health. It’s best to limit or avoid:
- Refined foods
- Processed meats
- Excess alcohol
Processed Foods and Additives
A study published in 2021 found processed foods promoted intestinal permeability and inflammation, especially those containing:
- Dietary Emulsifiers
- Polysorbate-80 is often used in ice creams and mouthwash.
- Sodium Sulfite is used as a preservative in dried fruits and processed meats.
- Sodium carboxymethylcellulose is also used in ice creams as well as cakes, baking breads, margarine, peanut butter, chewing gum, and can be found in toothpastes.
- Antimicrobial Additives
- Artificial Sweeteners
Foods Containing Nickel
Per the American Academy of Dermatology Association, foods that contain high amounts of nickel may trigger eczema in those who have skin reactions to the metal. The following are best avoided:
- Cocoa powder
- Soy sauce
The link between eczema and gut health is undeniable and backed by research. While there is no one-size-fits-all approach or cure, it’s worth exploring dietary changes if you are suffering from atopic dermatitis. A study published in 2014 acknowledged undergoing an elimination diet and removing certain food categories may help identify the root cause. But the researchers did caution it may not be the best approach for all. Working with a myPrimalCoach can offer an individualized approach to identify what your particular triggers may be, and help you with a gut-healthy, anti-inflammatory diet.