Eczema & diet – An update from a dietitian

It is a little known fact that eczema is affected by additives and natural chemicals in food. Many people know that allergy is almost always part of what happens. However even when they attend to the allergy foods that come up positive on allergy tests the eczema is not completely solved. In fact one way of knowing that diet investigation for food intolerance and chemical sensitivity is likely to have a positive outcome is the presence of eczema. Addition of IBS (irritable bowel syndrome), or migraine in some close family member improves this. Using the diet detective method of using everything known about food intolerance and sensitivity they can get more improvement. This important news needs to go out to families with eczema.

Your doctor is busy attending to allergies and the medical treatments for eczema. Most doctors are not familiar with the idea that there can be an additional benefit if the family look at additives and other food chemicals, but many parents know the eczema flares after party food, or particular foods such as citrus, spicy food, fruit juice or tomato. Yet the diet component is often dismissed, as if it should be magic on its own, rather than be part of what I call the “Total Body Load” of suspect items. Clinical research by dietitians experienced with food intolerance and sensitivity who have worked with families and used challenges have shown a role for food chemicals.

For over thirty years I have been seeing improvements in adult, childhood or infant eczema with dietary investigation. An interesting aspect is that the people whose diet I was investigating had usually not contacted me because as part of treatments for eczema. My main work has been to investigate the role of diet in ADHD – Attention Deficit Hyperactivity Disorder. The family would bring along a child with restless and impulsive behaviour, and poor concentration. Usually the symptoms would also include settling and sleep problems, being irritable, and “off with the fairies”. Sometimes the child had eczema as well, or a brother or sister had infant eczema, or a parent had eczema. After the diet trial they would often report that as well as diet decreasing the behaviour, mood and sleep problems, the eczema had decreased.

Eczema management can be quite a puzzle wondering if additives, perfumed products, citrus, other foods, perfumed products, pollen seasons, stress, aggravate it. Using the family sensitive history and the total body load ideas diet detective work can gradually help make sense of what is going on. Families can attend to food allergies, suspect additives, salicylates, amines and MSG, and all the environmental factors and work out which are their most important treatments for eczema.

You can use the diet detective method to design your own Family Elimination Diet. It considers only the additives, food chemicals and foods that are known to be suspect from the research and adds that to those foods considered suspect from the family sensitivity history. Additionally you can decide how strict you want it to be: easy to manage or stricter to get good results, or very careful. Then you do challenges to show if diet symptoms do return with food reintroduction. If symptoms return you then test individual foods and additives to develop your own diet made up of all the foods you do not react to and occasional ones you have only mild reactions to. This allows you to manage in the real world where you want to eat with others as normally as possible and have outings.

Diet is a natural cure for eczema. Because it is a natural cure, diet does not have any side effects and does not interfere or interact adversely with any other medication you need to have.

Just getting relief from severe eczema can make a big difference. I remember a family who were getting lenient from a strict diet and their daughter was still irritable, demanding and very restless. When I asked how they were going they reported being very pleased. They had managed the diet to the level of strictness that meant their precious little daughter no longer needed to wear wet wraps and finally felt like other kids at preschool. One advantage of the diet detective method is being able to balance how strict you want to be with diet in relation to the symptoms. Others comment with pleasure on how much the skin has improved not just where the itchy, red eczema was. “It’s as if I look 6 years younger” said one adult.

Most parents are told that those with infant eczema will grow out of many allergies, especially milk and egg. In fact where food chemical sensitivities are attended to improved tolerance of milk and egg will happen earlier. In those who have infant eczema it tends to continue in varying degrees of severity throughout life. Care with diet, creams and environmental factors still need some attention. In others it comes on much later.

People who have never had infant eczema can still get it as adults, even in their 50’s and later. Families with eczema know that it takes time to work out what medical treatment suits them. “Diet detective work” is the same. The trick is to reduce all the suspect items at the same time, for a month, and do challenges. This can take a little effort at first, but if symptoms are reduced then the additional effort required for diet treatment is minimised.

At some time in the life of each person with eczema it is wise to get the help of a dietitian familiar with dietary investigation, and use a book that contains all the details.