How Immune Cells Affect Dermatitis: Nutritional and Lifestyle Tips for Better Skin Health

In the complex world of immune responses, T-helper (Th) cells play a crucial role, particularly in inflammatory conditions like dermatitis. (Kim & Ahn, 2022; Ma, 2023; Wang & Xu Landén, 2015)
 
For those suffering from dermatitis, understanding the role of T-helper cells—and the factors that influence their activity—can offer valuable insights into managing and potentially alleviating symptoms.
 
This article will explore:

• What are T-Helper cells?
• T-Helper cells and their role in dermatitis
• The cell subtypes in dermatitis
• How Overactive Th Cells Fuel Dermatitis
• Leaky Gut’s Role in Th Cell Imbalance
• Supporting T-Helper Cells Nutritionally and Through Lifestyle
• Incorporate anti-inflammatory foods
• Support Gut Health with Probiotics and Prebiotics
• Include Nutrients That Support Th Cell Regulation
• Get Sufficient, Quality Sleep

What Are T-Helper Cells?

​T-helper (Th) cells are a type of white blood cell that help coordinate the immune response. These cells don’t directly attack pathogens but instead "help" by releasing signalling molecules called cytokines, which activate other immune cells. Th cells play a central role in orchestrating both immune defences and inflammation, making them crucial to the body’s ability to respond to infections, injuries, and foreign particles.

T-Helper Cells and Their Role in Dermatitis

​For those with dermatitis, Th cells tend to become overactive in response to harmless triggers. This overactivity can lead to chronic inflammation and an exaggerated immune response, resulting in the redness, itching, and swelling characteristic of dermatitis.
 
Th cells release pro-inflammatory cytokines, which act as chemical messengers to increase inflammation. This is especially problematic in skin disorders, as chronic inflammation can weaken the skin barrier and worsen symptoms over time.

Th Cell Subtypes in Dermatitis

In dermatitis, two main types of T-helper (Th) cells—known as Th1 and Th2 cells—tend to be overactive, each contributing in unique ways to the condition.

1. Th2 Cells: Th2 cells are a major factor in atopic dermatitis. They’re usually involved in allergic responses and help in producing antibodies, particularly Immunoglobulin E (IgE), which is responsible for allergy responses. When Th2 cells are overactive, they release signalling molecules (cytokines) like IL-4, IL-5, and IL-13. These cytokines lead to high IgE production, making the immune system react to otherwise harmless substances, like pollen or dust mites, with an allergic response. This Th2 “skew” not only drives skin inflammation but also weakens the skin barrier, allowing allergens and irritants to enter more easily and making flare-ups more frequent and severe.
2. Th1 Cells: Although dermatitis is largely a Th2-driven condition, Th1 cells also play a role, especially in chronic cases. Th1 cells are involved in a type of immune response called “cell-mediated immunity,” and they produce cytokines such as IFN-γ and TNF-α. When Th1 cells are overactive, they contribute to inflammation in a different way than Th2 cells, often leading to thickened, scaly skin over time. This chronic inflammation from Th1 cell activation can also cause skin to become tougher and less flexible due to continuous immune activation.
3. Th17 and Th22 Cells: In addition to Th1 and Th2 cells, other Th cell subtypes, like Th17 and Th22, also play a role in dermatitis. Th17 cells produce a cytokine called IL-17, which is linked to inflammation, especially in severe cases of dermatitis and in conditions like psoriasis. Th22 cells release IL-22, which disrupts the skin barrier, making it harder for the skin to retain moisture and easier for allergens to penetrate. This mix of Th cells makes dermatitis a complex condition, as each subtype contributes differently to skin inflammation and barrier issues.

How Overactive Th Cells Fuel Dermatitis

In dermatitis, an overactive Th cell response creates a cycle of inflammation and skin barrier breakdown. Here’s a closer look at how this happens:

1. Cytokine Release: Overactive Th cells release large amounts of cytokines, such as IL-4, IL-5, IL-13, and IFN-γ, which act as signals that boost immune activity. These signals attract other immune cells, like eosinophils and mast cells, to the site of inflammation. These cells release even more inflammatory compounds, leading to the redness, itching, and swelling typical of dermatitis.
2. Skin Barrier Disruption: The cytokines released by Th cells can also weaken the structure of the skin barrier. For example, IL-4 and IL-13—two cytokines released by Th2 cells—reduce the production of filaggrin, a key protein for skin barrier health. A weakened skin barrier loses moisture more easily and allows irritants, bacteria, and allergens to penetrate more deeply, which further activates the immune system and ramps up inflammation. If someone already has a genetic tendency for low filaggrin production, this process is intensified, making symptoms worse, faster.
3. IgE Production and Allergic Sensitisation: Th2 cells encourage B cells (another type of immune cell) to produce IgE antibodies, which are heavily involved in allergic reactions. High IgE levels create an exaggerated immune response to environmental allergens, which can trigger or worsen dermatitis symptoms. In atopic dermatitis, this sensitivity to allergens contributes to the chronic nature of the condition, as repeated exposure to allergens continuously triggers Th cell activity and inflammation.
4. Chronic Inflammation and Skin Remodelling: Persistent Th cell activation can lead to ongoing inflammation that begins to alter the skin itself. In cases of chronic dermatitis, the skin often thickens (a condition known as lichenification) due to repeated scratching and inflammation. Th1 cells, in particular, contribute to this long-term inflammation, releasing cytokines like IFN-γ, which encourage the production of inflammatory proteins and new skin cells. Over time, this ongoing inflammation changes the skin’s appearance and texture, making it thicker and rougher.
5. Autoimmune-Like Reactions: In some cases, the immune imbalance seen in dermatitis can mimic an autoimmune response, where the immune system mistakenly targets the body’s own cells. While dermatitis isn’t classified as an autoimmune disease, the persistent activation of Th cells creates a similar pattern of ongoing inflammation. This is one reason why dermatitis can be so challenging to manage, as the immune system remains in a constant state of heightened sensitivity and reactivity.

Leaky Gut’s Role in Th Cell Imbalance

The connection between gut health and immune function is well-established, and one pathway by which leaky gut affects dermatitis is through its impact on T-helper cells. When the intestinal barrier becomes more permeable—a condition often referred to as leaky gut—undigested food particles, toxins, and microbes can enter the bloodstream. The immune system sees these as invaders, prompting an immune response that includes the activation of Th cells.
 
In cases of leaky gut, this Th cell activation may be constant, leading to immune hyperactivity. For people with dermatitis, this immune imbalance can result in more frequent or severe flare-ups. Supporting the gut lining and regulating immune activity can help in reducing the intensity of Th cell overactivity, promoting a more balanced immune response.
 
You can read my recent article on Leaky Gut here.

Supporting T-Helper Cells Nutritionally and Through Lifestyle

Fortunately, certain dietary and lifestyle practices can help regulate Th cell activity, reduce inflammation, and support immune balance. Here are five practical tips to help manage Th cell overactivity and support gut health to improve skin outcomes.

Incorporate Anti-Inflammatory Foods

​A diet rich in anti-inflammatory foods can help regulate Th cell activity by reducing systemic inflammation. Foods high in omega-3 fatty acids, such as salmon, flaxseeds, and chia seeds, have been shown to dampen inflammation and may counterbalance the pro-inflammatory cytokines released by overactive Th cells. Additionally, fruits and vegetables, especially those rich in antioxidants like berries, leafy greens, and turmeric, help protect cells from oxidative stress, further supporting balanced immune responses.

Support Gut Health with Probiotics and Prebiotics

​Promoting a healthy gut microbiome can help regulate Th cell activity by strengthening the gut barrier and reducing the chance of immune overactivation due to leaky gut. Probiotics, which are found in fermented foods like yoghurt, kefir, and sauerkraut, introduce beneficial bacteria that support gut integrity and immune balance. Prebiotics, found in fibre-rich foods like garlic, onions, and asparagus, serve as food for these beneficial bacteria, helping them thrive and maintain a balanced microbiome.

Studies suggest that probiotics can play a role in reducing eczema severity, especially in children, which is a promising avenue for supporting Th cell balance in dermatitis.

Include Nutrients That Support Th Cell Regulation

Certain vitamins and minerals are essential for immune health and can help modulate Th cell activity. Key nutrients include:

• Vitamin D: Known for its role in immune modulation, vitamin D helps regulate Th cell activity, reducing the likelihood of an overactive immune response. Many individuals with eczema and dermatitis have been found to have low levels of vitamin D. Exposure to sunlight or supplementation (as advised by a healthcare professional) can support balanced Th cell responses.
• Zinc: This mineral is important for both immune function and tissue repair, making it essential for those with dermatitis. Zinc-rich foods like pumpkin seeds, chickpeas, and seafood help promote immune balance and skin health.
• Vitamin A: Vital for maintaining the integrity of the skin and gut lining, vitamin A also plays a role in immune regulation. Foods like carrots, sweet potatoes, and leafy greens are rich in vitamin A and can support immune function.

Manage Stress Through Mindfulness and Relaxation Techniques

​Chronic stress increases the production of cortisol, a hormone that can weaken the gut lining and promote inflammation. When stress is prolonged, it may exacerbate leaky gut and increase Th cell activity, leading to heightened immune responses and more frequent dermatitis flare-ups. Engaging in stress management techniques such as mindfulness meditation, yoga, and deep breathing can help reduce cortisol levels, promoting a healthier immune response.
 
Mindfulness-based stress reduction (MBSR) has been shown in studies to decrease inflammatory markers and improve immune regulation, making it a valuable practice for those managing dermatitis. Incorporating these techniques into daily life may help regulate Th cell activity and reduce the severity of skin symptoms.

Get Sufficient, Quality Sleep

Sleep is critical for immune regulation, and poor sleep can disrupt Th cell activity, leading to immune dysregulation and increased inflammation. During deep sleep, the body undergoes repair processes that support gut and skin health, including the maintenance of Th cell balance. Poor sleep, on the other hand, has been linked to increased inflammation and weakened immune defences.
 
Aim for 7–9 hours of restful sleep per night, establishing a consistent sleep routine and creating a calming bedtime environment. Good sleep hygiene practices, such as reducing screen time before bed and keeping the bedroom cool and dark, can improve sleep quality and support immune health.

​T-helper cells are central to the immune response in dermatitis, with their overactivity often contributing to inflammation and symptom flare-ups. By supporting Th cell balance through anti-inflammatory nutrition, gut health support, and lifestyle practices, it’s possible to promote a healthier immune response and alleviate skin inflammation.
 
These dietary and lifestyle practices can be helpful components of a broader dermatitis management plan, especially when personalised for individual needs. Consulting with a Registered Nutritional Therapist can offer tailored guidance to help regulate Th cell activity, manage inflammation, and optimise gut and skin health for long-term relief from dermatitis symptoms.

REFERNECES

​Kim, J., & Ahn, K. (2022). Atopic dermatitis endotypes: knowledge for personalized medicine. In Current Opinion in Allergy and Clinical Immunology (Vol. 22, Issue 3, pp. 153–159). Lippincott Williams and Wilkins. https://doi.org/10.1097/ACI.0000000000000820
Ma, C. S. (2023). T-helper-2 cells and atopic disease: lessons learnt from inborn errors of immunity. In Current Opinion in Immunology (Vol. 81). Elsevier Ltd. https://doi.org/10.1016/j.coi.2023.102298
Wang, A. X., & Xu Landén, N. (2015). New insights into T cells and their signature cytokines in atopic dermatitis. In IUBMB Life (Vol. 67, Issue 8, pp. 601–610). Blackwell Publishing Ltd. https://doi.org/10.1002/iub.1405