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

​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.

​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.

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.

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.

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.

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.

​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.

​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.

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.

​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.

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.

​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
 

The connection between gut health and skin conditions has drawn increased scientific interest, with research spotlighting the “gut-skin axis.” This complex relationship sheds light on why conditions like dermatitis may be worsened by imbalances in the gut, often linked to a condition known as leaky gut, or increased intestinal permeability. Understanding this connection can empower those with dermatitis to explore nutrition and lifestyle strategies that may relieve their symptoms.

​Leaky gut refers to a state where the lining of the small intestine becomes more permeable than it should be. In a healthy digestive system, the gut lining serves as a selective barrier, regulating what enters the bloodstream. However, when this barrier is compromised, larger particles—such as undigested food particles, toxins, and bacteria—can pass through, triggering an immune response. This constant immune activation can lead to chronic, low-grade inflammation, which has been associated with a variety of health issues, including autoimmune conditions and inflammatory skin diseases like dermatitis.

​Leaky gut can contribute to skin inflammation and worsen dermatitis through several mechanisms:

​When particles that shouldn’t be in the bloodstream cross over, it activates the immune system. This chronic, low-grade inflammation can affect various parts of the body, including the skin. For those with dermatitis, this inflammatory response can increase skin irritation and itching.

One mechanism by which leaky gut impacts dermatitis is through T-helper cells, a type of immune cell that becomes overactive in response to foreign particles. This overactivity can lead to increased skin inflammation, as Th cells promote the release of inflammatory compounds. Individuals with dermatitis often show a skewed Th cell response, and leaky gut may exacerbate this immune imbalance, leading to more intense or frequent skin flare-ups.

​The gut is home to a large population of bacteria that help regulate immune health. A leaky gut often goes hand in hand with a microbial imbalance, known as dysbiosis. Studies show that people with dermatitis, like eczema, often have different gut bacteria compositions than those without skin issues, suggesting a connection between gut imbalance and the severity of skin conditions.
 
The gut microbiome, or the collection of trillions of bacteria living in the gut, plays a critical role in maintaining gut health and integrity. A balanced microbiome can help regulate immune responses and support a healthy gut barrier. However, in individuals with leaky gut, there is often an imbalance in gut bacteria, a condition known as dysbiosis. This imbalance may result from dietary choices, antibiotic use, or stress, and it can lead to increased gut permeability and a higher likelihood of immune dysregulation.

​With a more permeable gut, the immune system is exposed to foreign particles more often, leading to heightened immune responses. In atopic dermatitis, a common form of dermatitis, this overactive immune system plays a large role in flare-ups and worsening symptoms.
 
For individuals with dermatitis, leaky gut can influence the skin by shifting the immune system into a more reactive state. This heightened immune response is particularly relevant in dermatitis, which involves an imbalance of immune activity that leads to skin inflammation, dryness, and irritation. When undigested food particles or pathogens pass through the leaky gut wall, they are flagged by the immune system as foreign invaders. The result is a chronic inflammatory reaction that can affect the skin, worsening dermatitis symptoms.

​Studies indicate that people with eczema, a common form of dermatitis, often have less diversity in their gut microbiome compared to those without skin issues. This reduced diversity may weaken the gut lining and increase inflammation. Some research even suggests that promoting a healthy gut microbiome through probiotics and prebiotics can help regulate immune responses and reduce the severity of eczema symptoms, particularly in young children. (1–3)

​Recent studies propose that the liver also plays a role in this connection, as it detoxifies compounds that have entered the bloodstream from the gut. When leaky gut allows more toxins to enter the bloodstream, it can overload the liver, leading to increased inflammation that ultimately affects the skin. This is sometimes referred to as the “gut-liver-skin axis,” and it may further explain how gut health influences skin conditions like dermatitis.

Nutrient deficiencies can worsen leaky gut by weakening the gut barrier, making the skin more susceptible to inflammation. Here’s a closer look at a few key nutrients that play an important role in maintaining a healthy gut and resilient skin:

1. Vitamin D: Known for its role in immune modulation, vitamin D is also essential for maintaining gut barrier integrity. Low levels of vitamin D are associated with increased gut permeability and have been linked to a higher risk of developing autoimmune and inflammatory conditions, including dermatitis.
2. Vitamin A: This fat-soluble vitamin is crucial for maintaining mucosal integrity in both the gut and the skin. Vitamin A deficiency can lead to a compromised gut lining and weaken skin resilience. Dietary sources include liver, carrots, and leafy greens.
3. Zinc: Essential for immune function and tissue repair, zinc helps maintain the structural integrity of the gut lining. Zinc deficiency has been linked to increased gut permeability and inflammation, making it a crucial nutrient for individuals with dermatitis. Zinc-rich foods include pumpkin seeds, chickpeas, and seafood.
4. Omega-3 Fatty Acids: Found in fish and flaxseeds, omega-3 fatty acids help reduce inflammation throughout the body. Studies show that omega-3s may improve skin hydration and barrier function, making them a valuable addition for those with inflammatory skin conditions.
5. L-glutamine: This amino acid is a primary fuel source for the cells lining the gut, known as enterocytes, and plays a role in strengthening the gut barrier. L-glutamine has been studied for its ability to reduce gut permeability, which can benefit those with leaky gut and skin inflammation.

Adding to the above nutrient highlights, here are five practical nutrition tips to further support gut health:

1. Start with a Balanced Diet: A diet rich in whole foods, including vegetables, fruits, lean proteins, and healthy fats, can help support a healthy gut microbiome. Fibre from whole foods feeds beneficial gut bacteria, which helps maintain gut integrity and may reduce systemic inflammation.
2. Incorporate Fermented Foods: Fermented foods such as kefir, kimchi, and sauerkraut contain live cultures that introduce beneficial bacteria to the gut, supporting a balanced microbiome. A diverse microbiome can help regulate immune responses and strengthen the gut lining, which may reduce dermatitis symptoms.
3. Add Bone Broth: Bone broth is rich in collagen and amino acids like glycine and glutamine, which can help repair the gut lining. Including bone broth in your diet can support gut health, potentially reducing inflammation that impacts the skin.
4. Reduce Alcohol and Caffeine: Excessive alcohol and caffeine intake can irritate the gut lining, increasing permeability. Reducing or moderating intake of these substances can support a healthier gut environment and potentially improve skin conditions like dermatitis.
5. Ensure Sufficient Hydration: Adequate hydration is essential for maintaining mucosal barriers and promoting skin hydration. Drinking enough water each day supports the body’s ability to flush out toxins, and staying hydrated can promote gut and skin health.

​In addition to diet, managing stress, getting sufficient sleep, and limiting NSAID and antibiotic use can all help maintain gut integrity and reduce inflammation. Chronic stress, for instance, increases cortisol levels, which can weaken the gut barrier over time. Similarly, restorative sleep supports immune health and skin repair, making it an essential component of a gut-skin-friendly lifestyle.
 
The connection between leaky gut and dermatitis reinforces the idea that good gut health is foundational to skin health. By focusing on gut-supportive nutrition, managing stress, and incorporating lifestyle changes, those with dermatitis may find relief from symptoms and improve skin resilience.
 
Working with a Registered Nutritional Therapist can provide personalised guidance for integrating these practices and ensuring nutrient needs are met to support both gut and skin health

Recent research has increasingly shown how important our gut health is in influencing many aspects of overall well-being, including the risk of developing allergies.
 
A new review has provided insights into how the gut microbiome, essentially the community of bacteria living in our digestive system, might impact allergy risk. It focuses on substances called short chain fatty acids (SCFAs). 
 
SCFAs, such as acetate, propionate, and butyrate, are produced when our gut bacteria break down dietary fibres. These SCFAs are believed to have a protective effect against allergies.
 
What Did the Research Review Find?
 
This comprehensive review looked at studies published up until September 2022 to see how SCFAs are linked to allergies. The researchers analysed data from 37 studies. Out of these, 17 studies focused on SCFA levels during pregnancy or early childhood and their connection to the development of allergies later. The other 20 studies examined SCFA levels in people who already had allergies.
 
Key Takeaways: How SCFAs May Help Prevent Allergies
 
The review found some evidence that SCFAs, especially when present during the early years of life, may help protect against developing allergies. This was most noticeable for conditions like eczema, asthma or wheezing, and certain food allergies in children.
 
However, the protective effects varied depending on the type of allergy and the age at which SCFA levels were measured. This suggests that the relationship between gut health and our immune system is quite complex and requires further research.
 
How Can Nutrition Boost Gut Health and SCFA Production? 
 
Given the growing evidence of the benefits of SCFAs in preventing allergies, it's important to understand how our diet affects gut health and the production of these helpful compounds. Diet is a key player in shaping our gut microbiome, and certain foods can help increase SCFA production and improve overall gut health.
 
The Importance of Fibre-Rich Foods
 
SCFAs are mainly produced when gut bacteria ferment dietary fibres. Foods like whole grains, fruits, vegetables, legumes, nuts, and seeds are rich in these fibres. Specific types of fibres, such as inulin, pectin, and resistant starch, are particularly good at promoting SCFA production.
 
Including a variety of fibre-rich foods in your diet can encourage a diverse gut microbiome, which is linked to higher SCFA levels and potentially a lower risk of allergies. For instance, apples, oats, chicory root, Jerusalem artichokes, and bananas are excellent sources of prebiotic fibres that support healthy gut bacteria.
 
Fermented Foods: Boosting Gut Diversity
 
Fermented foods like yoghurt, kefir, sauerkraut, kimchi, and miso contain live bacteria that can help maintain a healthy gut. These probiotics work alongside dietary fibres to boost SCFA production. Regularly eating fermented foods has been associated with greater diversity in the gut microbiome, which may support SCFA production and overall gut health.
 
The Role of Polyphenols
 
Polyphenols, found in foods such as berries, green tea, and dark chocolate, also play a role in supporting gut health and SCFA production. These plant compounds act like prebiotics or food for the probiotics, by stimulating the growth of beneficial bacteria and enhancing the fermentation process that leads to SCFA production. They also have anti-inflammatory properties, which may further help reduce the risk of allergies.
 
Omega-3 Fatty Acids: Fighting Inflammation and Supporting Gut Health
 
Omega-3 fatty acids, found in fatty fish, flaxseeds, chia seeds, and walnuts, are known for their anti-inflammatory benefits. Emerging research suggests that omega-3s may also positively affect the gut microbiome. While more studies are needed to understand their direct impact on SCFA production, omega-3s are beneficial for gut health and inflammation, which may help prevent allergies.
 
Cutting Back on Processed Foods and Sugars
 
Diets high in processed foods, refined sugars, and unhealthy fats can harm gut microbiota diversity and reduce SCFA production. These types of foods are linked to higher inflammation levels and an increased risk of developing allergies. Focusing on whole, nutrient-dense foods while minimising processed options is essential for supporting gut health and optimising SCFA production.
 
Looking Ahead: More Research Needed
 
While the findings from this review are promising, more research is needed to understand exactly how and when SCFAs provide their protective effects. Figuring out whether certain SCFAs are more beneficial at specific stages of development could lead to new strategies for preventing and managing allergies.
 
There’s exciting potential for SCFAs to be used in future treatments for allergies. However, more detailed studies are needed to clarify which SCFAs are most helpful and how they could be used effectively.
 
Conclusion: A New Path in Preventing Allergies
 
This review highlights the increasing awareness of how our gut health plays a role in developing allergies, particularly through the production of SCFAs. While the evidence suggests SCFAs have a protective role, especially in early childhood, there is still much to learn about their full effects. As research advances, SCFAs may become a key part of preventing and managing allergies, offering new hope for those at risk.
 
By focusing on a balanced diet rich in fibre, fermented foods, polyphenols, and omega-3s, we can support gut health and promote SCFA production. This not only strengthens our gut microbiome but also enhances our overall health, making it a vital part of any strategy to prevent allergies. As this area of research grows, combining dietary changes with new microbiome-based therapies could greatly impact how we manage allergies in the future.
 
To read the review in full, follow this link:  https://pubmed.ncbi.nlm.nih.gov/38391245/

You’ve probably heard that Vitamin D is important, but did you know that it can be critical if you suffer from eczema/dermatitis?  
 
This is why one of the first questions I ask clients is whether they know their Vitamin D3 status.  Do you know yours? 
 
If you want to know more about how vitamin D or the lack thereof might be influencing your skin health, read on. Today’s article covers: 

• What is vitamin D3 and why is it important? 
• How gene variations can have an impact on your Vitamin D levels
• Vitamin D and its specific role in Atopic Dermatitis/Eczema
• How can Vitamin D help if you have dermatitis/eczema? 
• How you can ensure that you are getting enough, whilst being careful to not have too much.

 
What is vitamin D3 and why is it important? 
 
Vitamin D3 starts off as cholecalciferol which we, in the main, absorb through our skin through UVB or sunlight exposure. The cholecalciferol then goes through numerous processes in the liver and kidneys to become what is known as a biologically active form, or a form that our body can easily use, calcitriol.  Vitamin D3 is, in fact, more of a hormone than a vitamin and it acts as a signaller to tell hundreds of genes what to do. 
 
We have Vitamin D Receptors (VDR) throughout our body that are just waiting for the calcitriol to come and bind with them. This binding of the calcitriol and the VDR triggers a cascade of vital bodily processes via genes from bone health and calcium metabolism to inflammation and heart health amongst many others.  
 
Vitamin D is most known for its effects on bone health as it helps calcium and phosphorus be absorbed from the gut, essential for the building and formation of strong bones. Low Vitamin D levels are linked to weak bones (Rickets) in children and osteomalacia (bone softening) in adults. (1)
 
Vitamin D is known to have anti-inflammatory properties, which is very useful if you are prone to inflamed skin as most eczema/dermatitis sufferers are. (2)
 
Vitamin D is thought to be important for heart health including hypertension and also brain health, due to the vast number of VDRs that can be found in brain tissue. (3)
 
How gene variations can have an impact on your Vitamin D levels
 
Gene variations you may have can, in some cases, impact on vitamin D availability or how responsive your receptors are to receiving the calcitriol.  
 
If a client comes to me and says that their Vitamin D3 levels are always low, then I would suspect a genetic variant at play either on the GC gene which controls supply of Vitamin D Binding Protein (VDPR) important for transporting Vitamin D around the body or variances on the VDR gene itself, meaning that receptors are less keen to receive and bind to the  circulating Vitamin D. 
 
Another gene variation linked to Atopic Eczema is filaggrin. Vitamin D influences the production and function of skin proteins including filaggrin, so maintaining your Vitamin D levels if you suffer from atopic dermatitis is especially important. 
 
Nutrigenomics testing can be helpful to see gene variances in relation to things like Vitamin D, inflammation or susceptibility to lactose or gluten intolerance amongst many others. I use Lifecode Gx as they provide a variety of reports that can help me unravel a great deal about an individual’s genes and how they are impacting their skin health. 
 
 
Vitamin D and its specific role in Atopic Dermatitis/Eczema
 
Vitamin D is also vital for the growth and repair of skin cells. It supports your skin barrier, which means that it is more resistant to attacks, and it has anti-inflammatory properties that are, as I’ve already mentioned, crucial for skin conditions like dermatitis and psoriasis. 
 
The interesting thing is that the science is clear. If you have eczema, it is very likely that your Vitamin D test results will show that you are Vitamin D deficient. Atopic Eczema sufferers specifically are more likely to be more Vitamin D deficient than the normal population. Have you tested your levels recently? 
 
How can Vitamin D help if you have dermatitis/eczema? 
 
Research has shown that maintaining vitamin D levels can lead to a significant reduction in eczema symptoms, especially inflammation and infection. This is especially clear in the winter months when exposure to sunlight is so much lower.  Many of my clients report that their skin naturally improves in the summer months. (4)
 
As mentioned above, vitamin D helps keep your skin water and infection ‘tight’ thanks to its action on filaggrin, amongst other skin proteins. If your skin is ‘leaky’ you are more at risk of infection or even allowing a contact allergen to trigger a flare.  A healthy skin barrier helps retain moisture as well, and we all know how much moisture a dermatitis sufferer needs to retain ! (5)
 
How you can ensure that you are getting enough, whilst being careful to not have too much.
 
As you may have noticed throughout the article, an optimal (serum) level of Vitamin D3 is vital for health but is also critical for skin health and eczema.  
 
Good sources of Vitamin D3 include: 

• Sunlight – the best and most convenient way of getting natural vitamin D3. Get out into sunlight daily and try to get about 20 minutes sun exposure on bare skin. Ensure that you don’t stay out long enough to suffer a burn. 
• Diet – foods including oily fish (salmon, sardines, mackerel, herrings etc) are good sources of vitamin D. So are fortified foods and egg yolks. The humble mushroom can also be a good source, especially if they’ve been left on a sunny windowsill where they have had their own levels boosted. 
• Supplements - the recommended daily intake varies by age, health status and daily exposure to sunlight, but the UK Government recommends 100 micrograms or 4,000 IU for a healthy adult, per day during the winter months. My advice would be to check with your health or nutrition practitioner to see which dosage is best for you as an individual and to always take a break from supplementing during the summer months. 

 
It is important to note that more is not necessarily better. Too much Vitamin D, specifically from supplementation, can be dangerous for your health. If in any doubt check with a health or nutrition practitioner and test to see where your starting levels are. 

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References. ​
 

1. Charoenngam N, Holick MF. Immunologic effects of vitamin d on human health and disease. Nutrients. 2020;12(7):1–28. 
2. Murdaca G, Gerosa A, Paladin F, Petrocchi L, Banchero S, Gangemi S. Vitamin d and microbiota: Is there a link with allergies? Int J Mol Sci. 2021;22(8):1–18. 
3. Mirarchi A, Albi E, Beccari T, Arcuri C. Microglia and Brain Disorders: The Role of Vitamin D and Its Receptor. Int J Mol Sci. 2023;24(15). 
4. Kim MJ, Kim SN, Lee YW, Choe YB, Ahn KJ. Vitamin D status and efficacy of vitamin D supplementation in atopic dermatitis: A systematic review and meta-analysis. Nutrients. 2016;8(12):8–17. 
5. O’Regan GM, Sandilands A, McLean WHI, Irvine AD. Filaggrin in atopic dermatitis. J Allergy Clin Immunol. 2008;122(4):689–93. 

Mast Cell Activation Syndrome (MCAS) is a complex condition that has been gaining attention in the medical community for its role in a variety of symptoms and diseases, including skin conditions such as eczema and dermatitis. (1–3)
 
This article aims to shed light on what MCAS is, how it’s diagnosed, its connection to skin conditions and potential management strategies. 
 
What is MCAS? 
 
MCAS is a condition where mast cells, a type of white blood cell that play a crucial role in the body’s immune response, behave abnormally, triggering immune related symptoms. 
 
Mast cells play a pivotal role in the management of inflammatory responses, acting as the defensive guardians against pathogens. These cells are found in tissues throughout the body, especially where the body is exposed to contact with foreign bodies, such as the skin, lungs, and digestive tract. 
 
When mast cells detect a foreign substance or an injury they release a variety of different chemical signals including histamine, cytokines, and growth factors, which are all part of the body’s defence systems.  This is normal and what keeps us healthy. 
 
Normally, mast cells help protect the body from disease and aid in wound healing but in MCAS these cells are overly sensitive and release too many of these chemicals leading to a range of symptoms that can affect every part of the body, including the skin, gastrointestinal, cardiovascular, respiratory and neurological systems. Long COVID is also thought to involve aspects of MCAS. 
 
Symptoms and Diagnosis
 
The range of symptoms involved in MCAS are vast and can vary significantly from one individual to another. Reported symptoms include: flushing, itching, urticaria (hives), stomach pain, nausea, vomiting, diarrhoea, low blood pressure, headaches and breathing issues. The severity of symptoms can range from mild to life-threatening. 
 
As you can tell these are symptoms that can overlap with many other conditions making diagnosis tricky. Officially there are three sets of criteria needed for MCAS diagnosis: 

1. Severe, recurrent symptoms of mast cell activation in at least two organ systems.
2. Laboratory proof that mast cell levels are high
3. Response to mast cell mediator targeting therapy such as antihistamines. 

 
The MCAS, Dermatitis Connection
 
The skin is one of the organs most commonly affected by MCAS and dermatitis (atopic, contact and urticaria) is the most common skin illness linked to this condition.  
 
Dermatitis, characterised by inflammation of the skin, can be exacerbated by the overactive release of histamine and other chemicals from mast cells, leading to redness, itching, and swelling, all symptoms so characteristic of this chronic skin condition.  
 
The different types of eczema/dermatitis have multifactorial root causes including genetic, environmental and immune system factors. The link between MCAS and dermatitis is found within the immune system, particularly in how mast cells can over secrete the chemicals that can exacerbate an existing flare or trigger a new one. A combination of MCAS with chronic, relapsing dermatitis can cause misery for sufferers. 
 
Histamine, one of the most well-known mediators released by mast cells, is involved in immediate allergic reactions and plays a significant role in vasodilation or increased blood flow, and recruitment of other immune cells to the site of injury or infection. If you are interested in learning more about histamine, I have written a series of 5 articles relating to histamine, which can all be found via my website.
 
Understanding the role of mast cells in immune responses and their contribution to conditions like MCAS and dermatitis underscores how intertwined both the immune system and skin health is. What is important to bear in mind is the need for support that may modulate mast cell activity but also alleviate the dermatitis symptoms. 

Management strategies for MCAS-Related Dermatitis
 
Managing diagnosed MCAS and dermatitis needs a rounded approach that takes into account both the overactive mast cells and the dermatitis symptoms. Here are some tips that may help: 

• Identification and avoidance of triggers. Keep a food, environment and symptom diary. Monitor what appears to be triggering your own personal symptoms. These could be foods, alcohol, temperature change, stress or many other things. 
• Diet and nutrition. Keeping your histamine levels low by following a lower histamine diet can be helpful for some. However, eliminating too many foods can lead to further restrictions and can be problematic in the long term. If you want to follow an elimination diet please work with a nutrition or health practitioner. 
• Stress management. Stress is a major mast cell trigger, so keeping your stress levels low is vital. Think about incorporating a daily meditation or yoga practice or even making time to do a hobby that brings you joy. 

 
In summary, MCAS is a multifaceted condition that can significantly impact the physical and mental wellbeing of affected individuals.  Having a medical diagnosis that then provides an appropriate treatment plan that alleviates symptoms is important, however, understanding the root cause of the hyper-activation be it food, environmental, lifestyle factors or stress is vital for long-term health.
 
References. 
 

1. Mihele DM, Nistor PA, Bruma G, Mitran CI, Mitran MI, Condrat CE, et al. Mast Cell Activation Syndrome Update—A Dermatological Perspective. J Pers Med. 2023;13(7). 
2. Frieri M. Mast Cell Activation Syndrome. Clin Rev Allergy Immunol [Internet]. 2018;54(3):353–65. Available from: https://doi.org/10.1007/s12016-015-8487-6
3. Theoharides TC, Perlman AI, Twahir A, Kempuraj D. Mast cell activation: beyond histamine and tryptase. Expert Rev Clin Immunol [Internet]. 2023 Jun 3;19(6):639–54. Available from: https://doi.org/10.1080/1744666X.2023.2200936

 

 Sign up for my news to receive the published articles straight to your inbox. 
Read more by clicking below to see my previously published articles: 
 

• Motivated to change but struggling to stay on track? Tips for long term transformation.

• Symptoms but no idea what’s triggering them? Here are some tips to unravel the mystery.  
• Top Tips for Eating for the Planet without Compromising Your Nutrition 
• I want to eat more plant-based but pulses give me terrible digestive issues
• What is the atopic march?
• Why is eczema/atopic dermatitis itchier at night?
• You’ve been diagnosed with an atopic condition, but what does that mean? 
• Atopic dermatitis/eczema – a chronic condition that effects all ages 
• The skin microbiome, the key to good skin health  
• Autumnal Allergies – Yes, it is a thing
• If one-size-fits all diets worked, don’t you think we would have the magic formula by now?
  
  

Who Am I? 
I’m Jessica Fonteneau, the Eczema and Digestive Health Nutrition Expert. I’ve worked with hundreds of clients to help them change their diets, better manage their flares, and find relief.
 
My vocation is to help those with eczema and digestive issues, because I have suffered with these interlinked conditions since I was 6 months old, and I truly know what it is like to experience these debilitating conditions. 
 
Every client I have ever worked with has their own triggers and ideal nutrition. There is no such thing as ‘one-size-fits-all’. Whether you work with me one-to-one or use my guided tools, my objective is to help you uncover what works best for you, so that you take back control and experience relief. 
 
My guided programmes are only suitable for adults as children have very specific nutrition requirements. I do, however, work with many child clients as part of my clinic. 
 
I also offer two free communities for adults caring for children with eczema and digestive symptoms, feel free to come and join us and get some well-deserved support. 
 

• Free community for adults with skin and/or digestive issues
• Free community for carers of children with skin and/or digestive issues

 
To easily keep up with my articles, masterclasses, ebooks and online programmes and receive exclusive access to early bird offers, sign-up to my newsletter.  
 
Interested in what I do and who I am? Go to my website: www.jessicafonteneaunutrition.com
 

As I look out the window and watch the endless, pouring rain, I think of a dermatitis trigger that loves this type of weather, mould.  

There have been quite a few truly tragic stories in the media over the past year, highlighting the devastating impact mould can have on health, particularly in relation to respiratory conditions, but did you even consider whether mould might be triggering your dermatitis flare? 
 
In this blog post, I’ll delve into the intricate relationship between mould exposure and dermatitis and explore ways to reduce the risks. 
 
A short mould overview. 
​
Mould refers to a type of fungus that thrives in damp and humid environments, basically the UK. Common indoor moulds include Aspergillus, Fusarium Stachybotrys chartarum and Clasporium Herbarum.  Stachybotrys chartaruium and Clasporium Herbarum are visible as black mould, but some other moulds are practically invisible to the naked eye.  
 
Mould tends to develop in areas that are out of sight. Just this week, I had a message from a client who said “you know you were questioning me around mould, and I said that there absolutely wasn’t any in my home? Well, we’ve just changed the floor in our kitchen and guess what we found under the lino”. 
 
Moulds, including the infamous black mould, thrive in damp environments such as kitchens, basements, and bathrooms. They can grow on various surfaces, including paper, wood, and fabrics. When mould touches the skin, or when individuals with a mould sensitivity inhale the spores, it can trigger different types of skin rashes characterized by redness, itching, swelling, and sometimes small bumps or blisters.
 
Dermatitis, what does it encompass? 
Dermatitis is a broad term encompassing a whole host of skin conditions from Atopic Eczema to contact dermatitis and even Cutaneous Aspergillosis a skin condition directly linked to the Aspergillus mould.
 
The Mould/Dermatitis Connection
Research has shown a compelling connection between mould exposure and development or worsening of dermatitis symptoms.  
 
People who live or work in damp environments with high mould concentrations have been observed to be more susceptible to skin issues.  It is believed that contact, either directly or via minute mould spores landing on the skin or being breathed in, can trigger inflammation that leads to the symptoms so common in dermatitis or eczema: red patches, itching and often pain. 
 
The most common types of dermatitis linked to mould are: 

• Atopic Dermatitis/Eczema. Mould spores acting as allergens provoke an immune response that result in the characteristic inflamed, itchy skin. 
• Contact dermatitis. Those with occupations putting them in close contact with mould such as building work or agriculture, can be at higher risk. 
• Seborrheic dermatitis. The mechanisms are unclear, but some evidence points to the fact that a microscopic fungus, Malassezia, may contribute to its development. 

 
Mycotoxins

Mycotoxins are toxic compounds produced by some mould species and which add another complex layer to the mould/dermatitis connection. These substances can enter the body through inhalation, ingestion, or skin contact. When mycotoxins come into direct contact with the skin, they can disrupt the skin barrier function, leading to increased permeability or leaky skin and higher risk of skin irritations.  Mycotoxins have been found to trigger rosacea, eczema and even acne. 
 
Immune Response

As previously touched on, both mould and mycotoxin exposure can trigger an immune response, leading to both inflammation and skin reactions. Whilst dermatitis isn’t considered an autoimmune condition, the constant igniting of the immune response is tiring for the body and can lead, in turn, to increased susceptibility to infections and inflammation.  An exhausting vicious cycle. 
 
Diagnosis

If you suspect that mould is triggering your skin, then you should go and see your GP for a diagnosis. Blood tests, finger-prick or patch testing can determine whether mould is an issue for you. 
 
Common medical treatments include over-the-counter antihistamines and cortisone creams. 
 
Nutrition practitioners also have access to some functional tests which may be useful. 
 
Tips for Prevention

If you have recurrent dermatitis and are at a loss as to why it is constantly triggered, then it may be worth exploring whether mould might be a cause: 

• Ensure that your home is properly ventilated to allow airflow that discourages the development of damp. 
• Consider using a dehumidifier, particularly in the winter months.
• Check your home for any hidden leaks and explore under flooring. As my client can testify, mould can appear in the most unexpected places.
• Minimise drying clothes on a radiator as it raises the humidity in a room. If you have no choice, consider running a dehumidifier at the same time. 
• Clean regularly, especially behind pieces of furniture where mould can develop without you even realising it. 

 
Sign up for my news to receive the published articles straight to your inbox. 
Read more by clicking below to see my previously published articles: 
 

• Motivated to change but struggling to stay on track? Tips for long term transformation.

• Symptoms but no idea what’s triggering them? Here are some tips to unravel the mystery.  
• Top Tips for Eating for the Planet without Compromising Your Nutrition 
• I want to eat more plant-based but pulses give me terrible digestive issues
• What is the atopic march?
• Why is eczema/atopic dermatitis itchier at night?
• You’ve been diagnosed with an atopic condition, but what does that mean? 
• Atopic dermatitis/eczema – a chronic condition that effects all ages 
• The skin microbiome, the key to good skin health  
• Autumnal Allergies – Yes, it is a thing
• If one-size-fits all diets worked, don’t you think we would have the magic formula by now?
  
  

Who Am I? 
I’m Jessica Fonteneau, the Eczema and Digestive Health Nutrition Expert. I’ve worked with hundreds of clients to help them change their diets, better manage their flares, and find relief.
 
My vocation is to help those with eczema and digestive issues, because I have suffered with these interlinked conditions since I was 6 months old, and I truly know what it is like to experience these debilitating conditions. 
 
Every client I have ever worked with has their own triggers and ideal nutrition. There is no such thing as ‘one-size-fits-all’. Whether you work with me one-to-one or use my guided tools, my objective is to help you uncover what works best for you, so that you take back control and experience relief. 
 
My guided programmes are only suitable for adults as children have very specific nutrition requirements. I do, however, work with many child clients as part of my clinic. 
 
I also offer two free communities for adults caring for children with eczema and digestive symptoms, feel free to come and join us and get some well-deserved support. 
 

• Free community for adults with skin and/or digestive issues
• Free community for carers of children with skin and/or digestive issues

 
To easily keep up with my articles, masterclasses, ebooks and online programmes and receive exclusive access to early bird offers, sign-up to my newsletter.  
 
Interested in what I do and who I am? Go to my website: www.jessicafonteneaunutrition.com
 

Foods, ingredients, or molecule intolerances appear to be on the rise and whilst some such as gluten or histamine are well known, others, such as salicylates, are more misunderstood. This article will delve into this lesser-known phenomenon exploring: 

• What are salicylates and what is salicylate intolerance? 
• Which symptoms are linked to salicylate intolerance? 
• What does the science say causes this condition? 
• How is salicylate intolerance diagnosed? 
• Suggestions on how to manage a suspected salicylate intolerance.

 
What are salicylates and what is a salicylate intolerance?  
 
Salicylates are natural chemicals found in many plants who use them to defend themselves against pests, bacteria, and environmental stressors. Salicylates are anti-inflammatory and as such have also been synthetically reproduced in laboratories for uses in medications, including aspirin and non-steroidal anti-inflammatories (NSAIDs) such as ibuprofen. 
 
Salicylic acid has excellent anti-fungal and anti-bacterial properties, leading to its common use as an ingredient in processed foods, condiments, cosmetics, and beauty products. 
 
In terms of food, salicylates are found in many plant foods to a higher or lesser extent. Some of the foods that are common triggers are: 

• Berries (especially strawberries), grapes, oranges, and apples
• Tomatoes, peppers, and broccoli 
• Cinnamon, curry powder and chili powder
• Almonds and peanuts
• Tea, coffee, and some fruit juices

 
Salicylate intolerance is where a person’s system has difficulty metabolising and tolerating salicylates, leading to a range of symptoms.  The phenomenon was initially observed in medically diagnosed patients with either aspirin-exacerbated respiratory disease (AERD) or NSAIDs-exacerbated respiratory disease (NERD) (1,2).   In the cases of both AERD and NERD, high doses of chemical salicylates can trigger asthma, rhinosinusitis and urticaria.  
 
Clinical case studies have observed that for some, simply eating a diet high in salicylates can contribute to a variety of symptoms, although this can vary from person to person and may also depend on the quantity of salicylates eaten or exposed to over a short period of time. 
 
Which symptoms are linked to salicylate intolerance? 
 
Whilst respiratory and skin symptoms are the most recognised symptoms of salicylate intolerance, there are others including: 

• Digestive issues: stomach pain, bloating, wind, diarrhoea
• Headaches
• Behavioural changes including irritability, restlessness or difficulty concentrating.
• Joint pain and swelling, similar to arthritis symptoms. 
• Fatigue. Both chronic fatigue and low energy levels are often described.
• Anaphylaxis. Whilst extremely rare, severe allergic reaction has been reported. 

 
What does the science say causes this condition? 
As with so many conditions, the exact cause of salicylate intolerance is not well understood, however there are some areas which are being explored: 

• Inability to metabolise or detoxify salicylates properly. 
• Genetic SNPs. Some studies have identified modifications on genes (SNPs) including on CYP2C9, NAT2 and UGT1A6 which might indicate a susceptibility to salicylate intolerance. (3,4)
• Overexposure from food, medical or topical sources can lead to symptoms.
• Underlying health conditions. It is thought that some health conditions including irritable bowel syndrome (IBS), intestinal permeability (leaky gut) or Inflammatory Bowel Disease (IBD) may increase the risk of salicylate intolerance, however it may also be the salicylate intolerance which triggers the health conditions. Further studies are needed to explore this. (5,6)

 
How is salicylate intolerance medically diagnosed? 
Diagnosis of salicylate intolerance is tricky, mainly because of the number of overlapping symptoms with other conditions.  A medical or nutrition practitioner will undertake: 

• A review of your symptoms and medical history. Could your symptoms be linked to other conditions e.g., IBS, food allergies, auto-immune conditions?
• A dietary analysis. Keeping a food and symptom diary can help identify common food triggers. A nutrition professional can use that information to evaluate whether salicylates may be a cause.  
• Challenge testing. If your medical practitioner suspects AERD or NERD then challenge testing may be undertaken within a hospital setting. 

 
For many, a salicylate intolerance is linked to other conditions or genetics and is not, itself, the root cause.  Sufferers tend to go heavily down the elimination root, which whilst does initially provide relief, is not a sustainable or healthy long-term solution. Working with a practitioner to discover the main trigger of the sensitivity is key. 
 
Suggestions for managing a suspected salicylate intolerance.

1. Review your diet by using a food and symptom diary. (you can download one FREE below). Note, that if you are reacting to everything then you need to work with a professional to find the route cause rather than starting to eliminate foods as the foods aren’t the actual issue.
2. Complete this quiz to see whether salicylates rather than histamines might be a trigger for you. 
3. Consider adopting a low salicylate diet. If you plan on changing your diet, you should consult with a healthcare or nutrition practitioner.  A low salicylate diet shouldn’t be followed for more than 3 weeks as it could lead to nutrient deficiencies. 
4. Pay attention to the ingredients of the foods you eat. Check the food labels. Many processed foods, condiments and sauces contain salicylates. 
5. What gene SNPs may you have that could contribute to a salicylate intolerance? How efficient are your detoxification pathways?  
6. Many over the counter medications are based on salicylic acid, so check with your pharmacist.
7. Skin and personal care products often contain salicylates. Try to choose those that are salicylate free. If in any doubt, contact the manufacturer. 
8. Lifestyle and emotions can influence how well a person can tolerate things. Get regular exercise and manage stress and relaxation. 

 
If on medication, please speak to your GP/consultant before making any changes to your diet. 

 
Sign up for my news to receive the published articles straight to your inbox. 
 
Read more by clicking below to see my previously published articles: 
 

• Motivated to change but struggling to stay on track? Tips for long term transformation.

• Symptoms but no idea what’s triggering them? Here are some tips to unravel the mystery.  
• Top Tips for Eating for the Planet without Compromising Your Nutrition 
• I want to eat more plant-based but pulses give me terrible digestive issues
• What is the atopic march?
• Why is eczema/atopic dermatitis itchier at night?
• You’ve been diagnosed with an atopic condition, but what does that mean? 
• Atopic dermatitis/eczema – a chronic condition that effects all ages 
• The skin microbiome, the key to good skin health  
• Autumnal Allergies – Yes, it is a thing
• If one-size-fits all diets worked, don’t you think we would have the magic formula by now?
  
  

Who Am I? 
I’m Jessica Fonteneau, the Eczema and Digestive Health Nutrition Expert. I’ve worked with hundreds of clients to help them change their diets, better manage their flares, and find relief.
 
My vocation is to help those with eczema and digestive issues, because I have suffered with these interlinked conditions since I was 6 months old, and I truly know what it is like to experience these debilitating conditions. 
 
Every client I have ever worked with has their own triggers and ideal nutrition. There is no such thing as ‘one-size-fits-all’. Whether you work with me one-to-one or use my guided tools, my objective is to help you uncover what works best for you, so that you take back control and experience relief. 
 
My guided programmes are only suitable for adults as children have very specific nutrition requirements. I do, however, work with many child clients as part of my clinic. 
 
I also offer two free communities for adults caring for children with eczema and digestive symptoms, feel free to come and join us and get some well-deserved support. 
 

• Free community for adults with skin and/or digestive issues
• Free community for carers of children with skin and/or digestive issues

 
To easily keep up with my articles, masterclasses, ebooks and online programmes and receive exclusive access to early bird offers, sign-up to my newsletter.  
 
Interested in what I do and who I am? Go to my website: www.jessicafonteneaunutrition.com
 
References: 

1. Skypala IJ, Williams M, Reeves L, Meyer R, Venter C. Sensitivity to food additives, vaso-active amines and salicylates: A review of the evidence. Clin Transl Allergy. 2015;5(1):1–11. 
2. Kęszycka PK, Lange E, Gajewska D. Effectiveness of personalized low salicylate diet in the management of salicylates hypersensitive patients: Interventional study. Nutrients. 2021;13(3):1–14. 
3. Park SM, Park JS, Park HS, Park CS. Unraveling the genetic basis of aspirin hypersensitivity in asthma beyond arachidonate pathways. Allergy, Asthma Immunol Res. 2013;5(5):258–76. 
4. Palikhe NS, Kim SH, Nam YH, Ye YM, Park HS. Polymorphisms of Aspirin-Metabolizing enzymes CYP2C9, NAT2 and UGT1A6 in Aspirin-Intolerant urticaria. Allergy, Asthma Immunol Res. 2011;3(4):273–6. 
5. Raithel M, Baenkler HW, Naegel A, Buchwald F, Schultis HW, Backhaus B, et al. Significance of salicylate intolerance in diseases of the lower gastrointestinal tract. J Physiol Pharmacol [Internet]. 2005;56 Suppl 5:89–102. Available from: http://europepmc.org/abstract/MED/1624719
6. Tuck CJ, Malakar S, Barrett JS, Muir JG, Gibson PR. Naturally-occurring dietary salicylates in the genesis of functional gastrointestinal symptoms in patients with irritable bowel syndrome: Pilot study. JGH Open. 2021;5(8):871–8. 

 ​

The trees begin to lose their leaves, and you sigh a great sigh of relief thinking that the hay fever and seasonal allergies season is finally over. Then you realise that you are still getting symptoms – itchy eyes, runny nose, a dermatitis flare. It is very possible and even probable that you are suffering from Autumnal allergies. 
 
TV adverts and magazine articles would have you think that hay fever and seasonal allergies only happen in the spring and summer, but that isn’t the case.  Autumn brings its own set of allergens ready to trigger a runny nose, atopic dermatitis, and itchy eyes. If it isn’t plant pollen, what are the autumnal triggers that can cause so many issues? 
 
Weed pollen, mould spores and house mites are the most common triggers for Autumnal allergies, read on to find out more details and to get my 5 tips to lessen the autumnal allergy symptoms.
 
Weed Pollen 
 
Not all pollen producing plants flower in spring.  A whole category of weeds flower in the autumn and produce the highly allergenic weed pollen. These plants usually flower from late August until the first frost (usually around the end of November but growing later with climate change). This category of plants includes common weeds found in the UK such as nettles and sorrel but also varieties that are much newer to the UK and Europe such as the American Ragweed. Not only is ragweed a recent invader, but it also produces one of the highest amounts of pollen, causing uncomfortable hay fever and dermatitis symptoms in many sufferers.  
 
Mould Spores
 
Mould is around us all the time, but at this time of year levels peak with the falling leaves gently composting on the ground releasing large amounts of allergenic spores.  These are the main types of mould which have been highlighted as being triggers for allergy symptoms: 
 
Cladosporium Herbarum – this is a black mould that you can sometimes be found on bathroom walls or in a fridge, but it is also found on rotting vegetation. This is the considered the most allergenic of the moulds as it is easily airborne and so can spread quickly. 
 
 
Penicillium Notatum – found in decomposing leaves and soil. This mould is also the type you find on food that is going off eg. bread and fruit. 
 
Alternaraia Alternata – mainly found in rotting wood and therefore, forests, but can also be present on food and textiles. 
 
Dust Mites
Many sufferers of asthma, eczema or hay fever also have a dust mite allergy and whilst dust mites exist all year, reactions tend to peak in autumn as the weather becomes damp but remains relatively warm and we retreat inside and close our doors and windows, but we haven’t yet put our heating on. 
 
5 Tips to Lesson the Autumnal Allergy Symptoms

• Avoid stomping through fallen leaves as the movement will shake up any pollen or mould spores.
• Mould spores like the damp, so ensure your home is well ventilated and consider furnishings that can be easily wiped or washed.
• Check your property for any signs of damp or mould and consider purchasing some dehumidifiers for some of the less well-ventilated areas of your home and/or the bedrooms
• Avoid drying your washing on radiators as this drastically increases the amount of humidity in the air. 
• Remember to clean your fridge regularly as mould often builds in the more hard-to-reach shelves

 
If you were interested in this article, you may be interested in these other blogs I’ve previously published: 
 
Sign up for my news to receive the published articles straight to your inbox. 
 
Read more by clicking below to see my previously published articles: 

• Motivated to change but struggling to stay on track? Tips for long term transformation.

• Symptoms but no idea what’s triggering them? Here are some tips to unravel the mystery.  
• Top Tips for Eating for the Planet without Compromising Your Nutrition 
• I want to eat more plant-based but pulses give me terrible digestive issues
• What is the atopic march?
• Why is eczema/atopic dermatitis itchier at night?
• You’ve been diagnosed with an atopic condition, but what does that mean? 
• Atopic dermatitis/eczema – a chronic condition that effects all ages 
• The skin microbiome, the key to good skin health  
• If one-size-fits all diets worked, don’t you think we would have the magic formula by now? 
  
  

Who Am I? 
I’m Jessica Fonteneau, the Eczema and Digestive Health Nutrition Expert. I’ve worked with hundreds of clients to help them change their diets, better manage their flares, and find relief.
 
My vocation is to help those with eczema and digestive issues, because I have suffered with these interlinked conditions since I was 6 months old, and I truly know what it is like to experience these debilitating conditions. 
 
Every client I have ever worked with has their own triggers and ideal nutrition. There is no such thing as ‘one-size-fits-all’. Whether you work with me one-to-one or use my guided tools, my objective is to help you uncover what works best for you, so that you take back control and experience relief. 
 
My guided programmes are only suitable for adults as children have very specific nutrition requirements. I do, however, work with many child clients as part of my clinic. 
 
I also offer two free communities for adults caring for children with eczema and digestive symptoms, feel free to come and join us and get some well-deserved support. 

• Free community for adults with skin and/or digestive issues
• Free community for carers of children with skin and/or digestive issues

 
To easily keep up with my articles, masterclasses, ebooks and online programmes and receive exclusive access to early bird offers, sign-up to my newsletter.  
 
Interested in what I do and who I am? Go to my website: www.jessicafonteneaunutrition.com
 
 

Every so often a new health buzz word emerges. The new “thing” that, once resolved, will, theoretically, solve everything.  
 
From the questions I get within my community forums or from clients, histamine seems to be the current molecule of interest, particularly in relation to skin, gut and autoimmune issues, but does it deserve this notoriety?  
 
There is a lot to unpick regarding histamine, so I have divided the topic into 5 separate articles. The first is published below and the next four will follow over the next month, so keep watching this space or sign-up for my emails to receive the articles direct to your inbox: 

1. What is the histamine and eczema/dermatitis link?
2. What is the histamine and gut health link? 
3. What is the histamine and auto-immune conditions link? 
4. Histamine and oestrogen – why histamine may trigger skin and gut issues at the menopause.
5. Histamine Intolerance is it really a thing? 

 
What is the histamine and eczema/dermatitis link? 
Today’s article covers: 

• What is histamine? 
• Histamine and the immune system, how does it work? 
• Histamine and eczema, what’s the link? 
• Which eczema types are most linked to histamine.
• My top tips for managing histamine as an eczema/dermatitis trigger.

 
What is histamine? 
 
Histamine is a neurotransmitter, produced by mast cells, found throughout the body, but specifically in the skin, respiratory system, and the gastrointestinal tract, but also by basophils, a type of white blood cell which is involved in an immune reaction. 
 
Histamine is mostly known for its involvement in the immune response cascade (one reaction, causing the next and so on).  This neurotransmitter is directly responsible for itching, redness and swelling (inflammation) but is also involved in numerous other processes including stomach acid, contraction of smooth muscle (muscles involved with respiration and digestion amongst others), and the dilation of blood vessels. 
 
Whilst histamine, the neurotransmitter, is the main driver, there are four different types of histamine receptors (H Receptors) which determine the type or location of a histamine response. (2,3)

• H1 receptors are linked to anaphylactic shock and shortness of breath, the most dangerous of all allergic reactions. However, on the flipside, H1 receptors also involve histamine in sleep-wake cycles, body temperature regulation, emotions, especially anger (think of that momentary hot flush), memory, and learning.  Most histamine related skin reactions are linked to this first category of H receptors.

• H2 receptors are mainly found in the digestive tract and heart and can be linked to stomach acid, low blood pressure, rapid heart rate and headaches.
• H3 receptors manage histamine release from mast cells and neurons within the brain and can be linked to mood via dopamine, serotonin, noradrenaline, and acetylcholine. 
• H4 receptors are found in bone marrow and are linked to the production of red blood cells, but also inflammatory disorders and autoimmune conditions. 

 
Histamine and the immune system, how does it work? 
 
When the body encounters an allergen, be it environmental (pollen or dust mites, for example) or food (e.g., gluten, dairy etc.) the immune system responds by producing immunoglobulin E (IgE) antibodies which bind to mast cells and basophils which then trigger the release of histamine. 
 
Histamine release makes blood vessels dilate resulting in blood rushing to the area and leading to the common signs of inflammation: redness, itching and swelling. 
 
Histamine is also involved in the inflammatory response when tissue (or skin) is damaged or infected, causing the blood vessels dilate, drawing blood flow and delivering white blood cells to the damaged area which then help to fight off possible infection.
 
Histamine and eczema/dermatitis – what is the link? 
 
Atopic Eczema alone affects an estimated 20% of children and 10% of adults in the Western world (1), which is an absolutely massive number of people.  If you suffer from any type of eczema/dermatitis you already know that it is a chronic inflammatory skin condition that can be dry, itchy, and inflamed, all symptoms linked to a histamine response. 
 
Most researchers agree that there is a link between histamine and eczema/dermatitis. Histamine triggers inflammation, causing itchiness, redness, swelling and testing has identified that individuals suffering from an eczema/dermatitis flare, have high levels of histamine. What is less clear is what the specific connection is. In other words, just as no two eczema/dermatitis sufferers appear to have the same triggers, the histamine connection may be different for everyone.  
 
In terms of current and recent research, the following three links have been specifically examined: 

1. Whether it triggers eczema/dermatitis in the first place.

1. Whether it only plays a role in exacerbating and maintaining a flare which has already been triggered.
2. Both.

 
Research suggests that histamine’s role in eczema/dermatitis may go beyond its inflammatory role.  Evidence has been found that it may contribute to the breakdown of the skin barrier, resulting in ‘Leaky Skin’, making skin less able to retain moisture and act as a protection against irritants.  This means that potential allergens and irritants cross into the body more easily, triggering an immune response. 
 
Exploring the eczema types most linked to histamine.
 
As we already know, not all eczema/dermatitis is alike, which means that not all types will necessarily have a histamine link, but those that are include:  

• Atopic eczema/dermatitis. This, the most common type of eczema, is associated to allergies and asthma and so it makessense that histamine is linked to this type. However, whilst histamine plays a role in exacerbating symptoms, it isn’t the only driver, other possible causes are low vitamin D status, a SNP on the Filaggrin gene, a poor gut microbiome, amongst others. To learn more about Atopic Eczema/Dermatitis specifically, you can read the linked article.

• Contact dermatitis. Contact dermatitis occurs when the skin comes into direct contact with an allergen or irritant, which can cause an inflammatory response involving histamine. Some of the main triggers for this type of eczema include metals eg. nickel, fragrances, cosmetics, latex, and some plants. 
• Urticaria (hives). Urticaria or hives are raised, itchy welts that appear on the skin and histamine is the main causes of this type of skin reaction. Hives can resolve quickly (which is generally considered less than six weeks) or can persist chronically, for a significant period.
• Prurigo Nodularis. This is a chronic (long-lasting) skin condition which comes up as extremely itchy lumps. Whilst the cause of Prurigo Nodularis is still unknown, histamine has been identified as being linked to the extreme itching individuals suffer.   

 
In summary, here are my 7 top tips for managing histamine as a trigger for eczema/dermatitis: 

1. Identify and avoid triggers. Use a food/environment and symptom diary to log reactions and help identify your own patterns and triggers. You can either use a form or your own diary/journal. Keeping track is essential. 
2. Adopt a low-histamine diet by avoiding some foods that are particularly high in histamine. Some of these foods include aged cheeses, fermented foods, processed meats, alcohol, tomatoes, spinach, and some types of fish.  Complete the histamine quiz here to see if you can identify whether high histamine foods may be an issue for you.
3. Avoid histamine-releasing foods. Whilst some foods aren’t high in histamine, they can trigger a histamine release from the body. These include citrus fruits, strawberries, chocolate, and nuts. Be wary about eliminating too much from your diet as you can make things worse, consider consulting with a nutrition professional. 
4. Support gut health. Histamine is metabolised and broken down in the gut, so the healthier your gut the less likely you are to be affected by histamine.  Consider adding probiotics and prebiotics to your diet. However, careful! Many foods considered good for the gut e.g., kefir and sauerkraut, can trigger histamine flares, so start small and increase rather than going all in immediately.
5. Enzyme supplements. DAO (diamine oxidase) is the enzyme responsible for breaking down histamine in the gut. Taking this supplement before a histamine rich meal may help people with naturally low levels of this enzyme, digest histamine foods better. As before, it is always better to consult with a nutrition practitioner before starting any supplementation.
6. Stress management. Did you know that stress and anxiety can trigger histamine? Include daily stress management techniques to keep yourself calm such as meditation, low impact exercise or hobbies that make your heart sing. 
7. Find out how your genetics may impact your relationship with histamine. The Lifecode Gx Histamine Intolerance test analyses the genes and nutrients needed to breakdown and remove histamine, showing where disruptions occur and how to support optimal function.  

Speak to your medical practitioner, Registered Nutritional Therapist or pharmacist adviser for further guidance. If on medication, please speak to your GP/consultant before making any changes to your diet. 


Histamine Masterclass - 1pm, Thursday 14th September. 

I will be holding an online Masterclass on histamine on Thursday 14th September 2023 at 1pm - claim your early bird ticket at £10.  Don't worry if you can't attend live, you can send your questions in advance and the Masterclass will be emailed to all attendees post the event.
 
Read more: 

• Motivated to change but struggling to stay on track? Tips for long term transformation.

• Symptoms but no idea what’s triggering them? Here are some tips to unravel the mystery.  
• Top Tips for Eating for the Planet without Compromising Your Nutrition 
• I want to eat more plant-based but pulses give me terrible digestive issues
• What is the atopic march?
• Why is eczema/atopic dermatitis itchier at night?
• You’ve been diagnosed with an atopic condition, but what does that mean? 
• Atopic dermatitis/eczema – a chronic condition that effects all ages 
• The skin microbiome, the key to good skin health  
• Autumnal Allergies – Yes, it is a thing
• If one-size-fits all diets worked, don’t you think we would have the magic formula by now? 
  
  

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Interested in what I do and who I am? Go to my website: www.jessicafonteneaunutrition.com
 
1.           Nutten S. Atopic dermatitis: Global epidemiology and risk factors. Ann Nutr Metab. 2015;66:8–16. 
2.           Buddenkotte J, Maurer M, Steinhoff M. Histamine and antihistamines in atopic dermatitis. Adv Exp Med Biol. 2010;709:73–80. 
3.           Patel RH; Mohiuddin SS. Biochemistry , Histamine. 2023;32491722.