Eczema, or dermatitis, is a non-contagious, inflammatory (meaning that the body’s immune system is activated) skin condition that usually involves a combination of itching, redness, oozing, raised bumps or blisters. Whilst not all types of eczema are the same, or have the same causes, this article covers their differences and some common food triggers.
Eczema flares can be ‘acute’, meaning that there is a sudden appearance of symptoms usually involving blisters and oozing, or chronic when the symptoms remain long-term but are drier in appearance with scaling and cracking. Most clients I work with report a mixture of both, chronic dryness with periodic acute flares.
The above is, however, a generalisation, even dermatologists admit that in many cases, the exact eczema type cannot be diagnosed and that no two people will experience the same environmental or food triggers or the same eczema symptoms
Hearing that you have eczema is one thing but there are different types of eczema and these can be triggered by different things, so it is worth knowing the difference. Eczema being eczema, of course, many people have a combination of several types versus just one. Here is a brief description of the main different eczema’s:
Contact Dermatitis is an eczema that is triggered by direct contact with an allergen/sensitivity eg. nickel or fragrance. The eczema only appears around the site of the contact such as earrings, a watch, belt buckle, perfume or deodorant. Contact dermatitis usually resolves itself, within 5-7 days, once the irritant has been removed.
Atopic Eczema is an allergic eczema that is often linked to asthma and hay fever and is particularly linked to itchiness.
A blood test for raised IgE levels can be used to see whether a true allergy is present. Interestingly, however, not all patients with diagnosed atopic eczema show raised IgE, some may experience a food/environmental sensitivity or intolerance reaction.
About 20-30% of UK infants are affected by atopic eczema.
Issues with a a skin barrier protein, filaggrin, was found, in 2006, to be strongly linked to atopic eczema.
Pompholyx (Dyshidrotic) Eczema
Pompholyx/Dyshidrotic Eczema is linked to atopic eczema and appears as extremely itchy, pin-prick blisters on fingers and/or toes. Over time the blisters turn into scaling and crevasses often form. This form of eczema creates intense itchiness but scratching only worsens the symptoms. This form of eczema often appears in young adults and can be triggered by warmer weather.
Seborrheic dermatitis generally appears on the scalp and above the eyes. It is usually less itchy than atopic eczema and has been linked to yeast infections.
Discoid (Nummular) Eczema
Discoid eczema usually occurs in middle-aged/older men. If this form of eczema appears in younger patients then it is actually a form of atopic or contact dermatitis. This eczema forms in round-shaped patches and may leave a long-term, lighter skin tone patch after the eczema has cleared.
Stasis (Venous) Eczema
Stasis eczema is often found on the lower legs and is linked to problems with circulation and veins. Medical treatment is linked to resolving the vein condition and applying creams to the eczema.
Neurodermatitis (Lichen Simplex Chronicus)
Neurodermatitis is when skin becomes thick and leathery due to repeated scratching or rubbing, either as a habit or due to stress and it is usually found in a single patch either on the leg or back of the neck. Topical creams are usually the first line of treatment.
A focus on Atopic Eczema and Common Food Triggers
For those types of eczema that have an inflammatory, immune system response (atopic, pompholyx, discoid and seborrheic) it is useful to find out what your personal triggers are.
It is important to note that eczema triggers are individual, during my many years in practice specialising in this area, I have found some common ground and some surprising triggers. My main advice would be to start keeping a food and symptom diary. This means noting what you have eaten during the 3 days preceding a flare. Here is a link to a free 'Food and Symptom Diary' tool I've prepared.
The top 6 categories of foods that my clinical experience has identified as the most common are:
Caution, however, about starting to remove whole food groups from your diet, especially if you considering taking anything out of a child’s diet, as doing so can exacerbate the problem rather than alleviate it. My advice would be to work with a nutrition professional.
I’ve also found that certain triggers follow what I could only describe as “trends”. For example, in my list above I have gluten, but truth be told, I am finding that it is featuring less and less as a potential trigger. I am, however, finding that triggers to almonds and soy are becoming much more common. Could this be a case of what we eat the most often has the potential to trigger atopic eczema sufferers more? Only time and research will tell.
My name is Jessica Fonteneau and as a Registered Nutritional Therapist MSc, I have significant clinical experience in supporting clients with digestive, skin and autoimmune disorders.
In addition, I have undertaken further study and training in two specific areas:
 Lord RS, Bralley JA (2008) Laboratory Evaluations for Integrative and Functional Medicine, 2nd Edition, Canada. Metametrix Institute
 Irvine AD, McClean WH (2006). Breaking the (un) sound barrier. The Journal of Investigative Dermatology. 1261200-1202
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