Eczema and diet: which foods should be avoided and favoured?

Theeczema is a skin inflammatory disease characterised by the emergence of lesions and itching (pruritus). This condition is very common and is the most widespread skin disease in France, following acne. Eczema primarily affects young children and infants but can also affect adults. It results from a particular interaction between genetics and environment.

Individuals suffering fromatopic eczema have a genetic predisposition. Studies have highlighted several anomalies on the gene coding for filaggrin, as well as on other molecules necessary for the integrity of the stratum corneum. These alterations result in a lack of sebum, lipid and cell adhesion molecule production, leading to a dysfunction of the protective skin barrier.

Atopic eczema should be distinguished fromcontact eczema, which develops in response to an allergenic substance and does not require any specific genetic predisposition. There are also other forms of eczema (nummular, dyshidrotic...), which are somewhat less common.

Eczema flare-ups are primarily triggered by the contact between the skin and allergenic substances. However, several studies have explored the link between diet and contact eczema, concluding that certain common allergens present in our food can contribute to increasing the frequency and intensity of flare-ups. A study conducted with 40 children suffering from contact eczema managed to identify the ingredients to which these children reacted.

Most studies establishing a link between diet and eczema point to the same foods. However, scientists do not recommend the complete elimination of all these ingredients potentially at risk. Indeed, considering the deficiencies this would cause, the risk/benefit balance would clearly tip on the wrong side. That's why it's rather advised to try to determine which food you react to, if there is one at all.

Indeed, it is important to remember that not everyone suffering from eczema is affected by this food hypersensitivity. To determine this, eliminate one ingredient from your diet for a month and observe if you notice a change in your eczema. Then proceed in the same way for each ingredient you suspect.

Please note : if an ingredient triggers your eczema flare-ups and you eliminate it, be careful that this does not lead to any deficiencies. For this, we advise you to seek advice from your doctor who can guide you towards other foods with an equivalent nutritional value or possibly prescribe you dietary supplements.

As of today, there is very little scientific evidence suggesting the need for individuals suffering from eczema to adopt a specific diet. In this area, the recommendations are the same as for individuals without skin problems: good hydration and a healthy, varied and balanced diet, of the Mediterranean type. However, to combat the inflammation caused by eczema, you can choose to focus on foods with anti-inflammatory properties.

This is particularly the case for foods high in omega-3, such as certain oily fish. Omega-3s are precursors to eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which in turn are precursors to anti-inflammatory molecules such as resolvins. These inhibit certain mediators of inflammation and reduce pain.

Certain green vegetables such as broccoli or artichokes can also be considered beneficial for people suffering from eczema. In addition to having antioxidant properties, they are anti-inflammatory, thanks to the flavonoids they contain. These molecules work by inhibiting the synthesis of pro-inflammatory cytokines.

• WARNER J. O. & al. Compliance problems in the dietary management of eczema. Archives of Disease in Childhood (1983).

• SANTIAGO S. Food allergies and eczema. Pediatrics Annals (2015).