Eczema Articles

Doctors rarely explore the link between food intolerance and eczema with their patients. Yet there is evidence that, for some eczema sufferers, relief (total or partial), can be obtained by a change in diet. Tests for allergies are sometimes carried out but food intolerance, which is less easy to diagnose, is frequently overlooked. To some extent this is understandable. Allergic reactions have an immunological response that can be measured and 'seen' in the blood but for food intolerance there is no such method of testing.

So, just what is food intolerance?

If you're body cannot tolerate a particular food, or one of its ingredients, then you will experience a reaction, such as eczema. Foods that have been found to cause eczema in some individuals include wheat, eggs, cow's milk, peanuts, additives such as tyramine, and naturally occurring food chemicals such as salicylate. There is, however, no way of being able to say that any one of these foods may be responsible for your condition. You are a unique individual with a different biochemical make-up to others with the same condition. Cow's milk may be responsible for Robbie's eczema but safe for Emma, salicylates in fruit and vegetables could be the cause for Mary but safe for John and so on. You can be intolerant of any of the following:

1. A complete food such as milk, soya, carrot, egg, pork, wheat, mushroom, chicken, apple.

2. A naturally occurring chemical such as: Salicylate in many herbs, fruit and vegetables. Tyramine in aged meat, cheeses and wine. Purines in protein foods.

3. An added ingredient that does not occur naturally in the food - such as a preservative, colouring, flavour or, artificial sweetener.

4. In a complex food, i.e. any processed food, you could be sensitive to any one of the ingredients. For example, in bread it is possible to react to wheat, preservatives, yeast, or bleaching agents. The simple truth is that any reaction, including the skin conditions known as eczema and dermatitis, can be provoked by any food.

If food was my problem surely I'd know, wouldn't I?

Not being able to see a link between what you eat and your eczema is not unusual especially if you have lived with the condition for many years. After all you eat food every day surely you would have noticed if a particular food was the cause and surely, if it was a possibility, your doctor would have said something. If only it was so easy ... . You could go throughout your whole life with your health being impaired without knowing that food was your problem or your doctor even suggesting it. Atherton (1) found that foods appear to play an important provocative role in many instances of atopic eczema, the reaction often appears to be slow and insidious, is almost always unrecognised by the patient and not detected by skin testing or tests for IgE antibodies (the traditional allergy tests).

Are you food intolerant?

The safest and most accurate, way of detecting food intolerance is by using an elimination diet that first removes the suspect food or food chemical, in all its forms, from your diet and is then reintroduced. To carry out this form of testing you will need to use a food diary. An example of one, including pages you can download for free, can be found at www.foodcanmakeyouill.co.uk. If there has been an improvement and, on testing, the eczema re-emerges then that food is not safe for you to eat. If, after a period of time, there is no reaction then the food is safe, for you, to eat. Before embarking on any form of food testing it is essential that you first discuss this with your doctor and ask for their supervision.

The evidence is out there ...

What follows is a brief summary of some of the research that has found links between food and eczema.

Hanifin (4) found that for eczema sufferers the most common food culprits were eggs, milk, peanuts, seafood, wheat and soya.

Sloper et al (7), examined the role of foods in the exacerbation of atopic eczema in children. The children's eczema improved in 49 of 66 (74%) cases after eliminating cows' milk, eggs and various other foods.

Veien et al (10), carried out a randomised, placebo-controlled oral challenge with food additives (preservatives and food colourings) on 101 individuals with eczema of undetermined origin but who suspected that the intake of certain foods aggravated their dermatitis. Thirty seven reacted to one or more of the food additives but not to a placebo. A further study by the same team (11), found improvement in the dermatitis of 262 of 675 patients who followed a restrictive diet for approximately one month. Sensitivities included metal salts, balsams, classic food allergens and food additives. A follow-up study was carried out 1-3 years later, showed that 144 ( 206 responded to the questionnaire) there was long-term improvement in their dermatitis.

Soutter et al (8), found that in 68 children with eczema, 79% had food allergies before the age of 10 months and 23% at 7 years of age. In a separate study of people with eczema, food chemical intolerance reactions were shown to irritate the rash in 47%.

Hoffman (5) et al found that 48% of those studied with eczema tested positive for an allergy to the milk protein a-lactatalbumin.

Van Bever et al (9) in a study of 25 children with severe atopic dermatitis found the condition linked to reactions to eggs, wheat, milk, soya, and various additives including tartrazine, sodium benzoate, sodium glutamate and sodium metabisulphite. They concluded that some foods, food additives, tyramine and acetylsalicylic acid, can cause positive double-blind placebo-controlled challenges in children with severe atopic dermatitis.

Burks et al (2) evaluated 46 patients with atopic dermatitis for food hypersensitivity. Sixty one per cent had a reaction to one of the foods tested. Egg, milk and peanut were the most common culprits. A further study by Burks et al (3), of 165 patients found that 60 per cent had at least one positive prick skin test. Milk, eggs, peanut, soya, wheat, cod/catfish and cashew accounted for eighty nine per cent of the positive challenges.

Sampson and McCaskill (6) studied 113 children with severe atopic dermatitis. Fifty six per cent responded positively. Once again, egg, milk and peanut were the most common culprits.

Sharla Race is a Researcher and Writer in food and health issues, particularly food intolerance

References

(1) Atherton DJ Diagnosis and management of skin disorders caused by food allergy. Ann Allergy 1984 Dec; 53(6 Pt 2):623-8

(2) Burks AW, Mallory SB, Williams LW, Shirrell MA. Atopic dermatitis: clinical relevance of food hypersensitivity reactions. J Pediatr 1988 Sep; 113

(3):447-51 (3) Burks AW, James JM, Hiegel A, Wilson G, Wheeler JG, Jones SM, Zuerlein N. Atopic dermatitis and food hypersensitivity reactions. J Pediatr 1998 Jan; 132(1):132-6

(4) Hanifin J M et al. Diet and atopic dermatitis. Western J of Med 151:6, 1989

(5) Hoffman D, Yamamato F, Ceiler B, Haddad Z. Specific IgE anribbdn~s in atopic eczema. J Allergy Clin Immunol 1975 (55) 256-67

(6) Sampson HA, McCaskill CC. Food hypersensitivity and atopic dermatitis: evaluation of 113 patients. J Pediatr 1985 Nov; 107(5):669-75

(7) Sloper KS, Wadsworth J, Brostoff J. Children with atopic eczema. I: Clinical response to food elimination and subsequent double-blind food challenge. Q J Med 1991 Aug; 80 (292): 677-93

(8) Soutter V, Swain A, Loblay, R. Food allergy and food intolerance in young children Asia Pacific Journal of Clinical Nutrition (1995) Volume 4, Number 3: 329

(9) Van Bever HP, Docx M, Stevens WJ. Food and food additives in severe atopic dermatitis. Allergy 1989 Nov; 44(8):588-94

(10) Veien NK, Hattel T, Justesen O, Norholm A. Oral challenge with food additives. Contact Dermatitis 1987 Aug; 17(2):100-3

(11) Veien NK, Hattel T, Justesen O, Norholm A. Dietary restrictions in the treatment of adult patients with eczema. Contact Dermatitis 1987 Oct; 17(4):223-8