Eczema — also known as atopic dermatitis — is an inflammatory skin condition that causes itchiness, dryness, rashes, and skin infections.
Certain foods may trigger these symptoms while others may help alleviate them.
This article explains what to eat and avoid with eczema and which supplements may help reduce the risk of developing eczema or improving symptoms.
What is eczema?
Eczema is the most common form of dermatitis or skin inflammation (1).
It’s caused by a complex interaction involving immune dysfunction, genetics, and the environment that disrupt the skin barrier function.
The skin barrier helps the skin retain hydration it’s your body’s frontline defense against germs and other toxins.
Consequently, water can more easily escape from the skin leading to dehydrated skin, and harmful substances can more easily penetrate the skin and cause infections.
The symptoms of eczema vary by age and in severity but generally include:
- dry, scaly skin
- open or weeping sores
Eczema usually starts in childhood, with about 60% developing the condition before one year of age and 90% by age five (2).
Children with eczema are more like to develop food allergies, with the most common being cow’s milk, eggs, peanuts, soy, wheat, fish, tree nuts, and shellfish (3).
Adults with eczema are less likely to have food allergies compared with children but are more likely to experience environmental allergens such as nickel, dust mites, molds, animal dander, and pollens (4).
The primary treatments for eczema are moisturizers, topical corticosteroids, ultraviolet light therapy, and for skin infections, antibiotics (2).
Beyond these treatments, diet can also help manage eczema symptoms.
An eczema diet eliminates or limits food that triggers symptoms.
Although food allergies are common in those with eczema, testing for them isn’t recommended since these tests tend to have a high rate of false positives, leading to unnecessary food restrictions (2).
However, food allergy tests can be a good starting point to identify potential food allergens, which can then be later confirmed with an elimination diet.
Elimination diet for eczema
An elimination diet removes food or ingredients from your diet that you believe are causing your symptoms.
These eliminated foods are then reintroduced, one at a time, while you monitor for symptoms to identify which foods are contributing to your symptoms.
In the elimination phase, you should eliminate foods that may be triggering your symptoms for 3–4 weeks (5).
After 3–4 weeks, you can reintroduce cow’s milk slowly over several days while you look for symptoms of eczema.
After cow’s milk, you can then reintroduce eggs, followed by other foods you may have eliminated.
Only introduce one food item or ingredient at a time as introducing more than one can make it difficult to determine which may be causing your symptoms.
If you experience symptoms after reintroducing a food, you can remove that food from your diet.
Beyond the elimination of cow’s milk and eggs, excluding other foods may also offer benefits.
Adults in one study reported improvements in eczema symptoms with the exclusion of gluten, alcohol, refined grains, and junk food, like potato chips, sugary drinks, cakes, biscuits, and sweets (10).
The adults in the same study reported improvements in skin health when they consumed more vegetables, fruits, and fish oil (10).
Risks of elimination diets
Elimination diets are commonly prescribed for identifying potential foods or ingredients that may be triggering eczema symptoms.
However, if followed for too long and poorly planned, they may lead to nutrient deficiencies and even food allergies that were not previously present, particularly in children.
For example, in one study, children with eczema who followed an elimination diet consumed less than 67% of the dietary reference intake (DRI) for calcium, vitamin D, and vitamin E (11).
In a different study, children with eczema who followed a prolonged cow’s milk elimination diet became allergic to it, even though they weren’t prior to eliminating it (12).
Based on these results, the authors of the study suggested that continuous exposure in those who can tolerate small amounts of cow’s milk may be beneficial to prevent the development of milk allergy.
Fortunately, these risks can be greatly reduced when it’s followed under the guidance of a registered dietitian.
Helpful supplements for eczema
Although there is limited evidence to support the use of supplements for improving eczema symptoms, fish oil and probiotics may be helpful.
Probiotics are healthy bacteria that help support a healthy gut microbiota, which plays a fundamental role in supporting immune health.
By supporting a healthy gut microbiota, and therefore a healthy immune function, probiotics are believed to relieve eczema symptoms.
Indeed, supplementing with certain probiotic strains — namely Lactobacillus and Bifidobacterium — by pregnant or breastfeeding mothers has been shown to reduce the risk of developing eczema in infants (13, 14, 15).
And although the effect is small to insignificant, probiotics may help relieve itchiness and improve sleep in infants, children, and adults with eczema with minimal adverse side effects (16).
Fish oil is rich in the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).
These essential fatty acids play important roles in controlling inflammation and improving immune function, which may help alleviate eczema symptoms.
Similar to probiotic supplementation during pregnancy or breastfeeding, fish oil supplementation may help decrease an infant’s risk of developing eczema as well as certain food allergens like eggs and peanuts (17, 18).
There is limited evidence on the effects of fish oil supplementation for managing eczema, but it may help strengthen the skin barrier and decrease skin dryness (19).
Fish oil supplements are generally well-tolerated but may cause minor symptoms like belching and nausea (20).
The bottom line
Eczema is an inflammatory skin condition that causes itchiness, dryness, rashes, and skin infections.
People with eczema commonly have one or more food allergies that may worsen symptoms so following an elimination diet may help identify these allergies.
However, it’s best to follow an elimination diet under the guidance of a registered dietitian to reduce the risk of nutrient deficiencies or the development of a new food allergy like cow’s milk.
Probiotics and fish oil supplements have some evidence to support their use by pregnant or breastfeeding mothers to reduce the risk of eczema in their offspring.
These supplements may also help decrease symptoms in those with the condition but the effects are likely small.