Eczema 101: From Triggers To Treatment

Let's go back to basics – what exactly is eczema and what causes it?

“The term eczema is used to describe a skin condition in which the outer skin layer is inflamed. There are different types of eczema, which are generally classified by the location of the breakout or the physical appearance. A common type of eczema is atopic eczema, also referred to as infantile, flexural (elbows, wrists and knees are flexural joints) or atopic dermatitis. Atopic eczema is an allergy disease with a hereditary trait and is common in sufferers of hay fever and/or asthma. Contact dermatitis is another type of eczema; there are two divisions within this type of eczema called irritant and allergic. Contact allergic dermatitis results from a deferred reaction to an allergen whereas contact irritant dermatitis, the more common one, occurs as a result of contact with irritants such as chemicals in hair and body products. Other types of eczema include seborrheic dermatitis, xerotic eczema, discoid eczema and venous eczema.” – Dr Shabir Daya, pharmacist and co-founder of Victoria Health

“Eczema is an inflammatory skin condition, although the causes are not fully understood. As with everything, it’s important to remember that no two people are the same, and the underlying problem can differ between individuals. More common triggers include allergies and/or intolerances to food, skin products or medications, as well as stress. Research also shows links with the gut microbiome, as well as inflammation in the body, which may be in part exacerbated by poor gut function.” – Alice Mackintosh, nutritionist and co-founder of Equi London

Is eczema related to hormones, like acne can be?

“Eczema can be related to hormonal changes for some people. It’s possible this is due to changes in the gut microbiome, or bowel habits at different times of the month.” – Alice

“We do not fully understand what causes eczema though it is thought to be a combination of genetics and some form of a trigger whether food sensitivity or imbalances in hormones. Certainly a decrease in oestrogen levels (as common in the menopause) makes the skin more prone to dehydration and therefore dryness, making your skin more vulnerable to eczema.” – Shabir 

Are some people more prone to eczema than others?

“You may be born with greater likelihood of eczema because of the genes you inherit. If one or both of your parents have eczema, you are more likely to have the condition. Some forms of eczema are a result of an overactive immune system too, which can result in inflammation.” – Shabir 

In your experience, what triggers a flare-up? 

“People who suffer from hay fever and asthma seem to be more prone to eczema. However, it’s tricky to pinpoint specific triggers, as in many instances, eczema may flare-up a few weeks after exposure to the trigger.” – Shabir 

“This varies hugely between individuals, but in my clinic, I see that nutrient deficiencies, poor diet, stress, reduced immunity, and poor gut health can all be contributing factors. It’s worth noting that all of these things can also contribute to inflammation in the body.” – Alice 

So can diet help with eczema?

“Our diet provides the key nutrients that are necessary for normal skin function, as well as helping to support our immunity, digestion and the rest of the body. Eczema can be a complex problem for many, but nutrition can be a key part of the puzzle. If you’ve tried everything but don’t eat the best diet, it’s certainly something to try, and in any event, a good diet is essential for overall good health. Remember changes to diet can take time to manifest with the skin, and you really need to be consistent for three months minimum to start to see changes. Try to eat more oily fish, ideally three times per week; fresh colourful vegetables, aiming for seven portions per day; berries of all kinds; fermented foods such as kefir, sauerkraut and unpasteurised cheese; nuts and seeds; organic meat; eggs; and nuts and seeds. Also try to cook with herbs and spices such as turmeric, cinnamon and fenugreek, and use fresh herbs such as coriander and parsley liberally in your cooking. On the flipside, try to avoid processed foods of any kind; refined, white carbs; added sugars and sweeteners; too much alcohol; burnt, charred foods; vegetable oils; and deep-fried foods.” – Alice 

“People who change their diet often find great benefits. An eczema diet ideally should avoid processed foods if possible. Bacon, tinned food, frozen preserved food, white sugar and flour are typically to be avoided. Severe eczema may also require the abstinence of wheat and gluten. There are many prescribed ‘eczema diets’ although most of these are very strict and hard to follow. I believe that if you cannot completely abstain from these foods, at least moderate their intake.” – Shabir

Is it worth trying an elimination diet to work out if a certain food is triggering your eczema?

“You can try an elimination diet, but it’s best to speak to a doctor before doing this. Two of the most common food groups to consider cutting out are dairy and gluten, but be sure to cut one out at a time, otherwise you wont know what is working. You’ll need to stick to an elimination diet for three months and be fastidious in your approach. Always research before you start an elimination diet and replace what you’re cutting out with healthy alternatives.” – Alice