You went out to eat the other night and had your favorite dinner: tuna tartare paired with sautéed spinach and a glass of your absolute favorite red wine. Overnight, you developed a huge rash that covers your entire chest, and today, you’ve noticed the start of several open sores, or at least a rash, on the back of both sides of your neck. What is the deal?! Come to think of it, the last time you came to this same restaurant, you had seafood and wine, and the next day, you remember a similar reaction. What does this mean? Today we are going to cover the causes, symptoms, and complications of eczema, it’s potential relationship to histamine intolerance, and what you can do to manage your eczema symptoms long-term.
What is eczema?
Eczema, also referred to as atopic dermatitis (AD), is a chronic skin condition that usually starts in infancy that is characterized by exacerbation and remission of episodes of skin lesions. Other symptoms of eczema include:
- dry skin
- itching, especially at night
- red to brownish-gray skin patches
- small raises bumps which may leak initially or when scratched and then form a crust
- thick, cracked, or scaly skin patches
- raw and/or sensitive skin.
Usually (not always) atopic dermatitis symptoms begin before age 5, but may continue up through adulthood. Unlike psoriasis, AD symptoms are not present all the time. Remission could even last for several years in some cases. The biggest issue with eczema is an increased risk of skin infection (look for white-yellow discharge, fever) and inability to get a good night’s sleep. If you suspect an infection or are so uncomfortable you can’t get a good night’s rest, follow up with a physician you trust (1).
Why do people have eczema?
The presence of eczema in some people can be traced back to a gene variation that affects your skin’s ability to provide protection from bacteria, irritants, and allergens. Without this inherent protection, your skin will be more affected by things you come into contact with in your environment. The primary risk factor for developing eczema is a family history of eczema, allergies, hay fever, or asthma (which can all be caused by histamine intolerance just FYI). However, as we will further discuss below, food sensitivities and a “leaky gut” can also play a huge role in whether you will have a flare-up or not (2).
If you know you have AD, you have to figure out what your triggers are. While they may be different for everyone, here is a list of commonly identified triggers that will give you a place to start.
- Chemical Irritants: these are products that you use daily, including dish soaps, body wash, shampoos, laundry detergents, or other cleaning products. Similarly, some people can have a reaction to their jewelry or clothing, including both the fabric of the clothing as well as any irritation from a tag rubbing on your skin.
- Environmental Irritants: when you have a hyperactive immune system, items like pet dander (cats > dogs), mold, dust mites, pollen, dandruff can cause your immune system to overreact, leading to a skin reaction.
- Extreme temperatures: weather changes as well as temperatures greater than 80 degrees F or less than 30 degrees F as well as changes in humidity can cause an immune reaction and can trigger eczema symptoms for many people.
- Stress: Symptoms of eczema can become more pronounced if someone is under mental and/or emotional stress.
- Food sensitivities: There are many types of food allergens and sensitivities that can trigger an eczema flare-up. The most common include gluten, dairy, corn, eggs, chocolate, nuts, and soy. This will be further discussed below under “SIBO and Food Sensitivities.”
- Hormone levels: Changes in your hormones levels can also aggravate eczema symptoms. For example, some women notice an increase in their eczema around the timing of their menstrual cycle.
- Microbial overgrowth: An unhealthy gut and the presence of bacteria like E.coli and staph can increase eczema symptoms. This will be further discussed in “Eczema, Histamine, and Gut Health” (2).
Eczema and Gut Health
As we know, the purpose of our skin is to act as one of the first barriers to the outside from physical, chemical, and microbial stressors. Irritation of the gut, caused by microbial overgrowth, combined with the genetic variation discussed above can decrease the effectiveness of your skin’s barrier. This will diminish the number of antibacterial proteins produced in the skin and can lead to hyper-inflammation and potential infections, both of which are hallmark signs of eczema/AD (2,3).
Similarly, the gut flora can influence what the skin is generating for protection from the environment, including fatty acids and oil (sebum) production. A change in these skin components related to a high microbe count or increased inflammation from food sensitivities can result in more inflammation and infection of the skin cells in the area, causing the development of acne, redness, and eczema (2).
Eczema and Histamines
When the skin is irritated, it produces a message transmitter called substance P. This chemical will cause the release of histamine from mast cells in the area, which will result in an inflammatory response. People with poor bacterial balance in their gut have increased substance P production, which will result in more histamine release and a hyper-inflammatory response (2).
There is some research to suggest that oral intake of probiotics will reduce skin inflammation, reinforce the skin barrier, and decrease skin sensitivity more than a topical medication to reduce the symptoms (2,4). That being said, not all probiotics work well with those with histamine intolerance. I like probiota histaminX from seeking health. Treating the reason behind the eczema will be more effective than just treating the symptoms.
Small Intestinal Bacterial Overgrowth (SIBO) and Food Sensitivities
An altered gut flora and an increase in intestinal permeability can cause an exaggerated immune response to specific foods. Research indicates that people dealing with eczema and other chronic skin conditions are irritated by certain foods (5,6).
The most commonly noted food sensitivities are wheat, gluten, dairy, soy, corn, eggs, nuts, chocolate, and sugar (2).
How can I reduce my eczema symptoms?
As discussed during this article, we have to think of eczema not as a disease in and of itself, but as an external manifestation of an internal issue. Your immune system is so overactive that it has started attacking your own skin. By treating the problem from the inside out, you will not only be able to reduce your skin symptoms, but also the allergies and the asthma that typically accompany it (the “allergic triangle”) (2).
- Eat an Anti-Inflammatory Diet
Eliminate known inflammatory foods as discussed above, like corn, soy, gluten, and dairy products. Focus on consuming foods high in antioxidants (fruits and veggies) and anti-inflammatory effects (fish, nuts, avocados, turmeric) (7).
- Eat a Low-Histamine Diet
Sometimes, eczema symptoms still stick around, even after modifying to an anti-inflammatory diet. In this case, you may need to look at eliminating high-histamine foods. Unfortunately, a number of healthy foods that are excellent for their anti-inflammatory properties, like fish, avocados, eggplant, spinach, tomatoes, bacon, or other dried and citrus fruits are high in histamine. This is a problem when you’re already releasing too much of your own histamine. Let’s return back to the example in the beginning of the article. The tuna, spinach, and red wine are all extremely high in histamines, which is likely why she’s having a reaction to her dinner, even though she doesn’t have any known food allergies. Just keep in mind that a “healthy diet” doesn’t always mean one that’s low in histamine (7). In a case study by Chung et al, a young individual has almost complete resolution of his AD symptoms by following a low-histamine diet (8).
- Heal your gut and get your intestinal bacteria in good balance
As we’ve discussed, your gut has a huge effect on your immune system, which makes sense considering 80% of your immune system lives in your gut. When the cells of your intestinal wall are damaged, unwanted substances “leak” into the body, where they are attacked by the immune system, causing inflammation. In the case of eczema, the effects of an overactive immune system are seen in the skin. In order to reduce the effects of leaky gut, remove the inflammatory foods and add good bacteria back into your gut, while cutting out any sugar, refined carbs, processed foods to address any potential side effects of SIBO (7).
Summary and What To Do
- Eczema is a chronic skin condition characterized by redness, dry skin, and the presence of skin lesions.
- Eczema triggers are very individualized and may be caused by chemical/environmental irritants or allergens, temperature changes, stress, food sensitivities, changes in hormone levels, or microbiome imbalances.
- Gut health, including the presence of “leaky gut” and SIBO, is likely causing many of your eczema symptoms. We need to treat these symptoms from the “inside out.”
- For improved gut health or to reduce gut inflammation, check out my my Histamine Support Kit for optimal control of your histamine related symptoms.
- If you’re still having trouble with your eczema symptoms, contact me to help you create a detailed plan for YOUR body! We will heal you from the inside out, together!
- Follow the detailed, 4-phase plan in my new book “The 4-Phase Histamine Reset Plan” which walks you through a step-by-step program to get on rid of your eczema and other symptoms related to histamine intolerance.
- Slominski A. A nervous breakdown in the skin: stress and the epidermal barrier. The Journal of Clinical Investigation. 2007;117(11):3166-3169.
- Benyacoub J, Bosco N, Blanchard C, Demont A, Philippe D, Castiel-Higounenc I, Guéniche A. Immune modulation property of Lactobacillus paracasei NCC2461 (ST11) strain and impact on skin defenses. Benef Microbes. 2014 Jun 1;5(2):129-36.
- Eczema: Can eliminating particular foods help? Link Here.
- Atopic Dermatitis and Disease Severity Are the Main Risk Factors for Food Sensitization in Exclusively Breastfed Infants Link Here.
- Chung BY, Cho SI, Ahn IS, et al. Treatment of Atopic Dermatitis with a Low-histamine Diet. Annals of Dermatology. 2011;23(Suppl 1):S91-S95.