Some evidence suggests up to 80 percent of people with early-onset, persistent, or severe AD also have
food allergies, though 20 to 30 percent of people with AD, particularly those with mild illness, don’t have them at all. Some children will outgrow their allergies, while others will continue to experience them into adulthood. It can also depend on the allergen; 90 to 95 percent of children outgrow milk and egg allergies, but allergies to nuts (including peanuts, which are technically legumes), seeds, and shellfish are often lifelong.
The Link Between Food Allergies, Food Sensitivities, and AD
The skin barrier becomes impaired in people who have AD. Once this happens, sensitivity increases not only to environmental
allergens but also to food allergens, says
Schweta Arakali, MD, an allergist at the Center for Allergy and Asthma Care in Allentown, Pennsylvania.
Even if you don’t have a food allergy — which causes reactions that can include
hives or
anaphylactic shock, among other possible symptoms — you can still have a food sensitivity.
“If you’re sensitive to a food, you may have worsening existing eczema patches, or you may notice your skin feels itchier overall,” says Marisa Garshick, MD, a clinical assistant professor of dermatology at Weill Cornell Medical College and a dermatologist at MDCS Dermatology in New York City. You may also develop a rash or have an upset stomach or diarrhea after you eat certain foods, she says.
It can be challenging to pinpoint a food sensitivity. Unlike a true allergy, which tends to cause a reaction right away but can take up to two hours, a food sensitivity reaction may take up to three days before you notice any symptoms.
“Some people might get [food sensitivity] symptoms within minutes to hours,” says Danilo C. Del Campo, MD, a dermatologist at Chicago Skin Clinic. “For other people, it might be a couple days after.” Once a food sensitivity reaction occurs, it could persist for days or even weeks, he says.
How to Know if a Food Is Triggering Your AD Flares
Although food allergies and sensitivities vary from one person to the next, some foods tend to cause symptoms for people with AD. Some of the most common culprits include:
- Peanuts
- Tree nuts
- Eggs
- Milk and dairy products
- Fish
- Shellfish
- Soy products
- Wheat
If you have a known food allergy, stop eating that food. Food allergies can become life-threatening, even if your past reactions were mild.
If you think you might have a food sensitivity and aren’t sure which food is triggering your symptoms, you may be tempted to try an
elimination diet. This is a process in which you stop eating one or more possible food culprits for several weeks before slowly reintroducing them into your diet and recording how you feel.
But experts usually don’t recommend people with AD start a food elimination diet — at least not without the help of an allergist.
“Prolonged or strict food avoidance may lead to more severe reactions in the future with ingestion,” says Dr. Arakali. That can mean more severe eczema as well as an increased risk of developing a true food allergy.
Plus, there may be many more causes of an AD flare-up besides food, says Arakali, including dust mites, dander, contact allergens, and nonallergic triggers, such as stress or infection.
Even if you’re allergic or sensitive to certain foods, cutting them out of your diet is only part of treating your AD. “It’s important to know that a true elimination diet in and of itself may not be enough to [treat] eczema,” says Dr. Garshick.
What to Do if You Think You Have a Food Allergy or Sensitivity
If you suspect something in your diet may be setting off AD symptoms and flares, see your dermatologist. They will likely want to try traditional eczema treatments before testing for food allergies, says Garshick.
Once you’re doing all you can to manage your AD with medical treatments, you can try adjusting your diet with the help of your doctor.
Emily Davis
James Bennett
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