10 Food That Can Cause Eczema Flare-Ups

Eczema is a chronic (long-lasting) skin condition that causes a dry, itchy rash. The rash can flare up, go away, and return over time.

The exact cause of eczema is unknown. Certain factors, including allergens, stress, and weather, can trigger eczema flares. Food can also trigger or worsen eczema, including atopic dermatitis, the most common type of eczema.

Milk, eggs, and soy lead the list of foods most commonly associated with eczema flare-ups. Here are those, plus seven other foods that can trigger or worsen eczema flares:

1. Milk: Milk is a common allergen. In people with a milk allergy, the immune system may overreact to one or more of milk’s proteins, such as casein or whey. This immune system overreaction can lead to various inflammatory reactions in the body, including eczema.
2. Eggs: People who are allergic to eggs can have a negative physical reaction to certain proteins in eggs, including an atopic dermatitis or other type of eczema flare.
3. Soy: Protein-rich soy is a plant food often consumed as soy milk, soy flour, and soy flakes, all of which can be found in various processed foods like sausages, baked treats, chocolate, and breakfast cereals. One study found that about 30% of people with atopic dermatitis may have a soy allergy. Not everyone with a soy allergy and eczema may develop symptoms when they eat soy, but it is possible for the food to trigger a flare.
4. Wheat: For those with celiac disease or gluten sensitivity, skin reactions like eczema are not uncommon. Wheat contains gluten, a protein that can cause digestive issues for some people and lead to adverse reactions like eczema flare-ups.
5. Fish: One study found that more than 10% of participants with atopic dermatitis had a food hypersensitivity to seafood. Parvalbumin (a protein that binds to calcium) has been identified as the major allergen in fish. Of the people sensitive to seafood, an overwhelming majority (82%) had chronic, persistent eczema lesions.
6. Shellfish: Tropomyosin protein is considered the major allergen in shellfish. (It’s the same protein that makes people allergic to dust mites and cockroaches.) Other shellfish proteins that may cause allergies and associated eczema flares include arginine kinase and sarcoplasmic calcium-binding proteins.
7. Peanuts: Peanut allergies and eczema are closely related. Eczema is a key risk factor for having a peanut allergy. If you have both conditions, being exposed to peanuts can worsen existing eczema symptoms.
8. Tree nuts: Hazelnuts, walnuts, cashews, pecans, Brazil nuts, pistachios, and almonds are examples of tree nuts. Allergies to these nuts are associated with early onset, persistent, and severe atopic disease. If you have eczema and a tree nut allergy, your eczema symptoms may worsen if you come into contact with a tree nut.
9. Tomatoes: Many people with eczema report tomatoes as a trigger food. These fruits are among a group of plants known as nightshades, which also includes eggplant, potatoes, and peppers. A small study found that about half of the 35 participants who stopped eating nightshades reported an improvement in eczema.
10. Citrus: Coumarins and furanocoumarins are compounds found in the skin and flesh of citrus fruits, such as limes. When exposed to ultraviolet (UV) radiation, these compounds can cause eczema flare-ups in some people who handle or eat the fruit.

Eczema food triggers can vary from person to person. Your eczema symptoms may start or get worse due to a food allergy or intolerance.

Food Allergies

If you have a food allergy, it means your immune system is overreacting to a particular food. The immune system response, paired with a broken skin barrier, is likely the cause of the relationship between food allergies and eczema.

An allergic reaction can either be immunoglobulin E (IgE)-mediated or non-IgE-mediated. An IgE-mediated response occurs within minutes of eating the trigger food, while a non-IgE-mediated allergic response typically shows 6-48 hours after eating the trigger food.

Food Intolerances

Food intolerances may be related to enzyme deficiencies (such as the inability to break down and digest compounds like lactose, a milk sugar) and gastrointestinal function. While food intolerances don’t trigger the immune system in the same way as allergies, they can still cause skin reactions like eczema as part of the overall inflammatory response.

While trace amounts of a food allergen can trigger allergic reactions, food intolerance is typically dose-dependent. The severity of the reaction depends on how much of that food is consumed.

A diet rich in fruits and vegetables, heart-healthy fats, and quality lean proteins can help maintain a healthy gut. Probiotic-rich foods are also beneficial. A healthier gut may promote a better tolerance to certain foods and assist in healing inflammatory conditions like eczema.

The Mediterranean diet, which is essentially an anti-inflammatory diet, may help manage eczema. Other anti-inflammatory diets include DASH (Dietary Approaches to Stop Hypertension), traditional Okinawan, and Nordic diets. These diets contain antioxidant-rich plant nutrients, fiber, and healthy fats—all of which support digestion, reduce inflammation, and aid in healing.

If you have dyshidrotic eczema, a dyshidrotic diet may help. Dyshidrotic eczema symptoms usually appear on the hands and feet, and nickel and cobalt are major triggers. A dyshidrotic diet limits foods with a moderate or high amount of these metals. This can include certain wheat, oats, buckwheat, soy beans, lentils, peanuts, beer, red wine, tomatoes, walnuts, and shellfish.

There are several ways to identify personal food triggers. Here are some methods you can use to figure out if there’s a food causing or worsening your eczema flare:

Allergy Testing

There are several allergy tests done under the close supervision of a healthcare provider that can help identify whether you are allergic to a certain food:

• Skin prick test: Your provider places a small amount of the suspected allergen on your skin and pricks the skin so the allergen can go under the surface. If you are allergic, a reaction such as swelling or redness should show within 15-20 minutes.
• Blood test: An allergy blood test measures how much IgE you have in your blood. When you have an allergic reaction, your body produces more IgE, so higher levels may indicate an allergy. Blood tests may also be used to detect food sensitivities, but their efficacy has been debated.
• Patch test: Your provider tapes the suspected allergen to your skin for two hours. In three or four days, they will check the area for signs of a reaction.

Food Diary

A food diary involves using a journal to track what you’ve eaten at what time each day, writing down any side effects. It is a useful approach to help identify personal food intolerances and sensitivities.

Writing a food diary can be time-consuming, but there are phone and computer apps to help you stay on track and simplify the process.

Elimination Diet

An elimination diet can help you determine which foods are causing symptom flare-ups. You’ll eliminate common trigger foods for 4-6 weeks, then slowly reintroduce them to your diet, one at a time, to determine what exacerbates your symptoms. It may also help determine what and how much you can consume without issue.

Always check with your healthcare provider before going on an elimination diet. They can help you manage your food choices without being deprived of necessary nutrients.

Eczema is an inflammatory skin condition that may be triggered or worsened by food allergies, sensitivities, or intolerances.

A healthcare provider can help you determine what food is causing your eczema flare-ups. They can also help develop a diet that would be best for your eczema and overall health.