The Elimination Diet for Eczema + Psoriasis
What is an Elimination Diet?
If you have psoriasis or eczema, chances are, something isn’t quite right with your diet. It is estimated that up to 20% of us suffer from some type of food intolerance or sensitivity. The two pillars of natural healing of eczema + psoriasis are moisturising and avoiding triggers. Certain foods and food groups can be considered a skin condition trigger.
The elimination diet for eczema and psoriasis is a short-term eating plan that involves removing certain foods from your diet for a period of time, typically 2-4 weeks. The purpose of the elimination diet is to identify foods that may be causing symptoms or allergic reactions, such as eczema or psoriasis. The diet is also used for sufferers of other conditions, such as IBS. After the elimination period, foods are slowly reintroduced one at a time to see if they cause any adverse reactions. These typically include redness, itching, or worsening skin condition symptoms. This process can help identify trigger foods and create a personalised diet plan to alleviate symptoms.
Eczema + psoriasis are often linked to food sensitivities or allergies, and an elimination diet can help identify trigger foods that may be causing flare-ups. Food is considered a trigger by approximately 25% of adult eczema sufferers + 40% of children that have eczema. Although the link is not fully understood, by removing these foods from your diet, you may be able to reduce inflammation and improve your skin's overall health.
We are all different, and what causes a flare-up in one person, may not affect another at all. The Elimination Diet is a way of finding what works for you. This method is a great way to begin natural healing internally. The Elimination Diet is an alternative to traditional food intolerance/allergy testing, which can be inaccurate. These tests tend to only be useful for a full-blown allergy and don’t pick up a mild sensitivity that could affect your skin.
The elimination diet is also a way of tackling the problem of the leaky gut). Leaky gut syndrome, also known as intestinal permeability, is a condition in which the intestinal walls become more permeable than usual. In a healthy digestive system, the intestinal walls act as a barrier that allows nutrients to pass through while blocking harmful toxins and bacteria. However, when the intestinal walls become too permeable, they allow larger particles such as undigested food particles, toxins, and bacteria to leak into the bloodstream, triggering an immune response. This immune response can lead to inflammation, which can cause a range of health issues such as food sensitivities, psoriasis, and eczema.
This diet requires commitment, but it is a huge relief if you can identify a food trigger. This is a proactive approach, which allows you to take control of your psoriasis or eczema. Remember why you are doing this, and remind yourself of your health and skin goals. Think of your new eating plan as an opportunity to try new foods and learn new recipes. The Elimination Diet provides a natural way to treat your eczema or psoriasis.
How to follow The Psoriasis + Eczema Elimination Diet
Foods to avoid during an Elimination diet for Eczema or Psoriasis
During an elimination diet for eczema or psoriasis, it’s important to avoid common trigger foods that may be causing or exacerbating your symptoms. It’s also important to avoid processed foods, as these can contribute to inflammation in the body. Instead, focus on eating whole, nutrient-dense foods like fruits, vegetables, lean proteins, and healthy fats. Keeping a food diary can also help you track your symptoms and identify trigger foods. To begin, make a list of everything you eat over a typical week. Review the list below and see if your diet consists of a large amount of the following:
- Gluten – Gluten is a protein found in wheat, barley, rye, and some other grains that can have negative effects on the skin. It is estimated that 25% of psoriasis sufferers also have gluten sensitivity. Gluten can cause digestive issues, bloating, weight gain + flare-ups for some individuals. Gluten can trigger an inflammatory response in the body, leading to skin inflammation and rashes. This can be particularly problematic for people with celiac disease or non-celiac gluten sensitivity, as their immune system reacts more strongly to gluten. A gluten-free diet has been shown to improve symptoms in some people with eczema, indicating that gluten may exacerbate the condition.
- Dairy – Dairy products contain saturated fat + hormones which raise inflammation in susceptible individuals. Some eczema sufferers have seen an improvement by switching from cow’s milk to goat’s milk. Dairy is the most common allergen for eczema
- Oats – The negative effects of oats are similar to those of gluten Oats are among the top eight food allergens. Symptoms can range from mild itching and redness to hives, swelling, and even anaphylaxis in severe cases.
- Eggs – Eggs can be a psoriasis trigger. Eggs contain a polyunsaturated fatty acid called arachidonic, which can contribute to the formation of psoriasis plaques in some individuals. Approximately a third of eczema sufferers also identify eggs as a trigger.
- Nightshades – Nightshades are a group of foods known as the potato family, which are theorised to trigger some eczema + psoriasis flare-ups. You can read more in our post- Nightshades: Surprising Foods That Can Trigger Eczema + Psoriasis
- Caffeine- Reduce or cut out coffee, especially after 2pm. Caffeine is a diuretic, so it may dry your skin out further. High amounts of caffeine can also disturb your sleep. Sleep is essential for those of us with a skin condition as this is when our skin renews + repairs itself.
- Citrus Fruits- It’s often advised to try cutting out citrus fruits, as they can lead to inflammation in some patients. Some people are allergic to citrus fruits and may experience symptoms such as itching, hives, and swelling upon consuming them. Even touching the skin of citrus fruit can trigger a reaction for some. This is more common in eczema sufferers. Citrus fruits are acidic, and consuming them in large quantities or on an empty stomach can trigger acid reflux and inflammation.
- Alcohol- Like caffeine, alcohol is a diuretic so it will dry your skin out. Alcohol is one of the most common triggers of eczema + psoriasis. Firstly, alcohol dehydrates the body, and as a result, it also dehydrates the skin. This dehydration can cause fine lines and wrinkles to become more pronounced, making the skin appear aged and tired. In addition, alcohol dilates blood vessels, making the face appear redder or flushed. This effect can be long-lasting and even become permanent over time with excessive alcohol consumption. Furthermore, alcohol can cause a decrease in collagen production, which is essential for skin health. Collagen helps to keep the skin firm and elastic, but with a decrease in collagen, the skin can become saggy and dull. Alcohol also causes inflammation throughout the body, which can manifest on the skin in the form of acne, redness, and puffiness.
- Sugar – Excess sugar intake can lead to inflammation in the body, which can manifest in skin conditions such as acne, psoriasis, and eczema. Sugar can also damage collagen and elastin in the skin, leading to premature wrinkles and sagging. A diet high in sugar can also lead to insulin resistance, which can contribute to skin discoloration and dark spots.
- Nuts- Some people are allergic to various types of nuts, and eating them can lead to severe allergic reactions, such as swelling of the face and throat, hives, difficulty breathing, and anaphylaxis. Studies show that nuts can make eczema worse for some people, in particular children. Peanuts are the most common culprits.
- Soy- Soy contains high levels of fatty acids, which may promote inflammation. 1 in 5 eczema sufferers has a soy intolerance. Soy contains proteins that can trigger allergic reactions in some people. Soy can also cause digestive issues for some individuals.
- Nickel- A low nickel diet has been known to provide numerous benefits for individuals with nickel allergy or sensitivity. By eliminating or limiting foods with high nickel content like chocolate, soybeans, and nuts, it is possible to reduce allergic reactions in sensitive individuals. This can result in fewer incidents of skin rashes and itchiness, and help manage other symptoms caused by nickel allergy. For people with nickel allergy, skin rashes are one of the most common symptoms. By avoiding high-nickel foods, it is possible to reduce the frequency and severity of these conditions.
Foods to eat during an Elimination diet for Eczema or Psoriasis
When following an elimination diet for eczema or psoriasis, it’s important to focus on nutrient-dense, whole foods that are less likely to trigger inflammation in the body. It’s also important to stay hydrated by drinking plenty of water and herbal teas. Keeping a food diary can help you track your progress and identify any trigger foods that may be causing your symptoms.
Include plenty of:
- Rice- Preferably whole grain as this can have an anti-inflammatory effect. Rice is rich in essential vitamins and minerals such as thiamin, niacin, iron, manganese, and selenium. These micronutrients play important roles in maintaining optimal health. For example, thiamin and niacin are essential for brain function and energy metabolism, iron is vital for healthy blood cells and manganese plays a role in bone
- Sweet Potato- Sweet potatoes are a great antioxidant and packed with Vitamin C. Sweet potatoes also provide skin-friendly potassium and fibre. Sweet potatoes are rich in antioxidants, including beta-carotene and quercetin, which can help reduce inflammation in the body. By reducing inflammation, sweet potatoes may help alleviate some skin issues and promote better overall skin health. Sweet potatoes are high in vitamin C, which is a crucial nutrient for collagen production. Collagen is a protein that keeps our skin firm and helps prevent sagging and wrinkles. By incorporating sweet potatoes into your diet, you can help increase your body's collagen production, which can lead to smoother, more youthful-looking skin.
- Protein Powders- Protein powders can be a convenient, low-calorie source of protein for those who are sensitive to eggs or those following vegan/vegetarian lifestyles. Pea protein and lactose-free options tend to work better than whey powder for those with food allergies.
- Meat- Buy organic meat wherever possible. Keep consumption of red meat to a minimum. Meat is an excellent source of protein. Protein plays a crucial role in building and maintaining healthy skin cells, and a lack of protein can lead to dull, lackluster skin. Consuming meat can provide the necessary amino acids for healthy skin, helping to boost skin firmness and elasticity. Meat is also a great source of several key vitamins and minerals that are important for skin health. For example, beef is high in zinc, which can help reduce inflammation and improve skin healing time. Omega-3 fatty acids, found in fatty fish like salmon, can help reduce inflammation and increase hydration, leading to plumper, more radiant skin. It's important to consume meat in moderation and to choose high-quality sources, like grass-fed beef or wild-caught salmon.
- Vegetables- Our psoriasis support smoothie + eczema smoothies are a convenient way to get your 5 a day. Eating a diet rich in vegetables not only nourishes our bodies, but also has a multitude of benefits for our skin. Vegetables are packed with essential vitamins, minerals, and antioxidants that support healthy skin function and can help us achieve a glowing complexion.
- Water & Herbal Teas- You can read more on our post- Herbal Teas for Eczema + Psoriasis. Keeping hydrated is essential for healthy skin. Dehydration can lead to inflammation in your skin, making it appear red and irritated. Staying hydrated helps to cool down the skin and reduce inflammation and redness. Drinking plenty of water helps to keep your skin hydrated and supple, improving its elasticity. When you have well-hydrated skin, it becomes less prone to wrinkles and fine lines.
- Good fats- Monosaturated fats are highly beneficial for our skin and prevent inflammatory reactions. The saturated fats in coconut oil will give your skin an extra boost. Good fats such as omega-3 and omega-6 fatty acids found in foods like avocado, nuts, and seeds, and fish can help keep the skin hydrated and supple, reducing the appearance of fine lines and wrinkles. They can also help strengthen the skin barrier, protecting it from environmental stressors that can cause damage and premature aging. In addition, good fats can help reduce inflammation in the body, which can lead to a reduction in skin redness, irritation, and acne breakouts. For those with dry skin, incorporating good fats into their diet can help improve the skin's natural moisture levels and alleviate dryness.
- Low sugar fruits- For more information see our post- The Ultimate Guide to Choosing the Best Fruits for Eczema + Psoriasis. Fruit is high in flavonoids, which fight inflammation. Blueberries are my go-to choice as they are packed with antioxidants.
- Probiotics – Research suggests that adding a prebiotic to your diet can improve symptoms of eczema for some individuals. Probiotics can reduce inflammation by promoting the production of anti-inflammatory molecules such as cytokines. This can help improve skin conditions such as acne, psoriasis, and rosacea. Probiotics also help improve the skin's barrier function by increasing moisture retention and preventing transepidermal water loss. A stronger skin barrier means better protection against external aggressors like pollutants, UV rays, and bacteria.
- Fish- Fish are a great source of omega-3 fatty acids, which fight inflammation. These fatty acids help to keep skin moisturised, reduce inflammation, and prevent the skin from becoming dry, itchy, or irritated. Oily fish contain higher levels. These include salmon, tuna, mackerel + sardines. In addition to omega-3 fatty acids, fish is also high in protein, which is important for the growth and repair of skin cells. A diet rich in protein can promote collagen production, which helps to keep the skin firm and elastic. Collagen is essential for maintaining the healthy structure of the skin and slowing down the aging process.
Keeping a Food Diary to track Symptoms
Keeping a food diary is an important part of an elimination diet for eczema and psoriasis. By tracking what you eat and any symptoms you experience, you can identify trigger foods and make adjustments to your diet accordingly. Be sure to record everything you eat and drink, including portion sizes and any condiments or sauces. Also, note any symptoms you experience, such as itching, redness, or inflammation. These symptoms tend to appear 6-24 hours after consuming an allergen (Reference 2). Over time, you may start to see patterns emerge that can help you make more informed decisions about what to eat and what to avoid.
It’s important to pay close attention to food labels during your elimination phase. If you accidentally consume an item you are eliminating, your results won’t be accurate and you may have to start this phase again.
Reintroducing Eliminated Foods to Identify Triggers
Once you have completed the elimination phase of the diet (2-4 weeks) and have seen improvement in your eczema or psoriasis symptoms, it’s time to start reintroducing the foods you eliminated one at a time. This process can take several weeks or even months, as you want to give your body enough time to react to each food before introducing another. Start with small amounts of the food and gradually increase the portion size over a few days. Keep track of any symptoms you experience and note which food may have triggered them. This will help you identify which foods to avoid in the future to prevent eczema + psoriasis flare-ups.
The length of the elimination diet can vary depending on the individual and their specific needs. It's typically recommended to eliminate foods for at least 2-4 weeks and then slowly reintroduce them one at a time to identify any trigger foods.
Once you re-introduce the food, the following symptoms indicate a sensitivity or intolerance:
- Skin changes (particularly for eczema or psoriasis)
- Constipation
- Sleep Problems
- Headaches
- Joint Pain
- Bloating
The Elimination Diet can take a long time, but be patient as the results are well worth it. Make sure you keep up your other good skin practices at the same time.
Eliminating certain foods from your diet can lead to nutrient deficiencies if not done properly. It's important to work with a doctor or registered dietitian to ensure that your diet remains balanced and that you are getting all the necessary nutrients. Don’t cut out too much too suddenly.
It is worth noting that the elimination diet does have its downsides. One of these is that it can make an intolerance more pronounced. If your body isn’t getting any of certain food groups, it can’t build up any natural tolerance to the allergen. This theory was confirmed by an eczema-focused study in 2016 (Reference 1), which found 19% of eczema sufferers experienced this after following the elimination diet. For example, if you identify dairy as a trigger and avoid it altogether, you may experience a greater flare-up than before the elimination diet the next time you consume it. Avoiding entire food groups forever can be impractical, not to mention unenjoyable!
While an elimination diet can help identify trigger foods and reduce inflammation, it may not cure eczema or psoriasis completely. It's important to continue to work with your doctor to develop a comprehensive treatment plan that may include medication, topical treatments, and lifestyle changes.
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The Best Diet for Eczema: Foods to Avoid and to Include
Nightshades: Surprising Foods That Can Trigger Eczema + Psoriasis
Sugar and Eczema or Psoriasis: Tips for Reducing Your Intake
10 Common Eczema + Psoriasis Triggers You Need to Know About
Can a Gluten-Free Diet Help Manage Psoriasis + Eczema Symptoms?
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1- Chang A, Robison R, Cai M, Singh A, Natural History of Food-Triggered Atopic Dermatitis and Development of Immediate Reactions in Children. 2016
2- Katta R, Schlichte M. Diet and dermatitis: food triggers. J Clin Aesthet Dermatol. 2014
