Eczema, also known as atopic dermatitis, is a common skin condition characterized by dry, itchy, red, and inflamed skin. It often flares up periodically and symptoms can range from mild to severe. Eczema affects over 30 million Americans, most often starting in infancy or childhood. While the exact causes of eczema are not fully understood, it is known to be related to overactivity of the immune system and genetics. However, environmental triggers like certain foods, stress, weather changes, and skin irritants can also provoke eczema flares. This leads many eczema sufferers to wonder: can spicy foods be a trigger?
What is eczema?
Eczema is an inflammatory condition of the skin that leads to redness, dryness, scaling, blistering, crusting, and intense itchiness. The most common areas affected are the hands, feet, wrists, ankles, insides of elbows and knees, neck, chest, and facial area. However, eczema can appear anywhere on the body.
Eczema can occur sporadically or chronically, with periods of flare-ups followed by times of remission. Flare triggers often include environmental allergens, stress, sweat, hot baths, dry air, dust mites, pets, clothing fabrics, soap, detergents, infections, and food allergies or intolerances.
While eczema can develop at any age, 65% of cases begin before age 1 and 90% of cases start before age 5. Eczema often runs in families with a genetic predisposition. It is also associated with asthma, hay fever, food allergies, or other allergic conditions.
Main features of eczema
The main features of eczema are:
- Dry, scaly, thickened skin
- Red, inflamed skin
- Intense itchiness, especially at night
- Raw, sensitive skin from scratching
- Oozing, crusting, flaking
- Thickened, cracked skin
- Sensitive skin
Types of eczema
There are several types of eczema:
- Atopic dermatitis: The most common form, often develops in infancy. Associated with asthma and hay fever.
- Contact dermatitis: Caused by contact with irritants or allergens.
- Dyshidrotic eczema: Affects palms of hands and soles of feet.
- Nummular eczema: Coin-shaped spots, often triggered by dry skin.
- Seborrheic dermatitis: Affects oily areas like scalp, face, upper body.
- Stasis dermatitis: Related to poor blood circulation in lower legs.
Atopic dermatitis is by far the most common form, accounting for over 90% of eczema cases.
What causes eczema?
While the exact causes are not fully understood, eczema is related to both genetic and environmental factors, such as:
- Overactive immune system
- Family history of eczema, asthma, or allergies
- Gene mutations that affect skin barrier function
- Environmental triggers like irritants, microbes, weather, stress
- Disruption of skin microbiome
- Food allergies or intolerances
In people with eczema, the immune system overreacts to perceived threats like viruses or bacteria. The overactive immune response leads to increased inflammation. Eczema flares are often triggered when the immune system detects an environmental substance like a food or pollen as a threat.
Genetic mutations can also cause a defect in the skin’s barrier function, allowing moisture out and germs and allergens in. This leads to dry, irritated skin.
Can foods trigger eczema?
For some people with eczema, certain foods are known to bring about or worsen eczema flares. Common food triggers include:
- Cow’s milk
- Eggs
- Soy
- Wheat
- Fish
- Shellfish
- Peanuts
- Tree nuts
These foods, especially the top 8 food allergens, contain proteins that may be identified by the immune system as a threat. This can activate an inflammatory response.
Food allergy testing or an elimination diet supervised by a doctor or dietitian can help identify problem food triggers. Once a food trigger is removed from the diet, eczema often improves.
Some experts believe problem foods may cause issues through an immune response rather than a true IgE-mediated food allergy. Instead, they hypothesize it may be a non-IgE cell mediated reaction. The theory is that certain proteins pass through a damaged gut barrier and activate immune cells, leading to inflammation. More research is needed in this area.
Can spicy foods trigger eczema?
Spicy foods like chili peppers contain a compound called capsaicin which gives them their heat. Capsaicin stimulates nerve endings in the mouth that sense heat and pain. This triggers the release of inflammatory substances in the body.
Therefore, some speculate that eating spicy foods may potentially instigate or worsen inflammation in people with eczema. However, only limited research has been conducted specifically on spicy foods as an eczema trigger.
A 2006 study published in the British Journal of Dermatology evaluated the impacts of spices, curry, and food sensitivities on worsening atopic dermatitis. 276 participants completed a detailed questionnaire about their symptoms and possible food triggers. The study found:
- 79% reported food sensitivities aggravated their eczema
- The most commonly reported food triggers were spices, curry, meats, seafood, eggs, and dairy
- 61% said spicy foods worsened their atopic dermatitis
The researchers concluded that spices and spicy foods indeed appear to provoke eczema flares in a significant proportion of patients. They hypothesized that chemical compounds in spices may act as haptens, stimulating an inflammatory reaction.
However, the study relied on self-reported survey data, so more controlled research is still needed. The effect of spicy foods on eczema seems to be highly individualized, with some patients reporting problems while others tolerate spicy foods without issue.
Tips for managing eczema and diet
If spicy foods seem to aggravate your eczema, here are some tips:
- Keep a food diary to look for connections between foods and flares.
- Limit foods that seem to trigger flares.
- Drink plenty of water, which may help dilute irritating compounds.
- Take antihistamines if your eczema flares up after eating spicy foods.
- Avoid spicy foods before important events if you know they affect your skin.
- See an allergist about possible food allergy testing.
- Work with a dietitian to identify problem foods and create an elimination diet plan.
General tips for managing eczema through diet include:
- Eat a balanced, varied diet with plenty of fruits, vegetables, lean proteins, and whole grains.
- Stay hydrated by drinking water throughout the day.
- Take a probiotic supplement to support healthy gut bacteria.
- Consider identifying and eliminating problem food triggers.
- Reduce intake of refined sugars, processed foods, and unhealthy fats.
- Manage stress levels through relaxation techniques.
The bottom line
For some people, spicy foods like those containing chili peppers or other pungent spices appear to exacerbate eczema flares. Research shows over 60% of eczema patients report spice sensitivities.
The capsaicin in chilies may stimulate inflammatory pathways. However, more controlled studies are still needed to confirm the connection. Reactions seem to be highly individualized.
If spicy foods aggravate your eczema, try limiting intake and see if your symptoms improve. Work with a doctor and dietitian to pinpoint your personal food triggers. While spicy foods may potentially worsen eczema for some, they can likely be enjoyed in moderation by others who don’t experience this response.
Frequently Asked Questions
Why do some foods trigger eczema?
Some foods may trigger eczema due to an abnormal immune reaction or allergy response. The immune system mistakenly identifies proteins in the food as a threat, leading to inflammation. Common food triggers include milk, eggs, soy, wheat, fish, shellfish, nuts, and sesame.
Do nightshade vegetables like tomatoes, eggplants, or peppers affect eczema?
Nightshade vegetables contain alkaloids like solanine or capsaicin that can be inflammatory. However, research has not confirmed a definite link between nightshades and eczema. Reactions seem individualized. Those with arthritis are more prone to nightshade sensitivities. Trying an elimination diet can help determine if nightshades are a personal trigger.
Does histamine in food affect eczema?
For some people, histamine-rich foods like aged cheese, wine, processed meats, tomatoes, spinach, and shellfish may worsen eczema. Antihistamines like Benadryl may provide relief. Following a low-histamine diet for 2-4 weeks can identify if high histamine foods are a trigger.
Can acidic foods like citrus or vinegar irritate eczema?
Acidic foods may potentially irritate sensitive eczema-prone skin, especially in raw form. However, definitive evidence confirming a link is lacking. Those with chronic hives or swelling of lips, tongue or throat with acidic foods likely have a true allergy and should avoid triggers. Trial and error helps determine if acidic foods affect your individual eczema.
Can probiotics and prebiotics help eczema?
Some research shows probiotics and prebiotics may reduce eczema severity, especially in infants and children. They help populate the gut with healthy bacteria to support immune function. However, more studies are still needed to confirm effectiveness. Talk to your doctor before using probiotic supplements.
Conclusion
In conclusion, while spicy foods have not been conclusively proven to trigger eczema flares, survey data indicates many patients report spice sensitivities aggravating their symptoms. Capsaicin and other compounds in hot peppers may instigate inflammatory pathways for some individuals.
If you experience worsening of eczema after eating spicy foods, try limiting your intake and monitor your skin’s response. Identifying personal food triggers through methods like elimination diets can help create an eczema-friendly diet plan tailored to your unique needs. Work with a doctor and dietitian to manage your eczema through nutrition and lifestyle approaches.