Eczema is an itchy, scaly skin rash that occurs commonly in children but also occurs in adults. When you have eczema, you develop patches of red, cracked skin that sometimes weep clear fluid. The condition, also known as atopic dermatitis, affects 10% to 20% of young children, and about 7% of adults will suffer from a bout of eczema over the course of their lives.
Eczema treatment usually starts with topical corticosteroids, and can progress to corticosteroids taken orally if the topical creams fail to curb the itching and inflammation inherent in the skin condition. In severe cases, physicians may try other drugs that suppress the immune system.
However, there may be another alternative for people seeking eczema treatment. The skin condition appears to be linked to celiac disease, and the treatment for celiac disease, the gluten-free diet, may help treat eczema as well in some people.
Eczema More Common In Celiac Population
It's not clear what causes eczema, but the skin condition appears to result from a combination of genetic predisposition and environmental factors. People with eczema seem to have both lower levels of a type of cytokine protein that's associated with a healthy immune system and higher levels of a cytokine protein that's involved in allergic reactions. Some physicians consider eczema an autoimmune condition.
Researchers have compared the prevalence of eczema in people who also suffer from celiac disease to eczema prevalence in control subjects, and they've found that eczema occurs about three times more frequently in celiac disease patients and about two times more frequently in relatives of celiac disease patients, potentially indicating a genetic link between the two conditions.
Some Studies Show Gluten-Free Diet Helpful in Eczema Treatment
It's possible that a strict wheat-free or gluten-free diet could help treat some cases of eczema -- both in celiac disease patients and in patients who haven't been diagnosed with celiac but who may have non-celiac gluten sensitivity.
In one study, Finnish researchers looked at candidates for eczema treatment who had suspected wheat allergies but not clinically confirmed celiac disease. Their aim was to identify the specific fraction of wheat causing eczema (which turned out to be gliadin, the toxic protein fragment in celiac disease), but they also found that four of the six adult eczema patients studied successfully treated their eczema by eliminating grains from their diets.
Another (much older) British study looked at the overall prevalence of immune system disorders in patients with celiac disease, and found about 5% of celiac disease patients also had eczema. Two of these patients, out of a total of 17, had "dramatic and persisting relief from their rash when on [the gluten-free] diet," that study reported.
Should Eczema Treatment Involve a Gluten-Free Diet?
In the studies I've discussed, a gluten-free diet helped some but not all eczema patients control their symptoms. So should you consider a gluten-free diet as eczema treatment?
If you've just been diagnosed with celiac disease and you also suffer from eczema, you may find that you resolve some or all of your eczema symptoms with a gluten-free diet. In addition, since eczema and celiac disease appear to be related genetically, and since both run in families, you may want to consider celiac disease testing if you have eczema and are related to people who have celiac.
If you have eczema along with celiac disease symptoms, you definitely should get tested for celiac disease, since you're already at a higher risk for the condition. Again, if you do turn out to have celiac, you may find as a bonus that the gluten-free diet helps to clear up your eczema symptoms.
Finally, if you've finished with all the medical testing you wish to have for celiac disease (regardless of whether you've been diagnosed with the condition), you might want to consider trying the gluten-free diet on a trial basis for several months to see if it helps with your eczema treatment. Just remember: for the diet to work, you'll need to follow it strictly, without cheating.
Atopic Dermatitis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Accessed Nov. 4, 2010.
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B.T. Cooper et al. Coeliac disease and immunological disorders. British Medical Journal. 1978, 1, 537-539.
E. Varjonen. Antigliadin IgE - indicator of wheat allergy in atopic dermatotis. Allergy. 2000 Apr;55(4):386-91.