Chapter 6
A range of nutrients work together to repair, renew and moisturise your skin. These are covered in detail in this chapter.
Note: For best results these nutrients need to be used in conjunction with the Eczema Diet. The following supplements should not be combined with herbal preparations or supplements containing vegetable extracts such as broccoli as they are rich in salicylates and other plant chemicals.
The body is truly remarkable and resourceful. It makes many of its own vitamins in the gastrointestinal tract and it stores minerals in the liver and bones; however, the body does not store or manufacture vitamin C so it must be consumed in your diet. Vitamin C (also known as ascorbic acid) aids the absorption of iron and copper, it’s vital for the formation of collagen in the skin, guards against infections and is required for liver detoxification. Vitamin C is a natural antihistamine as it destroys the imidazole ring of the histamine molecule.[1] For this reason it’s imperative that allergy sufferers avoid developing vitamin C deficiency as it can result in histamine toxicity and allergic reactions may increase in severity. You can prevent this from occurring by eating vitamin C-rich papaya, pawpaw or brussels sprouts and by taking a vitamin C supplement.
Signs of vitamin C deficiency include allergies, dry skin, bumpy/rough skin, easy bruising, small purplish spots on skin, fatigue, depression, tooth loss, haemorrhaging, bleeding gums, swelling of lower extremities, joint pain (mimics arthritis) and poor wound healing.[2][3] In infants, low or no intake of vitamin C (from breastmilk, when the mother is vitamin C deficient) can mimic ‘shaken baby syndrome’ (easy bruising, brain haemorrhage, blood pooling in the eyes and fractures).[4] According to recent research, Americans continue to suffer from scurvy (the ‘sailor’s disease’ of the 1700s) because people aren’t eating enough fruits and vegetables.[5]
Vitamin C deficiency can occur from dieting, from following a no-fruit diet (such as high-protein, low-carb diets), vaccinations/immunisations, frequent aspirin intake or high salicylate ingestion, the birth control pill, stress, cigarette smoking and diabetes.[6][7] Not all fruits and vegetables contain adequate vitamin C.
The following is a list of food sources of vitamin C with the content of vitamin C listed in milligrams:
Age range | Vitamin C (ascorbic acid) total daily intake* (supplement dosages in brackets) |
|---|---|
| Adults | 200–500mg (60mg twice a day in supplement form taken with food) and consume 2 1/2 cups fruit and vegetables, supplying approx. 200mg vitamin C |
| 5–17 years | 70–120mg (30mg twice a day in supplement form, taken with food) and consume 1 1/2 cups fruit and vegetables |
| 1–4 years | 60–100mg (15mg twice a day in supplement form, taken with food) and consume 1 cup fruit and vegetables |
| 0–12 months | 25–35mg from breastmilk or formula. Also give infants on solids 1 tablespoon to 1/2 cup of fruit and vegetables daily, depending on age and appetite. |
* Total daily intake is the minimum to maximum recommended amount obtained daily from both foods and a supplement. If a supplement is recommended, the individual supplement dosages and instructions are listed in brackets. For example, for adults the minimum amount of vitamin C from both foods and supplement is 200mg and the maximum is 500mg. A vitamin C supplement is highly recommended (and should be taken in divided dosages at meal times/not on an empty stomach), so in brackets you’ll see ‘60mg twice a day...’ which is a daily total of 120mg.
To meet your daily requirement for vitamin C (in amounts that are adequate for preventing histamine toxicity), vitamin C-rich fruits and vegetables must be eaten daily. For example, eat sliced papaya on porridge in the morning, a side salad with lunch and green beans and brussels sprouts with dinner.
Do not chew vitamin C tables as they can wear away teeth enamel, making teeth sensitive and painful. A powdered multi-formula supplement is preferable or a solid tablet swallowed whole (for children use a powdered supplement to avoid choking).
Vitamin C thins the blood. If nose bleeding occurs, halve the vitamin C dosage or take vitamin K at the same time. Do not take vitamin C supplements if you have haemochromatosis or if you have been prescribed aspirin, anticoagulants or antidepressants.
Glycine is an amino acid found in protein and it’s beneficial for eczema sufferers for many reasons: it’s anti-inflammatory, cell protective and vital for collagen synthesis in the skin.[8][9] Collagen is the ‘glue’ that binds the skin together, making it strong and attractive, and approximately one-third of collagen is composed of glycine. Glycine plays a role in liver detoxification of chemicals and supplementation can significantly reduce salicylate sensitivity.[10] Glycine helps to heal the damaged skin barrier.
Glycine is classed as a ‘non-essential’ amino acid, as the body is supposed to be able to manufacture its own supply if your diet is good. However, in eczema sufferers the ability to manufacturer glycine may not be adequate and/or the glycine receptors in their skin may be compromised. According to researchers from the University of Heidelberg in Germany, people with eczema and psoriasis have a striking reduction in glycine receptors in the skin.[11]
The following is a list of food sources of glycine with the content of glycine listed in milligrams:
Age range | Glycine total daily intake* |
|---|---|
| Adults | 2000–3000mg (2–3g) (1000mg glycine in supplement form)^ |
| 13–18 years | 800–1000mg (500mg per day in supplement form)^ |
| 5–12 years | 600–800mg (250–300mg per day in supplement form)^ |
| 1–4 years | 600mg (125mg per day in supplement form)^ |
| 0–12 months | Breastfeeding mothers can take glycine to increase glycine in breastmilk; glycine is in infant formulas but not in adequate amounts. Speak to a nutritionist before giving your baby glycine. |
| *Total intake from food and supplements. ^Take powdered glycine mixed with water before meals (dosages are in brackets). After your eczema clears up, gradually cut down on the supplement dosage to half the dosage or less. Read ‘Dosage note’. |
Salicylates end up in breastmilk so babies with eczema and salicylate sensitivity may benefit if their breastfeeding mother takes a glycine, magnesium and vitamin B6 supplement. Also consume Therapeutic Broth daily as it’s naturally rich in glycine.
High-dose glycine taken over long periods of more than six months can cause muscle aches at night, if you are low in oestrogen. If this occurs, discontinue use. Do not take glycine if you are on blood thinning medications such as aspirin, as glycine will reduce the effects of aspirin (it literally detoxifies it). If you are taking medications, seek medical advice before taking liver detoxification supplements.
In 1942 a diet experiment was conducted on healthy adults. The volunteers ate white rice, white flour products, sugar, fats, beef and raw egg whites. Within three weeks all the volunteers had itchy, scaly rashes that were diagnosed as eczematous dermatitis. At seven weeks they looked like death with ‘striking greyish’ skin, indicating poor blood supply to the outer parts of the body.[12][13] Their eczema was not labelled genetic or treated with a topical drug. They were given a biotin supplement and their symptoms completely reversed in less than five days.[14][15]
In 1942, Sydenstricker and colleagues were the first scientists to demonstrate the need for biotin in the diet. They had induced ‘egg white injury’ where the consumption of avidin, a protein in raw egg whites, latches onto the B-group vitamin called biotin so your body can’t use it. Biotin is required for delta-6-desaturase enzyme reactions in the body, and when this enzyme malfunctions from lack of biotin, skin inflammation is the first sign to appear. Biotin deficiency symptoms are: dermatitis or eczema, greyish pallor of the skin, scaly lips, nausea, loss of appetite, depression, moodiness, muscle pain, raised cholesterol and localised numbness.[16][17]
Unfortunately, and despite the research that has been available for more than 60 years, raw egg whites are still present in many supermarket products including dips, whole-egg mayonnaise and coleslaw dressing. Some health experts recommend protein shakes, containing fresh or powdered egg whites. We lick the bowl when making cakes or pancake mix containing raw egg. Traditional chocolate mousse and wedding cake icing contain raw egg whites. It may not be a coincidence that egg allergy is the number one allergy with which eczema sufferers present (and often they’re only allergic to raw eggs).[18]
Eating raw egg whites on the rare occasion won’t cause problems—egg white injury is achieved if you frequently eat dips, creamy dressings and/or whole-egg mayonnaise and other sources of raw egg whites.
• Check your diet for hidden sources of raw egg whites.
• Tell other people about egg white injury and stop buying products containing raw egg white—food manufacturers will stop using raw egg white in foods such as mayonnaise when consumers stop buying their products.
The following is a list of food sources of biotin with the content of biotin listed in micrograms:
Biotin can be manufactured by friendly bacteria in healthy intestines, yet this may not occur in rash-prone individuals due to genetics, high omega-6 intake, antibiotic use, a bout of diarrhoea or illness. The biotin in food is usually attached to protein and is poorly absorbed by the body, so a biotin supplement is essential for eczema sufferers.
Age range | Biotin supplement dosages |
|---|---|
| Adults | 100–150mcg per day in supplement form |
| 5–17 years | 50–75mcg per day in supplement form |
| 1–4 years | 10–50 mcg per day in supplement form |
| 0–12 months | Obtain biotin through breastmilk if breastfeeding or infant formula or speak to a nutritionist about biotin supplementation. |
High-dose biotin supplementation may lessen the effect of some cholesterol medications.
Vitamin B6 (also known as pyridoxine) is involved in more than 100 enzyme reactions including delta-6-desaturase which helps to reduce inflammation. Vitamin B6 is essential for eczema and allergy sufferers because it’s a natural antihistamine and it helps to reduce salicylate and monosodium glutamate (MSG) sensitivity. Vitamin B6 deficiency signs include dermatitis, irritability, mood changes, convulsions, numbness or cramps in the arms and legs, anaemia, smooth painful tongue, ulcers inside the mouth, skin cracks at the corners of the mouth or eyes, low blood sugar/hypoglycaemia and poor immunity (decreased lymphocytes and interleukin-2).[19][20] Vitamin B6 deficiency can be caused by or is associated with frequent alcohol consumption, poor diet, high-protein diet (this increases the need for vitamin B6), prescription drugs (such as anti-convulsants, anti-turberculosis and penicillamine), cirrhosis of the liver and malabsorption syndromes.
The following is a list of food sources of vitamin B6 with the content of vitamin B6 listed in milligrams:
Age range | Vitamin B6 supplement dosages |
|---|---|
| Adults | 8–13mg per day in supplement form |
| 5–17 years | 4mg per day in supplement form |
| 1–4 years | 1–2mg per day in supplement form |
| 0–12 months | 0.5mg from breastmilk or infant formula |
If you are taking prescription medications speak to a nutritionist or doctor before taking a vitamin B6 supplement.
Magnesium is an alkaline mineral known as ‘the great relaxer’ as it relieves muscle tension and stiffness, and it can decrease cravings for alcohol. Magnesium is needed for the functioning of more than 300 enzymes in the human body, it helps to alkalise the blood and it decreases chemical sensitivity when combined with glycine and vitamin B6. Magnesium deficiency can be caused by diarrhoea, poor diet, low protein diet (less than 30g/1oz per day), fat malabsorption, frequent alcohol consumption, frequent use of antibiotics or diuretics; and magnesium absorption declines as you age.
The following is a list of food sources of magnesium with the content of magnesium listed in milligrams:
Age range | Magnesium total daily intake* (supplement dosages in brackets) |
|---|---|
| Adults | 350–400mg (20–60mg in supplement form. The rest should be supplied by a healthy diet.) |
| 5–17 years | 240–350mg (10mg per day in supplement form) |
| 1–4 years | 130mg (5–10mg per day in supplement form) |
| 0–12 months | 30–75mg supplied from breastmilk or infant formula |
| *Read ‘Dosage note’. |
Magnesium supplementation can interfere with digoxin (heart medicine), some antibiotics, chlorpromazine (tranquiliser), penicillamine, oral anticoagulants and some anti-malaria drugs. Do not take magnesium at the same time as drugs to treat osteoporosis (take them at least 2 hours apart).
Zinc is vital for skin repair and maintenance and deficiency leads to skin lesions, dry and rough skin and delayed wound healing. A severe zinc deficiency, caused by faulty gene expression, induces bullous pustular dermatitis (blister-like dermatitis), patches of eczema and hair loss (alopecia).[21] Other deficiency signs include acne, stretch marks, white-coated tongue, white spots on fingernails, impotence, infertility, frequent infections, frizzy hair, poor sense of taste or smell and premature ageing of the skin. During your teenage years, rapid development requires zinc and these growth spurts can lead to zinc deficiency, and as the skin’s oil gland activity is regulated by zinc, acne can result.
Menstruation and ejaculation deplete zinc stores in the body and zinc deficiency can be caused by frequent alcohol consumption, high salt intake (from canned food, takeaway/restaurant food), high calcium intake, chronic stress, frequent consumption of coffee or tea, and high fibre diets rich in phytic acid (which is why soaking grains is recommended).
The following is a list of food sources of zinc with the content of zinc listed in milligrams:
You can do a simple zinc taste test to confirm if you have a zinc deficiency. This test is often available from health food shops, naturopaths and naturopathic clinics. When you have a measured dose of liquid zinc, hold it in your mouth for a few seconds before swallowing it or spitting it out. Your tastebuds will indicate the degree of need for zinc supplementation: if you have a deficiency, the mixture will taste like water, be pleasant tasting or leave a furry feeling in the mouth. If your body has plenty of stored zinc, the liquid will taste metallic or foul and you’ll probably want to spit it out.
Age range | Zinc daily intake |
|---|---|
| Adults | 20mg in supplement form* |
| 5–17 years | 10–15mg in supplement form* |
| 1–4 years | 5mg supplement* |
| 0–12 months | 2–4mg supplied from breastmilk or infant formula |
| *Salt and supplements containing calcium, iron and/or phosphorus can prevent zinc supplements from being absorbed so, if possible, have your zinc supplement 1 to 2 hours apart from these substances. |
Do not take zinc supplements if you have copper deficiency or if you’re taking tetracycline (a drug for infections) as zinc competes for absorption with copper and may make your medical treatment less effective. Do not exceed the prescribed dosage as excessive zinc intake can cause diarrhoea, abdominal pains, nausea, dehydration, dizziness and lethargy.
The mineral chromium is required in micro amounts for normal growth and general health. In 1959 it was identified as the active ingredient in ‘glucose tolerance factor’ and it enhances the action of the hormone insulin, which helps your body process glucose in the blood. Chromium is needed for the breakdown of proteins, carbohydrates and fats and it enhances the body’s ability to convert glucose to energy. It is not a miracle nutrient or a ‘wonder’ supplement but for those who are deficient in chromium, supplementation can greatly improve their energy levels, ability to think clearly and quality of life.
In the 1800s carbohydrate avoidance was recommended as part of a diet that prevented eczema; however, with additional information about the benefits of chromium supplementation, total carbohydrate avoidance is not necessary or advised (as you need dietary fibre for gastrointestinal health). Chromium supplementation enables sufferers to be able to enjoy good quality wholegrain carbohydrates while on the Eczema Diet.
The following is a list of food sources of chromium with the content of chromium listed in micrograms:
Modern western diets are low in chromium and generally rich in processed carbohydrates and frequent sugar consumption is considered normal, causing an increased need for chromium in the diet. Chromium supplementation can decrease sugar cravings and cravings for carbohydrates and it can reduce excessive hunger, fatigue (especially after meals or afternoon energy slumps), glucose intolerance and irritability (adding cinnamon to the diet can also lower blood glucose and increase insulin sensitivity—however, cinnamon is high in salicylates and only suitable in Stage 2 of the Eczema Diet).
Age range | Chromium daily intake |
|---|---|
| Adults | 45mcg in supplement form |
| 5–17 years | 25mcg (AI)* in supplement form |
| 1–4 years | 13mcg |
| 0–12 months | 1–7mcg from breastmilk or infant formula |
| *Adequate intake (AI) of 25mcg elemental chromium is equivalent to 200mcg of chromium picolinate. |
While statistics on chromium deficiency are limited, data from research suggests that only 0.4–2.5 per cent of chromium is absorbed from foods. Vitamin C and vitamin B3 (niacin) enhance the absorption of chromium, as does protein, so take a chromium supplement with a protein-rich meal.[22] Chromium picolinate is easier for the body to absorb than other types of chromium and a chromium supplement should also contain B6, B12, vitamin C, vitamin D3, folic acid, magnesium and zinc.
If you are taking medical drugs, consult with a nutritionist or doctor before taking chromium. If you have insulin-dependent diabetes seek advice from your doctor before supplementing with chromium as it alters blood sugar levels (insulin would need to be reduced if you were taking chromium but do this only with your doctor’s supervision).
Chromium + vitamin C + vitamin B3 + protein (to enhance absorption).
Vitamin D is manufactured in the skin after direct sunlight exposure and it’s obtained through your diet. It’s an important fat-soluble vitamin that directly and indirectly controls more than 200 genes (so if vitamin D is deficient how does this affect your genetics?). According to Sidbury and colleagues from the Children’s Hospital in Boston, children with moderate to severe atopic eczema have significantly lower levels of vitamin D compared with children who have mild symptoms.[23] A study by the same researchers found that adults with eczema consume diets lower in vitamin D than people without eczema.
Vitamin D deficiency is common, especially in cooler climates, and more than 1 billion people worldwide have vitamin D deficiency or insufficiency.[24] Deficiency is linked to a range of health problems including rickets, poor bone health, severe fatigue, psoriasis, muscle weakness and a 30 to 50 per cent increased risk of cancers of the colon, prostate and breast.[25][26][27]
What can diminish vitamin D in the body? Low or inadequate exposure to direct sunlight is the main contributing factor. This can occur in winter or cooler climates and from overuse of protective clothing and sunscreens. According to research published in the British Journal of Dermatology, frequent use of cortisone cream depletes vitamin D in the skin.[28] When you use topical steroids or other topical drugs prescribed for eczema you are advised to avoid direct sun exposure as topical steroids make the skin fragile and more prone to sun damage. Which highlights another reason why we need to adopt healthy alternatives to medicated creams.
Frequent, small exposures to sunlight help to restore vitamin D levels as does a healthy diet and supplementation, which is highly recommended for eczema sufferers.
The following is a list of food sources of vitamin D with the content of vitamin D listed in micrograms:
• Ask your doctor to check your vitamin D level.
• Make sure adequate amounts of vitamin D are being consumed in your diet.
• Have safe sun exposure daily: about 10 minutes every day of unfiltered sunshine directly on the skin will keep vitamin D deficiency away in healthy individuals. If you have eczema and/or vitamin D deficiency a supplement is advised.
Age range | Vitamin D3 daily intake |
|---|---|
| Adults | 90mcg in supplement form |
| 5–17 years | 30–60mcg in supplement form |
| 1–4 years | 15–30mcg in supplement form |
| 0–12 months | 5–15mcg from breastmilk or infant formula |
| Take vitamin D for 12 weeks then halve the dosage or discontinue use. 1mcg of vitamin D=40 IU (international units). For example, 90mcg=3600 IU. |
If you have diabetes speak to your doctor before taking vitamin D as it may lower blood sugar levels. You may not be able to take vitamin D if you have kidney disease, kidney stones or granulomatous disorders (immune disorder), as increased vitamin D intake may increase calcium in the blood.
a Vitamin D + calcium + magnesium + vitamin K (for bone health).
Vitamin E is the predominant antioxidant in human skin.[29] Supplementation can decrease the allergy marker immunoglobulin E (IgE) in allergy sufferers, improve immune responses and decrease the production and release of pro-inflammatory prostaglandins. A clinical trial published in the International Journal of Dermatology revealed that nearly 50 per cent of adults with atopic dermatitis who were treated with 400 IU (268mg) of vitamin E daily for eight months showed great improvement (compared to only one in the placebo group); and there was almost complete remission of atopic eczema in seven people taking the vitamin E, but none in the placebo group (four of the adults treated with vitamin E worsened, compared to 36 in the placebo).[30] While this study showed promising results, other studies have not been so positive and it must be stressed that vitamin E should be taken with vitamin C and alpha-lipoic acid so you don’t need to take the mega dose of vitamin E used in this study (vitamin C and alpha-lipoic acid recycle vitamin E, helping it to circulate for longer).
The following is a list of food sources of vitamin E with the content of vitamin E listed in milligrams:
Age range | Vitamin D3 daily intake |
|---|---|
| Adults | 80–100mg (119–149 IU) in supplement form |
| 5–17 years | 40–60mg (60–90 IU) in supplement form |
| 1–4 years | 20–30mg (30–45 IU) in supplement form |
| 0–12 months | 4–5mg (6–7.5 IU) (AI) from breastmilk or infant formula |
| Take vitamin E (d-alpha-tocopherol) with vitamin C and alpha-lipoic acid. 1 IU (international unit) of vitamin E is equivalent to 0.67mg of vitamin E. To convert IUs into mg (milligrams): multiply the number of IUs by 0.67. |
Vitamin E from natural food sources is called ‘d-alpha-tocopherol’ and it’s more potent than the synthetic form. Synthetic vitamin E is listed as ‘dl-alpha-tocopherol’ and this artificial form (denoted by ‘dl’) should not be taken.
Vitamin E thins the blood so do not take vitamin E if you are on blood-thinning medications such as aspirin or if you are undergoing surgery. If you are on any medications, consult with your doctor before taking vitamin E.
Quercetin is a potent antioxidant flavonoid found in fruits and vegetables and it’s the major therapeutic ingredient in onions and various herbal medicines. Quercetin is a natural antihistamine as it reduces blood histamine level and it can help to reverse the liver damage caused by nitrate consumption.[31][32] When combined with vitamin C it can quickly reduce and prevent hay fever symptoms. Quercetin is anti-inflammatory as it inhibits formation of pro-inflammatory leukotrienes, which are associated with eczema and asthma (see Diagram 3, ‘How prostaglandins control inflammation’).
The following is a list of food sources of quercetin with the content of quercetin listed in milligrams:
Age range | Quercetin daily intake |
|---|---|
| Adults | 80–130mg* in supplement form |
| 5–17 years | 40–60mg* in supplement form |
| 1–4 years | 10mg daily* in supplement form |
| 6–12 months | obtain quercetin from breastmilk or food if on solids |
| *Do not take quercetin as a single supplement—have it in a multivitamin formula that includes vitamin C, and have it in divided doses with food. For example, adults can have 40mg of quercetin twice a day with breakfast and lunch. |
Quercetin supplementation is generally safe.[33] High doses of quercetin (of 150mg or more) can cause side effects including low blood pressure, headaches, upset stomach and numbness and tingling, and may interfere with some medical drugs. If you have kidney disease avoid quercetin and other supplements.
Do not take quercetin if you are taking corticosteroids or cyclosporine. Avoid high-dose quercetin if you are taking blood-thinning medications (aspirin, warfarin etc.). If you are undergoing chemotherapy talk to your doctor before taking quercetin.
Alpha-lipoic acid, also known as lipoic acid and thiotic acid, is made in small quantities by a healthy body and it has the unique talent of being both water-and fat-soluble. In animal studies, alpha-lipoic acid supplementation increases the formation of the powerful antioxidant glutathione, which is essential for healthy skin and liver detoxification of chemicals, toxic metals, antibiotics and alcohol. Alpha-lipoic acid regenerates other antioxidants including vitamin C and vitamin E and it assists with converting glucose (blood sugar) into energy.
The following is a list of food sources of alpha-lipoic acid:
(Sources that are unsuitable while you have eczema: spinach, broccoli, peas, brewer’s yeast, asparagus, organ meats.)
Age range | Alpha-lipoic acid daily intake |
|---|---|
| Adults | 45–50mg* in supplement form |
| 5–17 years | 15–25mg* in supplement form |
| 1–4 years | 5–10mg* in supplement form |
| 0–1 year | obtain alpha-lipoic acid from breastmilk and food, if on solids |
| *Take alpha-lipoic acid with vitamins C and E as a part of a multivitamin formula. |
If you have diabetes or hypoglycaemia be cautious when taking alpha-lipoic acid, as it lowers blood sugar and may cause hypoglycaemia. If you are taking drugs to lower blood sugar, such as insulin, do not take alpha-lipoic acid without discussing it with your doctor (as your medications may need adjusting). Alpha-lipoic acid may interfere with thyroid-regulating medications.[34]
Essential fatty acids (EFAs) are vital for healthy skin and are classified as ‘essential’ fats because your body cannot manufacture them and they must be obtained from your diet. The two main groups of essential fatty acids are omega-3 and omega-6. Rich sources of omega-3 include linseeds/flaxseeds and fish, especially trout, salmon and sardines (eczema-safe fish).
To demonstrate how diet influences the skin, scientists De Spirt and colleagues gave two groups of women either flaxseed or borage oil for twelve weeks and a third group received a placebo which was olive oil. After six weeks of consuming 1/2 teaspoon of either flaxseed oil or borage oil, skin water loss was decreased by about 10 per cent, and by week twelve the flaxseed oil group showed further protection from water loss and the skin was significantly more hydrated. While the olive oil (placebo) group had no significant change, at twelve weeks the flaxseed-oil group had significantly less skin reddening (after irritation), roughness and scaling of the skin.[35]
No. Olive oil contains mostly omega-9 which does not influence skin hydration, and saturated fats, from meat and dairy products, promote dry skin in eczema sufferers. Research shows that diets high in fats, where 10 per cent of energy is consumed as saturated fat and monounsaturated fat (from vegetable oils, margarine and nuts) decreases skin hydration and increases the skin’s surface pH, making the skin more susceptible to microbe invasion and bacterial infections.[36]
For flaxseed oil dosages refer to section entittled “Linseeds/flaxseeds”.
Eczema sufferers may not digest or utilise fats adequately due to genetics or faulty enzyme conversions. I recommend eczema sufferers obtain their omega-3 from food sources rather than taking a supplement as the oil is better absorbed from foods. If you experience beneficial effects from taking fish oil supplements, and you would like to take them, look for supplements that are unflavoured and colour-free (children’s fish oil supplements usually contain natural or artificial flavours so they are not eczema-safe).
Eat eczema-safe fish twice a week (read ‘Safe seafood’). Have whole or ground linseeds/flaxseeds or fresh flaxseed oil daily. Flaxseed oil and oil supplements should be taken with soy lecithin granules to increase absorption (lecithin information). Recipes include Healthy Skin Smoothie; and in Stage 2 only, Flaxseed Lemon Drink.
The following is a list of food sources of omega-3 with the content of omega-3 listed in milligrams:
EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are omega-3 in its converted and more potent form. Many of the health benefits of omega-3 are attributed to EPA and DHA. EPA/DHA are also present in the foods listed below, especially coldwater fish:
*The EPA and DHA content varies depending on whether the skin has been left on or removed: fish with skin on are higher in fat so they are richer sources of omega-3 fatty acids, EPA and DHA.
Acne: Do not take flaxseed oil, omega-3 oils, evening primrose oil or any oil supplement if you have acne, as doing so may increase skin oiliness.
If you choose to take an omega-3 fish oil supplement be aware that it thins the blood and this increases the risk of bleeding, so discontinue use several weeks before surgery or childbirth. Do not take oil supplements if you are on blood-thinning (heart) medications such as aspirin and seek advice from a nutritionist if you are on any medications.
Probiotics contain health-promoting bacteria, also known as microflora, which are naturally found in the gastrointestinal tract of healthy people. At birth an infant’s gastrointestinal tract contains no bacteria—it is sterile—then during the first year of life colonisation begins and (ideally) a healthy range of bacteria is established. Microflora work by adhering to your gut wall and ‘policing’ potentially harmful microbes so they can’t multiply and thrive. Beneficial bacteria promote healthy digestion and they can manufacture some vitamins, including the B-group vitamins, so they help to decrease the risk of nutritional deficiencies.
Unfortunately, beneficial microflora are not always present in adequate amounts. Microflora imbalance or deficiency is associated with antibiotic use, illness, diarrhoea and/or poor health of the gastrointestinal tract. Microflora imbalance allows pathogens, such as candida albicans, to thrive in the gastrointestinal tract and this increases the risk of food intolerances and itchy skin. Research shows that an altered ratio of the microflora strains can precede the development of atopic eczema.[37] According to one such study, the presence of the bacterial strains Escherichia coli and Clostridium difficile is associated with an increased risk of eczema and allergies at two years of age.[38] The research suggests that probiotics can promote proper gut barrier function and healing of intestinal permeability. In some (but not all) studies, probiotics decreased allergic inflammation in eczema sufferers.
The signs that indicate you may have a microflora imbalance or deficiency include:
These symptoms can also be caused by other conditions and should be discussed with your doctor. Microflora imbalance can be caused by or is associated with the following factors:
The beneficial bacteria in probiotics come from two groups: Lactobacillus and Bifidobacterium. Within these groups are different strains such as Lactobacillus acidophilus and Bifidobacterium animalis. Please keep in mind that the benefits from probiotics are strain-specific. For example the strain L. acidophilus LA5 does not treat eczema (it helps conditions such as candida albicans) but the strain known as L. rhamnosus GG was found to improve eczema symptoms in 50 per cent of children with eczema.[39] Probiotics should be used after an eczema sufferer has taken a course of antibiotics, been ill, had diarrhoea, experienced an adverse or allergic reaction to food, or if you have compromised gut function, dandruff, candida albicans or fungal infestation. When choosing a probiotic supplement look at the ingredients panel for the specific strain of probiotic (e.g. L. rhamnosus GG). Probiotics are generally safe for infants and you can speak to a doctor or nutritionist regarding probiotics for your child.
Condition | Suitable probiotic strains[40–47] |
|---|---|
| eczema | Lactobacillus rhamnosus GG (also known as LGG or Lactobacillus GG) |
| Lactobacillus F79 | |
| Bifidobacterium animalis, B. animalis (also called B. lactis Bb12 or Bifidobacterium lactis Bb12) | |
| Lactobacillus fermentum PCC | |
| Lactobacillus reuteri ATCC 55730 (L. reuteri) | |
| L. reuteri DSM 122460 (combined with L. rhamnosus GG) | |
| candida albicans | L. acidophilus LA5 |
| L. rhamnosus GG | |
| L. acidophilus strain NAS | |
| L. acidophilus NCFM | |
| digestive dysfunction | L. rhamnosus GG |
| Bifidobacterium lactis Bb12 (also known as Bifidobacterium animalis, B. animalis or B. lactis Bb12) | |
| L. johnsonii La1 | |
| L. plantarum 299v | |
| L. paracasei Shirota | |
| propionibacterium freudenreichii HA-101 and HA-102 | |
| sauerkraut (probiotic food) | |
| antibiotic use | Lactobacillus rhamnosus GG (L. rhamnosus GG) |
| Lactobacillus acidophilus LA5 | |
| allergies | Lactobacillus rhamnosus GG |
| L. johnsonii La1 |
Age range | Probiotic daily intake |
|---|---|
| Children and adults | Refer to product label or speak to a nutritionist for dosage.* |
| 0–12 months | Refer to product label or speak to a nutritionist for dosage. Breastfeeding mothers: take the supplement yourself and put a few grains of probiotic onto your nipple before breastfeeding (do this twice daily); a tiny sprinkling of suitable probiotics can be added to lukewarm infant formula or sprinkled onto baby rice cereal twice daily. |
| *Have a suitable probiotic supplement twice a day, mixed in a little water or rice milk, taken before breakfast and in the afternoon. If serving probiotics to small children you can also sprinkle probiotic grains onto cold cereal or cooled baby rice cereal (don’t add probiotics to overly warm foods) or add it to their milk bottle after the milk has been warmed. |
Discontinue use of probiotics if diarrhoea or constipation occurs.
Research shows that eating foods rich in cryptoxanthin, a carotenoid that supplies vitamin A, can help to increase skin hydration when consumed as a part of a healthy diet.[48] Fat-soluble vitamin A has the opposite effect—it dries out the skin—and should not be taken in supplement form unless vitamin A deficiency has been diagnosed. Cryptoxanthin-rich foods include papaya and pawpaw, which can be consumed daily (they’re also rich in vitamin C). Other carotenoid-rich foods that are eczema-safe and vital for eczema sufferers include carrots, beetroot and sweet potato. Have at least one carotenoid-rich fruit or vegetable daily.
Calcium is the most abundant mineral in the body and it’s stored in your bones. The body regulates a constant level of calcium in the blood in order to keep the blood pH slightly alkaline, and this is beneficial for bone and skin health. In a study by Boelsma and colleagues, calcium helped to improve the acid mantle of the skin.[49] On the down side, high calcium intake can interfere with iron and zinc absorption.
Calcium is beneficial for skin health when consumed in moderation, so you can eat non-dairy, calcium-rich foods daily.
The following is a list of eczema-safe food sources of calcium with the content of calcium listed in milligrams:
*As the Eczema Diet is an acid–alkaline balanced diet, high intake of calcium is not required for the duration of the program. Read ‘High/mega dose calcium’ information below.
Age range | Calcium daily intake from food sources |
|---|---|
| Adults | 300mg |
| During breastfeeding and lactation | 800mg |
| 5–17 years | 300mg |
| 1–4 years | 300mg |
| Infants 7–12 months old | 270mg from breastmilk or infant formula, and food if on solids |
| Infants 0–6 months old | 210mg from breastmilk or infant formula |
You can take a calcium supplement while on the Eczema Diet if you have been prescribed a calcium supplement for a health problem, are pregnant or breastfeeding, post-menopausal or a child going through a growth spurt. Calcium is best taken when combined with magnesium, vitamin K and vitamin D, and taken separately to zinc or iron. Do not take calcium within 2 hours of eating an iron-or zinc-rich meal such as red meat, chicken, beans, lentils or seafood.
Combined dietary and supplemental intake of calcium should not exceed 2500mg per day as excessive calcium can cause adverse reactions. Do not take calcium if you have kidney failure, kidney stones, hyperparathyroidism, sarcoidosis or cancer. Calcium supplementation can interfere with medications so speak to your doctor if you take medications. Do not take antacids containing aluminium as calcium can significantly increase the amount of aluminium absorbed into the blood.[50] (If you need antacids it’s a sign your diet is too high in acid. See acid–alkaline balance information.)
The following is a list of the supplements best avoided by those with eczema.
Do not take mega doses of calcium in supplement form unless calcium has been prescribed by your doctor or a nutritionist (for medical reasons).
All herbal medicines, including St Mary’s Thistle which is in most liver detoxification supplements, are rich in natural plant chemicals such as salicylates. Green tea (in both tea form and in supplements) and supplement ingredients such as ‘vegetable extracts’, broccoli, wheatgrass juice and barley grass all contain very high levels of salicylates so they are not eczema-safe.
Fat-soluble vitamin A (retinol) helps to mop up excess oil in the skin so it decreases skin moisture, which is beneficial if you have acne but not good for eczema and dry skin. High intake of vitamin A is associated with a significant increase in surface pH (in women) and again this is not good for eczema sufferers who need a lower, acidic pH to guard against invading bacteria.[51] For this reason, eczema sufferers should not take a supplement containing vitamin A or cod liver oil or eat liver (e.g. lamb’s fry) without first consulting a nutritionist.
Keep in mind that you need vitamin A in your diet to avoid deficiency and you will obtain a safe amount of vitamin A from red meat, chicken, seafood and orange-coloured vegetables such as carrot and sweet potato (in the form of beta-carotene). Babies do not adequately convert beta-carotene into retinol so, to avoid deficiency, infants need dietary retinol/vitamin A from breastmilk, infant formula and/or finely ground meats when on solids.[52]
This chapter covered a wide range of supplements and not all of them are absolutely essential to take during the program (for example, fish oil and calcium supplements). So to avoid confusion, here are the main supplements recommended during the Eczema Diet:
1. Take a daily supplement containing vitamin C, glycine, vitamin B6, magnesium, natural vitamin E, biotin, zinc, alpha-lipoic acid, quercetin, vitamin D3 and chromium (vitamin K is also recommended to balance this formula). Once your eczema improves, reduce the dosages.
2. Consume whole or ground linseeds/flaxseeds daily (see section entittled "Linseeds/flaxseeds") or add flaxseed oil to Healthy Skin Smoothie.
3. Take a dairy-free probiotic supplement for eczema, for one to two courses (1–2 bottles) or after taking antibiotics, and after suffering from diarrhoea or fungal infestation (see ‘Probiotics’).