Gluten, a protein found in certain grains like wheat, barley, and rye, can trigger an inflammatory reaction in people with celiac disease or non-celiac gluten sensitivity. This can lead to gastrointestinal symptoms (such as stomach pain and diarrhea) but may also affect the skin as well.
This article explores whether there is a cause-and-effect relationship between gluten and eczema based on the current evidence. It also looks at whether a gluten-free diet may be of any benefit if you are living with eczema.
Gluten’s Affect on Skin
It is well known that people with eczema, especially those who develop eczema before age two, are more likely to have food allergies. Though food allergies don’t “cause” eczema, they can trigger the flare of existing eczema symptoms.
Even in the absence of a true food allergy, it is possible for certain foods to trigger an eczema flare in people with food sensitivities. These are abnormal reactions in the digestive tract that do not involve the same immune components as an allergy.
Eggs, milk, nuts, and dairy are foods that are commonly linked to eczema flares even in those who are not allergic to them.
The question to researchers is whether gluten can do the same. The idea that gluten affects the skin is not an obscure one. Gluten is known to cause a rash called dermatitis herpetiformis (DH) in people with celiac disease that will clear once gluten is removed from the diet.
With that said, DH only occurs in people with celiac disease, while eczema can affect anyone. Moreover, the way that DH occurs differs entirely from how eczema occurs. With DH and celiac disease, the underlying cause is autoimmune (meaning that the immune system attacks its own cells and tissues). With eczema, the underlying cause is largely unknown.
In the absence of celiac disease, it remains unclear how—or if—gluten causes any skin reaction. Even with non-celiac gluten sensitivity, the link to eczema remains theoretical at best.
Celiac Disease and Eczema
It is understandable why people believe that celiac disease and eczema are linked. Statistically, eczema occurs about three times more frequently in people with celiac disease and roughly two times more frequently in the relatives of those living with celiac disease. This suggests a genetic link between the two diseases.
With that said, a genetic link doesn’t necessarily mean there is a pathogenetic link (meaning the process by which a disease develops).
Studies suggest that celiac disease has a closer association with skin conditions like:
Cutaneous lupus (a skin complication of the autoimmune disease lupus) Dermatomyositis (an inflammatory disease causing muscle weakness and a skin rash) Vitiligo (a condtion that causes the loss of skin pigmentation) Behçet disease (a genetic disorder that causes blood vessel inflammation and skin lesions) Bullous pemphigoid (an autoimmune disease that causes fluid-filled blisters)
The one thing that eczema, celiac disease, and all of the above-listed conditions share is inflammation. Even so, the underlying inflammatory trigger for each differs, and there has yet to be evidence of a pathogenetic link between any of these diseases.
Gluten Sensitivity and Eczema
Non-celiac gluten sensitivity (NCGS) is not as well understood as celiac disease. However, there is some evidence of a link between people with symptoms of NGCS and eczema.
NCGS differs from celiac disease in that the underlying mechanisms are not the same. With celiac disease, the exposure to gluten causes an autoimmune response that triggers the release of immune protein known as immunoglobulin G (IgG). With NCGS, gastrointestinal symptoms will develop after eating gluten, but there will be no such rise in IgG levels.
In fact, the actual cause of both NCGS remains largely unknown.
What is known is that people with NCGC often do experience different forms of dermatitis, including eczema. Whether the conditions are connected or occur independently is still unknown.
It is also possible that NGCS may not always be related to gluten at all but rather be the result of an allergic reaction to wheat. Although a wheat allergy and gluten sensitivity cause many of the same symptoms, they are not the same things.
What a Rash From Gluten Look Like
Dermatitis herpetiformis (DH) is the rash closely linked to not only celiac disease but non-celiac gluten sensitivity as well. It is a relatively uncommon condition that tends to affect white people more than Black or Asian people and more males than females. People with DH tend to be between the ages of 15 and 40.
When DH occurs, it causes clusters of intensely itchy blistering rashes, predominantly on the elbows, knees, and buttocks. Severe cases can cause a rash all over the body.
Children with DH will often have reddish-brown patches on the palms of their hands caused by leakage of blood under the skin.
Can a Gluten-Free Diet Treat Eczema?
Despite there being no clear evidence that gluten can cause or worsen eczema, there are many people who insist that a strict gluten-free diet helped them resolve their skin condtion. This not only includes people with celiac disease and NCGS but people with neither of these diseases.
According to a 2017 survey published in the Journal of Dermatological Treatment, more than half of the 169 people with eczema who cut gluten from their diets reported seeing an improvement in their eczema symptoms. More or less the same was seen in people who cut wheat flour from their diet.
Similarly, a 2013 study from India found that, among 149 people with eczema, 80% saw an improvement in their symptoms when following a strict hypoallergenic diet (which includes cutting out gluten).
The main drawback of these studies is their small size. Also, the results were not consistent, with some people experiencing improvement and others not. This suggests that the reason for the improvement may or may not have anything to do with gluten. Further research is needed.
A gluten-free diet is not a substitute for eczema treatment.
Summary
Despite the fact that many people claim to experience an improvement in the eczema symptoms after eating a gluten-free diet, there is no evidence of a link between eczema and either gluten sensitivity or celiac disease.
It is possible that gluten is not the cause of an eczema flare but that a wheat allergy could be to blame.
A Word From Verywell
If you are not sure what is causing your eczema symptoms to flare, start by becoming familiar with the many different eczema riggers. These include soaps, detergents, dust mites, pet dander, certain fabrics, skin infections, stress, hormonal changes, or food allergies.
Next, keep a diary of any of the things you may have eaten, experienced, or been exposed to prior to a flare. Over time, you may begin to see a pattern developing. If you suspect something is an eczema trigger, avoid it if you can for a month or so to see if there is any sustained improvement.
