10 Unlikely ‘Everyday’ Suspects Of Eczema Triggers

An ‘INSIDE’ Look into Inflammation

Do you know that some of the worst foods for eczema are found in products that are rich in preservatives and natural chemicals?

Eczema flares can seem so random that it is hard to believe that outbreaks do follow logical pattern. They can be directly related to exposure to certain triggers or allergens in your child’s environment, food or chemical.

Your child’s eczema can begin to heal once you identify and cut these triggers; but you have to first be aware of them for it to be possible. The trick is really about figuring out what these allergens are. In the case of sensitivity, the negative reactions can be delayed and appear only few days later. Even allergy tests such as blood IgE or skin prick test may not pick up food sensitivity.

The frequent presence and exposure for the allergen, even though not apparent, when avoided can allow your child’s skin to improve and recover.

Whilst sensitivities can be many and varied, we feel that it may be less daunting for parents to start with a few checklists of common ‘offenders’ related to eczema and work from there.

CHECKLIST: Common Foods Culprits in Eczema

1. Cow’s Milk or Dairy

Dairy allergy is one of the most common allergies for babies and toddlers. It is also on the top 8 foods that are responsible for 90% of childhood allergies.

Often confused with lactose intolerance because they share same symptoms, dairy allergy is a negative reaction to the milk proteins in cow’s milk, namely:

• Casein – Found in solid part (curd) of milk that curdles
• Whey – Found in liquid part of milk that remains after milk curdles.

These proteins are also found in processed food and quite often, gluten-cross reactors too. What it means is that proteins can trigger an immune response similar to the way gluten does. So, if you are intolerant to gluten, chances are that you can also form antibodies against milk proteins.

Sources: Cow’s milk and any by-products made from cow’s milk e.g. cheese, yogurt, butter, cake, etc.

2. Eggs

Egg allergy is another very common food allergy in children with eczema. Second only to milk, it is typically observed in second 6 months of a baby’s life. The proteins found in egg whites are thought to act as carrier for bacterial protein to cross gut barrier in blood stream. This then stimulates an overactive immune system. Egg yolks may be better tolerated in comparison.

Raw eggs, if eaten frequently, can cause a biotin deficiency that trigger eczema or similar rashes. This was mentioned in the ‘Egg White Injury’ paper. Cooked eggs, however, do not have the same anti-nutrient effect.

Sources: Eggs and any foods that contain eggs e.g. bread, noodles, batter, etc.

3. Wheat and Gluten

Gluten allergy is the most common culprit that aggravates eczema in older kids or adults. Minute clumps of gluten may get deposited under the skin, causing itchy rashes. These tiny particles may take years to clear up once you go gluten-free.

Grains may contain proteins that may also trigger similar autoimmune reaction in the way gluten does so the offenders may expand beyond wheat to include quinoa, buckwheat, millet, amaranth, rice, arrowroot, sorghum and so forth.

Sources: Wheat, barley, rye, brewer’s yeast, malts and any oats not specifically labelled as gluten-free.

The hidden source of gluten can be found in processed foods e.g. ketchup, milk shakes, malt syrup, gravy, seasoning, salad dressing, chicken broth, pasta, fries, sausages, bread, noodles, etc.

4. Soy and Soy Derivatives

Another common allergies in babies and children, soybeans are a member of the legume family and a staple in Asian culture. Soy is very rich in amines and MSG (both natural or artificial), which may aggravate eczema and other types of skin inflammation.

Additionally, if you are not consuming organic soy, you are likely consuming genetically modified (GMO) soy which adds additional problems to the mix.

Sources: Soybean. Commonly used as ingredients in foods e.g. soy sauce, tofu, miso, tempeh, edamame, seasonings, etc.

Hidden soy is also found in many processed foods e.g. crackers, broths, canned meat, cereals, infant formula, processed meat, sauces, etc.

5. Sugar

Cutting sugar may also improve eczema in some cases, possibly due to intolerance to fructose or sucrose caused by a lack of digestive enzymes, fructose and sucrase. When you eat sugar or high-glycemic (GI) food (a food that rapidly converts into sugar), your body can break these carbohydrates into glucose which raises your insulin or blood sugar level. The spike in insulin in turns alerts the body to create inflammation that produces enzymes that break down collagen and elastin. This process is known as glycation. Other than thinning and dryness, it also affects the skin’s ability to self-repair as a result, eczema wounds may not seem to improve or take longer to heal.

Sources: Sugar. Also found in anything that contain high-fructose corn syrup, sweeteners such as agave, honey as well as processed foods e.g. soda, candy, dried or canned fruits, sauces, condiments, dressings, fruit juices, energy bars, cereals, etc.

6. Salicylate Food

Salicylates are natural chemicals that are found in many fruits and vegetables, herbs, nuts, teas, coffee and spices. It can also be found in perfumes, baby teething gel and aspirin. A research by Loblay and Swain found that salicylate-rich foods can worsen eczema symptoms in more than 52% people.

Some fruits can cause itch for hours and among these that are increasingly exacerbating eczema are: Grapes and their by-products such as juices, sultanas and raisins are source of itch-promoting constituents, salicylates, amines and natural monosodium glutamate (MSG). Kiwi fruit and fruit juices such as apple, orange or berry juice are also strong acidifying and contain salicylates and amines. Avocado, a healthy addition to a diet, is another unlikely culprit that can worsen eczema symptoms if your child has salicylate sensitivity.

Many foods naturally contain salicylic acid. In general, the highest amounts of salicylates are found in fruits, vegetables and spices. Meat, fish and dairy products contain very little or none. The two major food groups of vegetables and fruits listed below are high in salicylates. Bear in mind that these foods are not inherently bad; unless you are intolerant or allergic to salicylates.

Sources:

Vegetables – Capsicum, chili, eggplant, herbs and spices (basil, mint, parsley, fennel, etc.), olives, onions, mushroom, sauerkraut, seaweed, spinach, broccoli, cauliflower, corn, cucumber, pumpkin, zucchini, radish, etc.

Fruits – Avocado, tomatoes, berries (blackberries, cranberry, raspberry, blueberry, mulberry), cherry, date, dried fruits (apricot, peach, banana, figs, mango, currants, raisins, prunes, sultanas), kiwi, passionfruit, pineapple, redcurrant, strawberry, custard apple, banana, dragon fruit, durian, apple, guava, jackfruit, longan, lychee, papaya, pomegranate, rambutan, watermelon, etc.

7. Monosodium Glutamate (MSG) 

MSG is a natural building block of proteins that enhances the flavour of foods. It is one of the most problematic food additives. Loblay and Swain research found that 90% of people with eczema are sensitive to this additive and 35% saw their eczema symptoms worsening after consuming foods containing MSG.

The adverse reaction can be associated with the free glutamic acid, a source of MSG present in many packaged food; and many do not know that they are sensitive to flavour enhancers, in particularly, children are most commonly affected.

In Asian culture, soy sauce is rich in amines and both natural and artificial MSG. This may also partially explains why soy can trigger eczema and other skin inflammation.

MSG sources can be found in natural foods or in artificial enhancers added to packaged food as outlined below:

Sources:

Natural MSG – Tomatoes, Fish paste, soy sauce, tamari, all sauces, yeast extracts, broccoli, Mushroom, spinach, green peas, grapes, raisins, sultanas, prunes, baked beans, miso, tempeh, kombu extract, hydrolyzed vegetable protein, protein powders, etc.

Artificial Enhancers – Soy sauce, BBQ sauces, all sauces, flavoured chips, crackers, crisps, meat paste, sausage, chicken nuggets, marinated meat, chicken salt, dressings, stock cubes, carrageenan, Vegemite, gravy, baked beans, traditional Chinese foods, seasonings (Ajinomoto, Zest, Ve-Tsin, etc), pectin, maltodextrin, whey protein/isolate, etc.

Hidden Sources (Identify Keywords such as) – Glutamate, monosodium glutamate, monopotassium glutamate, glutamic acid, calcium caseinate, gelatin, textured protein, hydrolyzed protein, HVP, yeast extract, yeast food, autolyzed yeast, yeast nutrient, HPP yeast extract, anything ultra-pasteurized, anything fermented, ribonucleotide numbers 620 to 635. Ribonucleotide is the ‘new’ MSG where food manufacturers used to market their product as having ‘No MSG’ but still allows the foods to taste salty and savory.

8. Dried Fruits 

Dried fruits contain high level of itch-provoking amines, salicylates, natural MSG and preservative, Sulphur dioxide. Research by Loblay and Swain also found more than 50% of those with eczema react negatively to preservatives commonly used in dried fruits.

Sources: Apricot, dates, peach, banana, figs, mango, currants, raisins, prunes, sultanas.

9. Soft Drinks or Sodas 

Researchers from New Zealand discovered that children eating junk food and soft drinks 3 or more times a week have higher chances of developing severe eczema and asthma. These processed foods and drinks are rich in refined sugar, artificial chemical and saturated fats that are bad for skin health and liver. This is in line with the finding by Japanese researcher who reported young children with eczema also had fatty liver!

Sources: All packaged or processed drinks such as soft drinks and sodas.

10. Other Inflammatory Foods 

Certain foods, particularly those inflammatory and ‘heaty’ foods may also provoke and aggravate eczema symptoms, for examples, nuts (e.g. peanuts, walnut etc.), corn, nightshade vegetables, shell fish and seafood, hot spicy food, sugary food, food additives (e.g. propylene glycol, formaldehyde-releasing preservatives, food colouring, etc.).

Holistic Eczema Management

In a holistic approach of eczema management, equally important as a good skincare and bathing regimen is the avoidance of triggers or allergens for your child.

For your child, it means substituting some of their current food choices with eczema-friendly foods and to follow through certain foods elimination until the inflammation has subsided or stabilized. For your baby, even if they are still exclusively breastfed and yet to be introduced solids or milk formula, mother’s milk can be an unexpected source of trigger. In some babies who are prone to allergy, even a tiny amount of food protein that passes through the breast milk can prompt an eczema flare.

In A Parent’s Practical Tips to Identify Eczema Triggers article of our Eczema Diet, Nutrition & Allergies Series, it offers insights and tips on how you can observe and investigate possible triggers with a tool that will be valuable for you to track your child’s symptoms and reactions to certain food or drink consumed.

Resources:

• Loblay R & Swain A.R. 2006. Food Intolerance. Clinical Immunology Research Centre, University of Sydney. https://fedup.com.au/images/stories/LoblaySwain1986.pdf
• Skypala, I. J., Williams, M., Reeves, L., Meyer, R., & Venter, C. (2015). Sensitivity to food additives, vaso-active amines and salicylates: a review of the evidence. Clinical and Translational Allergy, 5, 34. http://doi.org/10.1186/s13601-015-0078-3
• Swain A, Soutter V, Loblay R, Truswell AS. Salicylates, oligoantigenic diets, and behaviour. Lancet. 1985 Jul 6;2(8445):41-2. https://www.ncbi.nlm.nih.gov/pubmed/2861485.