Eczema

Written By Brittyn Coleman, MS, RDN/LD

What is Eczema?

Eczema is a common group of skin conditions that causes itchy, dry, inflamed, irritated skin with a rash-like appearance.

  • There are 7 types of eczema: [3]

    • Atopic dermatitis

    • Contact dermatitis

    • Dyshidrotic eczema

    • Nummular eczema

    • Seborrheic dermatitis

    • Stasis dermatitis

  • Roughly 10% of individuals with autism also experience eczema. [2]

  • Eczema often starts in the first few months of life. Most individuals outgrow eczema by adolescence, but this is not always the case as eczema can continue on into adulthood.

  • Eczema is typically diagnosed through observation of the skin by a dermatologist or primary care practitioner.

    • A skin patch test or biopsy may be performed to rule out other skin conditions if the practitioner is unsure.

  • Researchers are unsure of the exact causes of eczema, but believe a combination of genetics and dietary/environmental triggers play a role. [3]

    • A mutation of the gene responsible for creating filaggrin, a protein that helps the body to maintain a healthy protective barrier on the top layer of the skin, is thought to be linked to eczema. [3]

    • Without sufficient filaggrin production, moisture is able to escape the skin barrier and bacteria, viruses and toxins can enter in. [3]

  • In addition to autism, eczema has been linked to asthma, allergic rhinitis, staphylococcus infections, food allergies, depression, anxiety, and behavioral disturbances. [3]

 
 

Signs & Symptoms

Signs and symptoms of eczema may be different from one child to the next:

  • Itchy skin

  • Dry, flaky skin

  • Inflamed, discolored skin

  • Rough, leathery feel to skin

  • Scratching until bleeding

  • Skin oozing or crusting

Potential Root Causes

Researchers are unsure of the exact causes of eczema, but believe a combination of genetics and dietary/environmental triggers play a role. [3] It has also been identified that individuals with eczema tend to have an overactive immune system which is commonly triggered by substances in the diet and environmental triggers. A few of these potential triggers include:

  • Stress

  • Food Allergies or Sensitivities

  • Exposure to environmental allergens such as pets, grass, dust mites, and pollen

  • Overheating due to clothing, blankets, hot baths/showers or temperature

  • Dry, unmoisturized skin

  • Irritants from body care, laundry detergent, household cleaners, or even juice from fruits, vegetables or meats. Some other common irritants include:

    • Certain metals, particularly nickel

    • Cigarette smoke

    • Fragrances

    • Fabrics like wool and polyester

    • Antibacterial ointments like neomycin and bacitracin

    • Formaldehyde, which is commonly found in disinfectants, some vaccines, and adhesives

    • Isothiazolinone, an antibacterial found in personal care products such as baby wipes

    • Cocamidopropyl betaine, commonly found in shampoos and lotions.

 
 

Next Steps

Diet

  • Identify and remove food sensitivities to decrease inflammation, calm the immune system, and allow the gut to heal.

    • Consider an elimination diet to identify food triggers.

    • Certain foods are naturally inflammatory, such as simple starches (see: carbohydrates), cane sugar, artificial ingredients, and MSG.

    • Other foods may be uniquely inflammatory to the person.

      • Some of the most common foods that cause gut inflammation due to sensitivities are gluten, dairy, soy, and corn.

      • Gluten, in particular, may contribute to intestinal permeability due to a protein it contains called gliadin. A gluten-free diet may be indicated.

  • Repair Leaky Gut. Visit the Note on Leaky Gut to learn more.

  • Since an overactive immune system can play a role in eczema flare ups, support the immune system.

    • Emphasize a colorful diet full of fruits and vegetables that your child enjoys.

    • Consider berries, citrus fruits, dark leafy greens, and mushrooms.

      • *If your child is a picky eater consider feeding therapy with a certified therapist or dietitian.

  • Many diets claim to improve eczema including the Feingold Diet, Failsafe Diet, Low Salicylate Diet, and Low Histamine Diet.

Lifestyle

  • Keep a journal to help identify triggers

  • Manage scratching

    • Distract your child with toys, playing, or reading when they are bothered by itching

    • Keep nails trimmed short and clean

    • Consider mittens or soft gloves during an eczema flare-up

  • Consider Toxic Load, and take next steps to reduce toxins in the environment

    • Avoid toxins in skincare, body care, and household products.

    • Visit EWG.org/skindeep to learn more about the products you use and the chemicals they may contain.

  • Reduce stress by implementing practices like yoga, meditation, etc. Yes, even kids with autism can participate and benefit, but it will look different for everyone.

  • Implement a daily bathing and moisturizing program.

    • Before introducing a new product to your child’s skin, take the following steps:

      • Check the product’s label to determine if there are any particular ingredients your child is already known to be allergic to.

      • Review products granted the National Eczema Association Seal of Acceptance to determine if a product you are interested in is recommended..

      • Use the product to spot test a small area, roughly the size of a pea, on your child’s wrist or crook of the elbow. Do not wash the area for 24 to 48 hours and monitor for any type of reaction such as redness, itchiness, flaking skin, or a rash. 

    • Simple lotions and moisturizers to consider:

 
 

Supplements

More research is needed to establish firm supplement recommendations for eczema. Below are a few of the supplements that are commonly considered:

 
 

DISCLAIMER: Before starting any supplement or medication, always consult with your healthcare provider to ensure it is a good fit for your child. Dosage can vary based on age, weight, gender, and current diet.

Eczema & Autism in the Research

Autism & Eczema

  • Children with Autism are prone to skin, food, and respiratory allergies [1]

  • A research study examined responses from the National Health Interview Survey to identify children aged 3 to 17 years of age and their experiences with food, skin, or respiratory allergies.

  • The study determined that 17% of children with autism had some type of skin allergy compared to roughly 10% of children who were not diagnosed with autism.

  • The vast majority of the children who experienced eczema and autism were also boys.

  • This study suggests that eczema is more prevalent in children with autism, particularly boys.  

Gut Health and Eczema

  • This study concluded that early life gut bacteria, as early as 3 weeks of age, is likely to influence the risk of developing eczema. [9]

  • Researchers found that there was a significant difference and abnormalities in the microbial composition of infants who went on to develop eczema.

    • This significance was only observed in infants who had developed some form of allergic reaction by 36 months of age.

  • It was also hypothesized that the greater the extent of dysbiosis, the more likely the child was to develop severe allergic reactions and other conditions such as rhinitis.

  • Colonization of specific bacteria, such as E-coli, during the first few weeks of life was shown to delay the colonization of the gut by butyrate- and propionate-producing bacteria.

    • These bacteria are known to produce short-chain fatty acids (SCFA) which provide fuel to intestinal epithelial cells and are known to strengthen intestinal barrier function.

    • Lack of these bacteria and SCFA could compromise gut health and contribute to the development of Leaky Gut

  • [1] Guifeng Xu MD. Association of Allergies with Autism Spectrum Disorder. JAMA Network Open. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2683952. Published June 8, 2018. Accessed December 11, 2021. 

    [2] Shin K-O, Crumrine DA, Kim S, et al. Phenotypic overlap between atopic dermatitis and autism - BMC neuroscience. BioMed Central. https://bmcneurosci.biomedcentral.com/articles/10.1186/s12868-021-00645-0. Published June 22, 2021. Accessed December 11, 2021. 

    [3] Eczema Symptoms & Causes. National Eczema Association. https://nationaleczema.org/eczema/. Published August 27, 2020. Accessed December 11, 2021. 

    [4] 8 Skincare Ingredients to Avoid.. National Eczema Association. https://nationaleczema.org/eczema/. Published August 27, 2020. Accessed December 11, 2021. 

    [5] EWG Skin Deep® Cosmetics Database. EWG. https://www.ewg.org/skindeep/. Accessed December 11, 2021.

    [6] Eczema. Raising Children Network. https://raisingchildren.net.au/guides/a-z-health-reference/eczema. Published August 5, 2021. Accessed December 11, 2021. 

    [7] Roudsari MR, Karimi R, Sohrabvandi S, Mortazavian AM. Health effects of probiotics on the skin. Crit Rev Food Sci Nutr. 2015;55(9):1219-1240. doi:10.1080/10408398.2012.680078

    [8] Vaughn AR, Branum A, Sivamani RK. Effects of Turmeric (Curcuma longa) on Skin Health: A Systematic Review of the Clinical Evidence. Phytother Res. 2016;30(8):1243-1264. doi:10.1002/ptr.5640

    [9] Ta LDH, Chan JCY, Yap GC, et al. A compromised developmental trajectory of the infant gut microbiome and metabolome in atopic eczema. Gut Microbes. 2020;12(1):1-22. doi:10.1080/19490976.2020.1801964

    [10] Hou DD, Zhang W, Gao YL, Sun YZ, Wang HX, Qi RQ, Chen HD, Gao XH. Anti-inflammatory effects of quercetin in a mouse model of MC903-induced atopic dermatitis. Int Immunopharmacol. 2019 Sep;74:105676. doi: 10.1016/j.intimp.2019.105676. Epub 2019 Jun 7. PMID: 31181406.

Authors

Sinead Adedipe, MS

Edited and Reviewed by: Brittyn Coleman, MS, RDN/LD, CLT

Brittyn Coleman, MS, RDN/LD https://www.autismdietitian.com
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