Dietary advice tips:
(5) Eczema
A well-balanced diet is essential for healthy skin, but the involvement of diet in the aetiology of common skin diseases (eg, eczema) remains unproven. Many sufferers and their carers are tempted to try a variety of dietary treatments, particularly the avoidance of certain foods, because of the belief that the condition may be caused by food allergy. The following advice is appropriate:
- In a small proportion of people, certain foods may exacerbate the disease, but special diets should not be started without dietetic help, especially in young children in whom there is a risk of nutritional deficiency.
- Exclusion diets can be restrictive and difficult to implement. This should be explained to the patient and/or carer to ensure that they assess whether the diet is worse than the disease.
- Exclusion diets are best reserved for those with severe eczema which is unresponsive to standard treatment with emollients and corticosteroids and for those with a clear history of allergy.
- Common food culprits include milk and dairy produce, pork, offal, fish, shellfish, nuts and food colouring.
- For infants and children up to the age of five years, a properly formulated infant milk formula (eg, Infasoy, Wysoy) is essential if cows' milk is excluded from the diet.
- If there is no improvement in the eczema after three weeks of an exclusion diet, the individual should return to the normal diet.
- If there is an improvement, foods should be reintroduced gradually to identify which foods cause the problems.
- Evening primrose oil - Trials have shown that gamma-linolenic acid (GLA) taken regularly in a dose of 160-320mg (children) and 320-480mg (adults) can reduce itching in some patients.
This series of "dietary advice tips" is intended to be a reminder of the main points to be made by pharmacists when giving nutritional information to the public. The conditions included in the series are those where diet is a well recognised risk factor, those in which diet contributes to the management of the condition, and others for which patients may welcome sound dietary advice. The series is written by Dr Pamela Mason (a pharmacist with a postgraduate qualification in nutrition)
