 Eczema is a common skin disease, and there are plenty of drugs on the market to combat it, but what about diet? Are there foods that trigger eczema, and can dietary changes be used to treat it? Watch to find out. Eczema, also known as etopic dermatitis, is a chronic inflammatory skin disease. In fact, the leading cause of healthy years of life loss due to common skin diseases because it's just so common, affecting about a fifth of us. And it's not just an itchy rash, it's associated with other diseases, too. Yes, it can be itchy, exhausting, embarrassing, but in kids may increase risk for ADHD, though that may just be from the sleep deprivation, and in adults may increase the risk of major depression, and it's on the rise. There are drugs for it. Of course, there are always drugs, steroids of the first-line therapy, but then there are immunosuppressants as well, with more in the drug pipeline. You know the medical profession is desperate when they're forced to go back to the basics and start applying leeches to people. Previously, I talked about the safety and efficacy of other more natural treatments, but what about diet? Our story begins in 1920, a year doctors were realizing how good this oxygen stuff was, though maybe not as good as injecting people with mercury. But a researcher at Johns Hopkins reported a number of cases in which by omitting eggs, meat, and milk from the diet, patients' eczema improved. Who's going to profit off of that, though? No wonder it took 58 years before it was put to the test. Figuring eggs and milk were the two foods most likely involved in eczema, they excluded them in chicken and beef, since it may just be chicken and cow proteins more generally, in a randomized double-blind controlled trial swapping in soy milk instead, and 70% of the patients improved. One person got worse on the no-egg, no-chicken, no-milk, no-beef diet, but almost everyone else got better. So the researchers conclude that for many kids, avoiding those foods may induce a clinical improvement, and interestingly, it didn't seem to depend on whether allergy tests showed that they were allergic to milk and eggs. Either way, they tended to get better regardless. You can do randomized double-blind food challenges, where you give kids with eczema various foods in opaque capsules, like one with egg powder, one with wheat powder, etc. And egg was found by far to be the most offending food. For example, in this study where they just cut out the eggs, dramatic improvements were documented for both the amount of skin involvement and the severity of the eggs and lesions after removing eggs from the diet. But in about 90% of cases, the mom had no idea that eggs were a problem. Why? Because it wasn't like they were eating scrambled eggs or something. Almost all the egg exposure was hidden. They were exposed to hidden egg products and packaged foods, and so they had no idea why their eczema was so bad until this study where they removed all eggs and egg products from their diets. Eggs are evidently the most frequent cause of food sensitivity in children. Out of hundreds of kids with eczema tested, egg allergy was documented in two-thirds of those with sensitivities. In fact, a child having a blood reaction to egg white proteins appears to be one of the best laboratory tests for predicting future allergic diseases in general. It appears to be the ovomucoid protein within egg white that seems to be causing most of the mischief. About 40% of kids with eczema have some form of food allergy, and the more food allergies they have, the more likely it appears they're going to suffer from eczema and make it worse. Those who react to cow's milk protein are significantly more likely to suffer severe eczema, showing the important role cow's milk proteins may play in the induction and increased severity of eczema in children. Often parents switch from cow's milk to goat's milk in an attempt to improve their children's eczema, but goat's milk should never be given to kids with cow's milk allergy because they often cross-react with one another, which has been confirmed with double-blind placebo-controlled food challenges. Ass milk, on the other hand, is a different story. Switching kids to donkey milk improved their eczema, and for that matter, horses' milk might as well. The original randomized double-blind controlled trial of diet and eczema found that cutting out eggs, chicken, milk, and beef significantly improved eczema in 70% of the kids that completed the study. Subsequent studies found similar results, though in this case, for example, it only seemed to work for a quarter of the kids. The bottom line, out of 13 studies on avoiding milk eggs or both, 10 out of 13 studies documented overall clinical improvement. The economic burden of eczema caused by just regular cow's milk formula alone may be hundreds of millions of dollars a year, though eggs appear to be worse, in terms of predicting persistence and severity of the disease. Sensitization to egg white and cow's milk can occur even in breast-fed infants, though, and so presumably the source of the exposure is the passage of egg and cow proteins through the mother's milk, but you don't know until you put it to the test. New mothers were randomized to cut out eggs, cow's milk, and fish from their diet during the first three months of breastfeeding after giving birth, to continue their regular diet. And indeed, the infants of mothers who cut out the eggs, milk, and fish were significantly less likely to have eczema by age six months, though after that age the decreased rates of eczema in the no eggs, milk, or fish group was no longer statistically significant. Follow those same kids out to four years, though, and those whose moms cut out the eggs, milk, and dairy for just three months while breastfeeding had significantly lower eczema rates even years later. Consuming that hypoallergenic diet during breastfeeding, cut childhood eczema rates in half. Eating more plant foods may also help. The majority of fruit and vegetable studies suggest that higher consumption by mothers during pregnancy and children in early life results in reductions in asthma, another allergic type disease. Maybe it's the phenolic phytonutrients and plants that are helping, supported by evidence that certain vegetarian diets appear to alleviate the severity of skin diseases in adults with eczema, though if you look at that citation, it was a very strange diet. They found striking benefits in terms of reducing the severity of eczema, and even two months after they went off the diet, they were still doing better than when they started, but the diet was just vegetable juice, brown rice, kelp tofu, tahini, and persimmon leaf tea, and severely calorie restricted. And just straight fasting alone can improve eczema, as can a strictly plant-based diet, which is not so surprising given the data on children showing how much better they can do cutting out eggs and dairy. In spite of these data, dermatologists and pediatricians have for many years denied the role of food in eczema, even though as many as 80% of kids make benefit cutting out milk and or eggs, regardless of what the various allergy tests show. You can't necessarily tell if diet is going to help until you yourself put it to the test in your own body, and that's what parents are doing. They're not waiting for their pediatricians to catch up. 75% of parents with eczema-stricken kids have tried some form of dietary exclusion, most commonly cutting out dairy and eggs, though only about 40% of parents who tried it feel that it worked. But hey, why not give it a try? A typical recommendation you see in the medical literature is like, look, if you have a child with some bad eczema and the drugs aren't working, then why don't you try cutting out some foods? But that seems to me backwards. If foods are contributing, why not treat the cause and eliminate the offending foods and then do the drugs if diet isn't enough? Now there are some pretty nutty eczema diets out there, like the so-called few foods diet, excluding everything except lamb, potatoes, rice, crisps, broccoli, and pears. To my surprise, it was actually put to the test. I told you docs were desperate, and it failed to show a benefit. Basically, if you don't know where to begin, the simplest approach may be you to just cut out dairy and eggs and see what happens. That's a controversial recommendation, though, avoiding fish, beef, eggs, and dairy without medical supervision that might trigger malnutrition-related pathology. What? I checked out that citation, and it's just another article making an unsupported claim. Now, if you exclude everything, like 99% of your diet is rice milk, well then obviously that's completely insufficient. But for most parents, the number one thing they add to their child's diet for eczema is vegetables, and the number one thing they cut down on is junk food. And I don't think we have to worry about a junk food deficiency.