Diet taboos for patients with eczema

First, permanently avoid foods that are known to cause allergies； Second, during an acute attack of eczema, temporarily avoid foods with high histamine levels, strong irritants, and high allergenicity. There is no need to deliberately avoid other foods as long as they do not aggravate symptoms after eating them.

Don’t think this is a general statement. I have been working in clinical dermatology for 7 years. I have seen too many people blindly follow the "Eczema Diet List" on the Internet and blacklist milk, eggs, seafood, beef and mutton. The taboos will make the skin yellow and thin, and whether the eczema will recur or not. Let me tell you an interesting thing. I once had a patient who made a list of taboos, including potatoes. When I asked him why, he said that potatoes were said on the Internet to be a fat food. I didn’t know whether to laugh or cry at the time. He had been eating potatoes for more than 20 years and was fine, but he banned them just because of a word on the Internet. It was purely unnecessary.

Not long ago, a 26-year-old girl came for a follow-up consultation. She had suffered from chronic eczema for almost four years. She said that she had not even dared to touch hot pot in the past four years, and she only dared to drink sugar-free warm milk tea. As a result, she accidentally took a bite of dried mango brought by a friend last week, and half of the red rash appeared on her arm. She was so itchy that she could not sleep all night. I checked the previous allergen test report for her, and it was clear that only mango and dust mites were positive. She blindly avoided a lot of unnecessary ones. Instead, due to long-term insufficient protein intake, the skin barrier repair was extremely slow, and the eczema was healed more than twice as slowly as others.

At this point, we have to mention the most debated issue of "hair food": Traditional Chinese medicine believes that eczema is "dampness and heat, and wind evil invades from the outside." Foods that are pungent, warm, and generate dampness and heat, such as mutton, mango, lychee, and seafood, will aggravate the dampness and heat in the body and aggravate eczema, so they are all classified as hairy food that needs to be avoided.； The view of modern evidence-based medicine is that as long as there is no clear evidence of food allergy, all foods can be consumed normally, and the claim of food allergies lacks support from large sample data. In fact, these two views are not conflicting at all, and there is no need to argue about right or wrong: if you do have more red rashes and aggravated itchiness after eating mutton, then it is a food that needs to be avoided for you. If you don’t have any reaction after eating it, it is perfectly fine to eat hot pot in winter, and you don’t have to be tied up by the “fawu” frame.

Of course, this does not mean that there are no common items that need attention. Especially during an acute attack of eczema, the histamine receptors in the skin are already in a highly excited state. Eating high histamine foods at this time will directly add fuel to the inflammation. I have seen several patients who were almost recovering, but after they ate half a plate of drunken shrimps, cooked seafood that had been stored for several days, or strawberries and pineapples that had just been released, they got up with itching and went to the emergency room that night. It’s not that these foods themselves are bad, it’s just that their histamine content is much higher than ordinary foods. Healthy people are fine eating them, but patients in the acute stage of eczema can’t bear it. Once the rash disappears and the itching subsides, there’s basically no problem eating them again.

There is also the question that people ask the most, "Can I eat spicy food?" This individual difference is even greater. I have a patient from Chongqing who has been eating spicy food since he was a child. He still eats hot pot during eczema attacks, and nothing happens. ； But there are also patients from the north who rarely eat spicy food. Suddenly they ate a meal of spicy crayfish. Half of their face swelled that night, and the rash spread directly to their necks. To put it bluntly, it just depends on your usual eating habits and reaction after eating. You don’t have to follow other people’s standards.

The most important thing is to eat too much. There was a 5-year-old patient before. Her mother heard people say that people with eczema should avoid all hair products. She even refused to eat eggs, milk, and soybeans. She gave the child boiled vegetables and millet porridge every day. When he came to see the doctor, the child was so thin that there was only a handful of bones left, hypoprotein edema appeared, and the eczema was more serious than before. You must know that the repair of the skin barrier requires sufficient protein, vitamins and trace elements. If you cut off the nutrients, what can you do to grow your skin?

In fact, after all, the criterion for judging whether to avoid food is very simple. It depends on your own body reaction: within 24 hours after eating a certain food, if the itching becomes significantly worse and the red rash becomes more frequent, stop for 2-4 weeks, wait until the condition stabilizes, and then try a small amount. If you have the same reaction twice, try to avoid it in the future.； If you don’t feel anything after eating, just eat when you need to. After all, you can’t eat this or that every day, and your mood will be so bad that it will affect your immune status and make your eczema heal more slowly.

Oh, by the way, here’s a little reminder: If you’re not sure what you’re allergic to, don’t make blind guesses. Go to a regular hospital for a food allergen test or food intolerance test, which is more useful than searching a hundred taboo lists online.