As the weather finally begins to warm up, allergy season is in full swing! Flare-ups of eczema can often come around this time with the changes in temperature and sensitivity of the immune system. Dry, itchy red skin of an eczema flare-up can definitely have a significant impact on your quality of life. These flare ups can come back frequently due to various triggers, such as air pollution, temperature, certain materials (eg. wool), and even mental or emotional stressors.
Eczema is often a manifestation of imbalances going on inside of the body, so it’s important to get to the root cause of the issue by identifying what your triggers are and reduce the inflammation so you may prevent future flare ups and gain better control of this condition.
Eczema, also called “atopic dermatitis”, is a chronic inflammatory condition which involves itchy, red, cracking skin often on the flexural surfaces in adults (eg.elbow crease) and extensor surfaces in younger children and infants (eg. elbow area). About 20% of infants and children who experience eczema can have it continue into their adolescence or adulthood . There is a huge genetic component to eczema, with there often being a family history of allergies, asthma and/or eczema as part of the overall health picture.
The three of these factors can often propagate each other to create a cycle of skin being itchy, causing us to scratch it, which then leads to further skin damage, inflammation and itching.
A typical Western diet is higher in processed sugar and saturated fats which means it is often higher in omega-6 fatty acids than in omega-3 fatty acids. Omega-6 fatty acids promote inflammation. An ideal diet is well-balanced in omega-6 and omega-3 fatty acids at a ratio of 2:1 (instead of 30:1 in typical Western diets). The higher intake of omega-6s can already put us into a pro-inflammatory state, which can contribute to the inflammatory response in an eczema flare-up. Additionally, it seems that higher dietary intake of omega-6s in children can contribute to the presentation of allergic conditions such as asthma, allergic rhinitis (runny nose, sneezing) and eczema, itself . So how can supplementing with omega-3s help?
We know that omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are potent anti-inflammatory products. One of the mechanisms by which eczema flares up is a hypersensitivity reaction to a trigger, which causes a release of pro-inflammatory molecules. When supplementing with omega-3s, research shows that they protect against inflammation from allergic reactions and modulate the immune system . For adults, between 2-4 grams of combined EPA and DHA is beneficial*.
Polyunsaturated fatty acids such as omega-3s and omega-6s are important in skin health because they become part of your cell membranes, including your skin cells. The Omega-3’s role in skin barrier maintenance is more functional than structural, in that they produce chemicals that allow cells to communicate with one another . This key feature helps to dampen inflammatory reactions that may occur due to exposure to your pro-inflammatory triggers. Therefore omega-3s work to decrease pro-inflammatory immune cell production which can cause damage to the body’s own cells .
In severe cases of eczema, the scratch-itch cycle can lead to increased production of skin cells which can cause thickening and scarring. Omega-3s seem to decrease disease severity by preventing the thickening of these skin cells which happens in advanced disease progression .
There is a multitude of research which shows that when pregnant women supplement with omega-3s during their pregnancy and when breastfeeding, there is a trend towards decreasing risk of eczema in their offspring [3,5]. This means lower risk in infants who have a family history, as well as decreased severity of the disease. Another interesting finding was that after 12 months, infants whose mothers had supplemented with omega-3s during their pregnancy had a lower sensitization rate to hen’s egg . This is important to note because hen’s egg is a common allergen which can contribute to immune system dysfunction as well as eczema.
Pregnant and breastfeeding women benefit from omega-3 supplements which are higher in DHA (at least 1g) compared to EPA, which can also help support the development of the infant’s brain and skeletal system*.
Getting to the root cause of eczema usually involves identifying triggers and learning what may be causing an internal dysfunction. With eczema, we often see other immune imbalances (eg. asthma, allergies), and can see digestive symptoms such as constipation, especially in the case of food allergies. For this reason, it may be worth it to consider an anti-inflammatory diet and include foods that are rich in antioxidants and polyphenols which combat damage in the body. Eczema is a frustrating condition experienced by adults and children alike. However, by paying close attention to nutrition and environmental factors and triggers, it is possible to get your symptoms under control. Optimizing your intake of omega-3 fatty acids and choosing an anti-inflammatory diet is one strategy that may improve your skin’s integrity and soothe inflammation, restoring its health.
*Please speak with your healthcare practitioner to determine what the best dose of omega-3 supplementation would be best for your particular case and situation.