Atopic dermatitis is an inflammatory disease that manifests itself with dry skin and a tendency to irritation, swelling and itching and whose disease goes through phases of outbreaks and calm. And cases have doubled in the last 20 years. Although there is a 30 percent higher risk in children under 10 years of age, it is caused by a deficiency of a protein, filaggrin, which acts by joining the cells of the epidermis. The skin then does not have the ability to maintain adequate hydration and will not be able to stop the entry of irritating or infectious agents that cause such characteristic reactions in the skin.

However, as Carme Chorto, a pharmacist on the Eucerin scientific team, says, "there are also a number of external factors that intensify the symptoms of the disease, such as stress, heat, sweat, pollen, dust, the hair of pets, detergents, low environmental humidity... which contributes to the itching intensifying," says the expert.

External factors that can make the disease manifest or become more bothersome are stress, heat and sweat, allergens such as pollen, dust or pet hair, and certain irritants, such as detergents or fabric softeners or certain cosmetics. Low environmental humidity (produced by heating or air conditioning), skin infections or not hydrating the skin adequately, will contribute to making it drier and intensifying itching.

Atopic dermatitis is a condition that in Spain affects 20% of children and is another of the most common skin pathologies in adults, it requires special care and attention. To combat and improve the symptoms of this disease, we spoke with three experts in the field so that they can tell us what treatments, tricks and diet would be the most suitable to combat the disease.

And as Bet Blanco, the person in charge of training at Bioderma, assures, proper skin care is essential to control the appearance of eczema.

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Shopping for products for atopic skin

Diet: can it trigger or aggravate atopic dermatitis?

The fact that a diet can trigger or aggravate dermatitis is always a matter of debate and although no conclusive studies have been obtained. There is talk of how foods such as certain fruits or tomatoes can cause a reaction by direct contact with the skin.

"The skin rashes and itching that we can suffer after eating certain foods are just a warning from the body itself to warn of an intolerance and we must seek the help of a specialist to detect which food has been the cause to treat it properly", points out Carmen Fernández, tutor of the Master's Degree in Food Safety and Nutrition at IMF Business School.

And according to different medical studies "those affected by atopic dermatitis, children and adults, tend to have a higher risk of suffering from food allergies and foods such as eggs, milk, nuts or soy can trigger it," says Carme Chorto.

However, before eliminating any food from the diet, a specialist should be consulted. And of course, avoid exciting foods and ingredients such as coffee, cocoa, alcohol because they increase itching and diets rich in sugar, flour and saturated fats.

In this sense and to avoid this type of situation, Carmen Fernández, tutor of the Master's Degree in Food Safety and Nutrition at IMF Business School, affirms that "it is important to always check the labels and make sure in restaurants not only that it does not contain the allergen itself , but that there can be no cross-contamination and at home it is very important to wash food well and not to mix kitchen utensils".

What to eat or not to eat to combat and treat atopic dermatitis?

To improve the symptoms of atopic dermatitis, experts recommend eating a diet rich in omega 3 fatty acids (salmon, tuna, vegetable oils) and vitamin A (carrots, pumpkin, tangerines, melon or watermelon) that help improve the skin condition. This vitamin is essential for the proper functioning of the immune system and for the formation of new proteins, and its deficiency can aggravate dry and scaly skin.

Vitamins E or C present in avocado and olive oil or oranges, broccoli and kiwis, as well as other fruits and vegetables, act as antioxidants and are beneficial for our body and our skin.

However, experts such as Dr. Marius-Anton Ionescu, a member of the Uriage Dermatological Laboratories scientific committee, assures that there are foods that can even aggravate atopic dermatitis such as peanuts, smoked meat, red fruits, canned meat (for food preservatives), eggs (due to possible allergies to egg protein), dairy products, products rich in fatty acids and fish (range and fish of this type).

So what is clear is that diet clearly has an impact on atopic skin. "Their patients are genetically predisposed to suffer from more food allergies than the general population and, on the other hand, there are certain foods (such as tomatoes, citrus fruits or spicy foods) that can worsen dermatitis despite not being allergic" Lidia also points out Maroñas, dermatologist at the International Dermatological Clinic.

As data, according to a study by Ordesa and Pediatopic, 73% of families with babies with atopic skin do not make changes in their children's diet because experts consider that it is only necessary if some type of allergy or intolerance to some food.

The relationship of dairy products with atopic dermatitis

Dairy products can cause allergic reactions in people with a tendency to suffer from some type of skin allergy due to certain foods and if they can be one of the causes, points out Dr. Ionescu, member of the scientific committee of the Uriage Dermatological Laboratories. However, the case of products with gluten is different (despite the fact that the number of celiac patients has increased in recent years) a patient may have atopic skin, but not be celiac and "gluten is not among the allergens most dangerous for people with atopic skin" says Ionescu.

In other words, "an unjustified gluten-free diet will not improve the condition of atopic skin", as stated by Lidia Maroñas, Dermatologist at the International Dermatological Clinic.

Severe atopic dermatitis in infants is often related to cow's milk protein allergy in up to 50% of cases. In fact, cow's milk is one of the foods most strongly linked to atopic dermatitis. "In high-risk infants, it is recommended to promote and maintain breastfeeding for at least 4-6 months together with the administration of protein hydrolysates" recommends Maroñas.

What has not yet been proven is the effectiveness of following a specific diet to prevent atopic dermatitis, since it is determined by a genetic predisposition and by environmental factors that cause skin inflammation and a break in the epidermal barrier. Some foods can aggravate the reaction, but avoiding them does not guarantee prevention of the disease.

The best treatments against atopic dermatitis

Dermatologists work in two fundamental areas: the early treatment of eczema and the strengthening of the skin barrier with emollients specially indicated to alleviate the symptoms of this disease.

"For hydration, we recommend balms, lotions or creams with a high percentage of fat, containing omega fatty acids (necessary for the formation of the skin barrier) and it is good that they contain some type of anti-inflammatory, since skin with atopic dermatitis always has a certain degree of inflammation," says Chorto. And of course, ingredients that calm itching, to prevent scratching and all its complications.

Ideally, moisturize after a bath or shower (better with warm water and no more than 10 minutes) with slightly damp skin to facilitate absorption. And when choosing a cleanser, synthetic gels or syndets are recommended and if they contain oils in their formulation, such as the so-called oleogels, it is better to always choose hypoallergenic and fragrance-free ones.

Food allergies and intolerances are related to atopic dermatitis

According to Dr. Lidia Maroñas, Dermatologist at the International Dermatological Clinic, she assures that patients with atopic dermatitis have a genetic dysfunction of the skin barrier that favors sensitization to allergens, being frequently associated with other immunoallergic diseases such as asthma, rhinitis and food allergies. And 40 percent of children with allergies suffer from atopic dermatitis.

However, there is no miracle diet that will cure the disease, but there are dietary guidelines to follow: "have a varied, balanced diet, rich in nutrients and trace elements, do not suppress the intake of any food unless there is a medical diagnosis of allergy diet and knowing that gluten is harmless in people without gluten intolerance or celiac disease, even if they have atopic dermatitis".