Eczema and Diet

ECZEMA

📅 24th September 2026

⏱ 5 min read

Eczema and Diet: Why What You Add In Matters More Than What You Cut Out

If you've searched "eczema diet" recently, you'll have found no shortage of lists telling you exactly what to cut out — dairy, gluten, nightshades, sugar, sometimes entire food groups. It's understandable why these lists are so popular: when your skin is flaring, you want something concrete to do. But here's the honest picture the research actually shows: for most people with eczema, food is not the root cause, and a lot of the confident-sounding "avoid this" advice circulating online is based on self-reported surveys rather than controlled research. Some genuine food allergies do exist and matter enormously for the people who have them — but for everyone else, cutting out food groups without proper guidance can do more harm than good.

So rather than starting with what to eliminate, I want to flip the question: what should you actually be adding in?

Louise Cowlishaw

BANT Registered Nutritional Therapist

Why unsupervised elimination can backfire

It feels intuitive that removing a "suspect" food should help. But your gut is home to trillions of bacteria, and the diversity of that microbial community depends heavily on the diversity of what you eat — particularly the range of fibres reaching your colon. When you cut out entire food groups without a clear reason or professional support, you often narrow your diet more than you realise, which can reduce that microbial diversity and create gaps in key nutrients. Given that gut health and inflammation are closely linked, an unsupervised elimination diet can end up working against the very thing you're trying to fix. This is exactly why any elimination approach should be done with support from a registered nutritionist, dietitian, or nutritional therapist — not worked out alone from a blog list.

What to add in

Fermented foods. Of everything studied in relation to eczema and diet, probiotics have the most genuinely promising evidence — modest, but real, particularly with multiple bacterial strains rather than just one. You don't need a supplement to start: kefir, natural yoghurt, sauerkraut, kimchi, miso, and tempeh are all accessible ways to bring more live cultures into your diet regularly.

A wide diversity of fibre-rich foods. This is about variety as much as quantity. Different types of fibre feed different families of gut bacteria, so eating a genuinely broad range of vegetables, fruits, whole grains, legumes, nuts and seeds supports a more resilient, diverse microbiome than any single "superfood" ever could. A simple goal: aim to include a wider range of plant foods across your week rather than the same five on repeat.

Why this works: building tolerance from within. Fermented foods and a diverse fibre intake do more than just add "good bacteria" — together, they help create a healthier gut microbial environment that produces short-chain fatty acids (SCFAs) like butyrate. SCFAs are a key fuel source for the cells lining your gut, and they play a central role in supporting intestinal barrier function — essentially helping keep that lining resilient rather than more "leaky" than it should be. A stronger gut barrier means better communication with your immune system, which in turn supports a more balanced, anti-inflammatory internal state rather than one primed to overreact. Over time, this is part of how improving your gut environment can genuinely increase your tolerance to foods, rather than simply avoiding them indefinitely — which is really the crux of why "adding in" tends to be more powerful than "cutting out."

Polyphenol-rich foods. Berries, apples, onions, broccoli, herbs, spices, and green tea are all rich in polyphenols and compounds like quercetin, which have general antioxidant and anti-inflammatory properties. These won't single-handedly resolve a flare, but as a consistent part of your diet they support your body's overall inflammatory balance.

Healthy fats — omega-3, omega-6, and monounsaturated fats. As I've written about before, omega-6 isn't the enemy it's made out to be — GLA specifically plays a role in skin barrier support, and oily fish (salmon, mackerel, sardines) brings omega-3 to help balance it. Monounsaturated fats, found in olive oil, avocado, and nuts, round this out and are a cornerstone of the anti-inflammatory dietary patterns most consistently linked to better outcomes across inflammatory conditions generally.

What to moderate

Alongside adding these in, a few things are worth moderating — not eliminating, but being mindful of: alcohol, refined carbohydrates and high sugar intake, and saturated fat found in ultra-processed and fried foods specifically (distinct from the olive oil, oily fish, and nuts recommended above). These are consistently associated with a more pro-inflammatory internal environment, which is worth being aware of even though none of them are an eczema "cause" on their own.

Why this isn't one-size-fits-all

Even within this add-in approach, individual differences matter. Your existing gut microbiome, genetics, and current nutrient status all affect how your body responds to any of this — which is why a personalised assessment tends to get better results than a generic list, however well-researched. If you want to understand what your body specifically needs rather than guessing from a blog post (even this one), that's exactly the kind of thing I help clients work through.

DM me any questions, or book a free 20-minute call to talk it through.