Atopic dermatitis allergic food

There is currently no "AD taboo list" that applies to everyone. According to clinical statistics, the most common high-risk foods that trigger allergies are divided into two categories - the four most common types of allergic reactions are milk, eggs, nuts, and shelled seafood. Itchy skin, rashes, and even swollen lips will appear within a few minutes to 2 hours after eating.； Delayed-onset diseases are mostly caused by light-sensitive fruits and vegetables such as wheat, processed foods containing a large amount of food additives, and mango/pineapple/celery. It may take 1-3 days after eating for the skin lesions to worsen. Each person's allergic food is completely personalized. Blindly avoiding all foods will drag down the skin barrier due to lack of protein and trace elements, which will make dermatitis heal more slowly.

Believe it or not, I had a 3-year-old patient a while ago. My mother heard that AD requires strict food taboos. She would not let the child touch even a bite of eggs, milk, or seafood. Over the past six months, he has become 2 centimeters shorter than his peers and has a sallow complexion. As a result, a serum-specific IgE test + patch test was performed, and it was found that the child was only allergic to cashew nuts. He had not been able to eat any white food for most of the past six months.

What’s interesting is that many people still get allergen test reports. As long as they see a positive arrow, they directly add the corresponding food to the blacklist. In fact, this approach has long been deprecated. The old version of the diagnosis and treatment idea is indeed "avoid if positive", but the 2023 version of the "China Atopic Dermatitis Diagnosis and Treatment Guidelines" has been clearly adjusted: only foods that have clearly triggered aggravation of skin lesions need to be avoided, and there is no need for lifelong taboos - as the intestinal barrier develops in children, after 3-5 years old More than 60% of allergy to milk and eggs can resolve on their own. On the contrary, adult AD patients should pay more attention to delayed allergies. Many times, the allergy does not occur immediately after eating. After two days, the body starts to itch and red rash. Most people will not associate the discomfort with what they ate two days ago, so naturally they cannot find the allergen.

The most reliable way to find food allergies is not to spend a lot of money on dozens or hundreds of allergen tests, but to keep a food diary for 4-6 weeks. I have a 28-year-old female patient who had a red rash on her elbow fossa that oozed repeatedly for more than half a year. She checked her allergens twice and found no problems, so she followed my advice and kept a diary. During that time, she even drank milk tea and had to take pictures of the ingredient list and save it on her phone. She clearly marked how much syrup was added and whether creamer was added. , when she finally checked the records, she discovered that every time she drank bubble milk tea with non-dairy creamer, the skin lesions on the elbow fossa would definitely worsen on the third day. Before, she had always thought that she had touched something dirty, and did not think about the milk tea at all. After she stopped eating processed foods containing non-dairy creamer, the frequency of recurrences dropped by half.

As for the controversial question on the Internet about whether hair should be avoided, in fact, both sides of the argument are reasonable: the traditional Chinese medicine system has always believed that AD is related to blood heat and dampness. Beef, mutton, seafood, and spicy food will aggravate the dryness in the body and easily induce the recurrence of skin lesions.； However, large-scale clinical data from modern medicine show that as long as there is no clear aggravation of skin damage after eating, the high-quality protein and unsaturated fatty acids in these foods can help repair the damaged skin barrier, which is beneficial to the condition. I usually advise patients to try a "half-dose stimulation": for example, if you want to eat beef, eat one or two pieces of stewed beef, and then don't eat other new foods that you haven't tried for three days. Observe the condition of the skin. If there is no itching or increase in rash, eat what you need in the future. If it really gets worse, just stop for 3 months and try again. There is no need to beat him to death with a stick.

There is also the myth that "AD requires abstaining from sugar and gluten." I met a patient who, in order to strictly abstain from gluten, did not even dare to eat soy sauce. He ate boiled vegetables and brown rice every day. In fact, only patients who have been diagnosed with gluten allergy or who clearly feel itchy after eating high-sugar foods need targeted avoidance. Others really don’t need to set so many restrictions on themselves.

To be honest, many AD patients always want to find a universal list of taboos and just follow them and they will be fine. In fact, how can there be such a good thing? Your skin is much more reliable than a test report. Spending more time observing what you feel comfortable eating and what makes you itch is much more useful than following a list of food taboos on the Internet. After all, the purpose of our food taboos is to make our skin comfortable, and we have to live our lives as usual, right?