FOOD INTOLERANCE NETWORK FACTSHEET

About eczema and other itchy skin rashes

Eczema can be related to:

· food intolerance (sensitivity to food chemicals such as salicylates, sulphites or other food additives)

· food allergies (a reaction to the proteins in foods)

· environmental allergies e.g. grass, dustmites

· chemical sensitivities, e.g. latex, formaldehyde in building materials and wrinkle-free fabrics, irritants in washing powders, soaps, perfumes, cleaners and many others

If you come from a family with migraines, irritable bowel symptoms or behaviour problems, your eczema might be a reaction to certain food chemicals such as additives and salicylates. Sulphite preservatives can be a big problem with rashes, especially for children and big beer and wine drinkers, and there are other preservatives, colours and flavour enhancers that can cause problems. Salicylates (in most fruit and some vegetables) are another big suspect in this type of eczema. If cutting down on additives is not enough to clear up your skin, a low chemical elimination diet - free of additives, low in salicylates, amines and flavour enhancers - supervised by a dietitian can pinpoint exactly what is affecting you (ask for our list of supportive dietitians, see below). Salicylates are natural pesticides that are present in varying amounts in most fruit and some vegetables and are particularly high in tomatoes, broccoli, citrus and all juice. These chemicals can pass through breastmilk to affect babies. Note that the new A2 milk from selected Jersey cows with a different protein (www.a2australia.com.au) is helpful for some eczema cases. Others may need to switch to soy or ricemilk.

If you come from an allergic family (with a history of hayfever, asthma), it may be worth having allergy testing for food or environmental triggers. The most common food allergens in Australia are milk, eggs, peanuts and other tree nuts, seafood, soy and wheat. True allergic reactions often occur quickly (eg within 30 minutes) which makes it easier for you to identify the problem.

For adults, if your eczema has only developed since you started your current job, and particularly if it gets better during long holidays, you need to consider occupational eczema - that is, related to latex gloves or other chemicals at work. One woman's long term dermatitis (hands and arms) turned out to be related to formaldehyde in her car's steering wheel (see Story [276] below).

With a skin rash that starts suddenly in a person with no previous history of rash, consider the new flavour enhancers of the 635, 627, 631 group. The Ribo Rash factsheet on the website is a good place to start. Sometimes Ribo Rash is misdiagnosed as eczema. MSG may also be a cause – see MSG Factsheet.

The side-effects of prescription or over the counter medication can cause a sudden new rash.

People who improve when they avoid wheat products may need to consider the bread preservative (282) or a particular type of rash associated with gluten called dermatitis herpetiformis that often remains undiagnosed. It can take a lot of detective work, so please feel welcome to ask questions - people with skin rashes often need some extra help.

How to avoid environmental chemicals

Personal items

Toothpaste:

Soul Pattinsons Plain, or make your own: mix 3 parts baking soda with 1 part salt - add 3 teaspoons of glycerol/glycerine to each quarter cup of dry mixture.

Soap:

uncoloured, low-perfume (eg Simple)

Redwin Sorbolene Moisturising Bar with Vitamin E and Glycerine www.redwin.com.au

EnviroCare Sensitive Body Hair Cleanser (from health food stores) www.ecoshop.com.au

Shampoo/ conditioner:

eg Dermaveen oatmeal, QV oatmeal in pharmacies

Deodorant:

unperfumed roll-on eg Simple

Sunblock:

Megan Gale invisible zinc (from David Jones or by mail order www.adorebeauty.com.au/adorebeauty/viewitem.asp?idproduct=2491); Ego Sunsense Low Irritant sunblock;UV Natural

Lip Balm:

Lansinoh preservative-free moisturiser and lip balm (from pharmacies); Vaseline

Skin creams:

Plain sorbolene. For the extra sensitive, your local pharmacy can make a batch of pure sorbolene with 10% glycerin.

Ego brand of skin creams from pharmacies

QV brand of skin creams from pharmacies, such as QV Kids Wash.

Dermeze ointment, a moisturiser for dry skin developed by Royal Childrens Hospital, from pharmacies. You may have to order it. It contains liquid paraffin 50% and white soft paraffin 50% and is especially good for eczema.

Household

Washing powder (no perfumes, no enzymes):

eg Lux, Planet Ark, Omo-sensitive

No: perfumed fabric conditioners, soakers, ironing sprays

Cleaning:

Soda bicarb

Vinegar

Enjo cleaning cloths

Steam cleaning

Low perfume dishwashing detergent (Palmolive original, Morning Fresh)

Dishwasher powders are acceptable

No: perfumed cleaners, aerosols, airfresheners, essential oils, incense, pesticides including cockroach baits

No: commercial cleaners, eg carpet cleaning

Medicines

No fruit or other flavoured syrups

No butter menthol or other cough lollies

No salicylate-containing medications: aspirin or other nonsteroidal anti-inflamatories, no salicylate containing acne lotions or wart remedies, no oil of wintergreen lotions, no mentholated rubs or liniments, no herbal or homeopathic medications

No coloured, flavoured or preserved tablets or capsules: ask for plain white or empty contents of capsules into a small amount of failsafe icecream or maple syrup

For eczema, avoid formaldehyde in fabrics and building materials. Avoid renovations during your elimination diet and systematic reintroductions. '100% pure cotton' sheets and clothes from K-Mart for instance, all contain formaldehyde for wrinkle control. This won't be on the label. You have to ask manufacturers.

Steroids: An increasing number of parents are complaining to the Food Intolerance Network that they are offered only steroid creams for their babies and young children's eczema, yet some of these creams unless used very sparingly can have irreversible side effects including skin thinning, flushing and bruising. For more information, see http://dermnetnz.org/treatments/topical-steroids.html.

A reader's story: I took my 3 year old son to the doctor. He was covered in a sudden full body rash. The doctor gave me a script and said to smother him head to toe. I was adamant that I wanted to know why, I didn't just want to cover him in cream. It's nice to know why it happened so you can avoid it the next time. The doctor didn't say he didn't know. He just got up and said I'd wasted his time. So I changed to another doctor.

SOME RASHY STORIES

[1011] Allergy to Sorbolene (March 2006)

When our daughter first developed a rash our GP diagnosed it as pityriasis rosea, which is uncommon but not unheard of in babies and resolves itself after about 6 weeks. Two months on the rash was still there, so since then we have been trying to figure out the cause via the GP, naturopath, paediatrician, etc. Then one day I took my daughter to see the clinic sister who has seen her rash LOTS of times and mentioned to me almost in passing that some people can be "allergic" to sorbolene. Apparently people can build up a sensitivity to it over time and we've been slathering it on our poor daughter for months! I stopped putting it on and within a day her rash started improving. [Sensitivity to Sorbolene can be to the ingredient TEA which is used in the Redwin soap, above]

[451] Severe eczema and cradlecap in a fully breastfed baby (August 2006)

My two and a half year old daughter has had severe eczema and cradle cap since she was a few months old, I never made the connection between the eczema and food allergy because she wasn’t even on solids when we first noticed the eczema. She was fully breastfed and I am embarrassed to admit that it didn’t occur to me that what I ate may be causing the rash! I had her to the doctor plenty of times over her first two years and came away with all sorts of creams and lotions, but nothing that worked. (Mind you the doctor never once suggested food allergy either!)

Anyway six months ago she had an allergic reaction to peanut butter, we took her to an allergist who performed skin prick tests and not only is she anaphylactic to peanuts but also allergic to egg and tomato. We eliminated all nuts and egg and tomato from her diet and whilst she improved and her cradle cap went, her skin still didn’t clear up. She still scratched a lot (mostly at night), got allergic shiners under her eyes, and always seemed to have a slight cough and a clear runny nose.

I recently got hold of Fed Up with the idea of doing the elimination diet then slowly introducing things back in to see what else may be causing her eczema. I am pleased to tell you that the eczema is now completely cleared up along with all the other symptoms simply due to avoiding all preservatives.

Before going fully failsafe we eliminated all those nasties from our diets and what a difference it has made! I just want to say thank you for what you do and for making it so much easier for parents like me, who 18 months ago had no idea what 160b or 282 were and thought I was giving my children healthy food with their yoghurt and cheese spread etc. I almost look at my daughter’s anaphylactic allergy to peanuts a blessing in disguise, because if not for that I never would have investigated food allergies and would still be obliviously feeding my family all sorts of nasty things.

[431] My daughter gets eczema and asthma from salicylates (July 2006)

When my daughter was two I noticed that her eczema seemed to flare up after I had given her spaghetti one day or two before. I asked my dietitian if it could be tomatoes and she said "yes - it can be salicyates". So I stopped giving her spaghetti and tomatoes thinking this would solve the problem however she still had eczema so I just treated it. When she turned three years old she started getting asthma, about every month and when she had a virus or a cold. My daughter always only drank water or milk but at her Kindy Christmas Party we had to give her some cordial to drink because there wasn't anything else and that night she had asthma. The same thing happened a month later after she had a raspberry fruit drink. My doctor just told me how to treat the asthma so I went to my dietitian. She prescribed vitamin supplements and took my daughter off dairy which reduced the frequency and severity of the asthma but made the eczema worse. It took a couple of months for me to realize that I was mixing the vitamin powder in orange juice, then the dietitian gave me a list of all the foods that contained salicylates so I could avoid them. A few weeks after we started avoiding salicylates, my daughter's skin started clearing up. So you can see the pattern with the tomatoes, fruit juice and orange cordial with real fruit juice – reader by email.

[247] 635: Ten week rash from 635 (April 2003)

I have never suffered any kind of food allergy in my life (43 years) and then about ten weeks ago I found myself suffering from an extremely intense and constant itch of my hands and arms. After two days of this I found I had come out in hives, starting on my upper chest, abdomen and back. It then spread to my arms and my legs and from then on each day might be different combinations of location of the hives, but always somewhere. They were worse at night causing intense itch and lack of sleep, I can't begin to tell you how unbearable the itch was and how it affected my everyday living and my ability to work. On several occasions my lips have been swollen and I find on occasion that although my upper lip doesn't look particularly swollen, it feels 'thick' and like I have been to the dentist. Once my eyelids puffed up too. Through studying the foods that I had eaten I became almost certain that it was 635 causing my problem. For almost two weeks I avoided all foods containing this additive and was finally able to come off the antihistamines I had been forced to live on. I then ate a seasoned lamb steak bought from my local butcher and the next night the hives were back. Guess what? On contacting the butcher concerned, he was able to tell me that the seasoning used on those steaks contained 635. I wish this product had never been put on the market. I'm sure it is what, to put it frankly, has caused me absolute hell almost continuously for over two months. For more information, see Ribo Rash factsheet on the website

[433] Preservatives including sulphites (July 2006)

"I have a 3 year old son who was diagnosed with eczema around the 12 month mark. He started having rashes when he was put on solids but nothing too serious. Last year we took him to a skin specialist who told us his condition was very mild and prescribed cortisone (Elocon). When we asked for allergy testing, she told me it was not caused by foods. Fourteen months and a few tubes of Elocon later, his condition was very bad. He would scratch himself in his sleep to the point of bloodstains on the sheets and had problems staying asleep. His skin was permanently scarred and bloody because of scratching the same spots so they never had a chance to heal. I was in despair and did not know what to do especially as I took him to my GP and he again refused to do anything other than prescribe Elocon."

Eventually this mother decided to try diet for herself and contacted the Food Intolerance Network through our website. Through cutting down on additives she found that preservatives were the main culprit and wrote:

"Since we took him off additives and preserved foods (eg lollies, juice, sausages), his skin has improved very well. He stopped scratching and started to sleep through the night. Then on Saturday he had half a sausage and bam, itching and redness started within 30 minutes. Luckily it only lasted a few hours and again yesterday we went to a party and against my better judgment I let him have orange juice and soft drink and same thing happened.

“Because I now know exactly what he eats, it is easy to pinpoint the cause. I am disappointed with our medical practitioners, the so called specialists, especially the one who saw my son last year and put him on steroids. I have become an avid label reader and when I explained to my 3 year old why he cannot have all the stuff he normally loves, he surprised me with how well he is coping."

[432] Eczema and sulphites again (July 2006)

My daughter developed eczema when she was being introduced to solid foods at about 6 months but I didn't take her to the doctor for another year and then we managed it with eczema cream until we went travelling when she was two. The eczema got much worse while we were travelling and eventually we tried the elimination diet. We went gluten free right from the start and at first she got much worse. It took us months to work out that she was sensitive to many food chemicals but especially sulphites, which were in gluten free flours and also in the bore water on our property. I was also using a herbal cream that was making her eczema worse. She is very sensitive and reacts to Sorbolene, and smells like Estapol.

[1012] Eczema exacerbated by dust mite allergy (March 2006)

A few years ago my son's health was declining with eczema attacks lasting several hours, and hives breaking out without us knowing the reason. He was already on a restricted diet but he was awake for 2-4 hrs every night, screaming "please help me, Mummy", and his legs were sometimes so scabbed up that he could not straighten them enough to walk. He was five. Eventually, we found the problem was dust mites. We knew he was sensitive to them because he had been allergy tested by a doctor, but I had "relaxed" a little with the vigilance I had previously had. And then I realised that the whole time, he had a big tear in the dustmite cover on his mattress.

So I went back to using the dust mite wash from the supermarket, and washing his sheets four times in clear water after that, and hanging them on the line all day, every six weeks. And washing his sheets in hot water every three days. And clearing his bedroom of everything except a bed, and wet-dusting once a week. he difference was amazing. The first night, he actually slept through. And now, a year and a bit later, his legs, which were just big scabs from bum to ankle, are beautiful creamy soft smooth skin. And a much happier boy. The emotional scars are still there, and taking time to heal. We got a book about eczema by a dermatologist that discusses the emotional toll on the family, and it is so true.

[276] Dermatitis from formaldehyde in car steering wheel (September 2003)

I have always been prone to skin irritations since I was a little girl. During my mid teens in the 60s I contracted quite bad dermatitis on the backs of my hands. This manifested itself on the palms of my hands too, at times, and no-one seemed to be able to discover the cause of the irritation, the resulting blisters and weeping skin. Skin specialists recommended various creams and potions including tar ointments, pure lanolin, various other forms of similar creams and ultimately full strength cortisone ointment which seemed to be the only thing that reduced the itch and the inflammation. I continued to use the cortisone ointment on my hands from that time until only a few years back when I decided to speak to a dermatologist here in Canberra. During the period of those years my hands fluctuated in the severity of irritation, sometimes really bad, and at other times less severe.

The dermatologist did a skin patch test in which I had to leave various substances on my skin for a week without touching or removing the patches. During that week I returned to the dermatologist on the Wednesday and the Friday to check the reactions. On the Wednesday there were two substances that had caused a slight pink spot on my skin. However, by the Friday these two had increased in redness and another one had begun to cause inflammation of the skin.

The three offending chemicals turned out to be:

Formaldehyde - used in large amounts in many plastic industries, building materials, eg paints, glues, varnishes, some pesticides. It is also found in small amounts in cosmetics, eg creams, shampoos, make-up, nailpolish, new fabrics and clothes, high quality paper, house-hold cleaners, disinfectants and in smoke from cigarettes or fires.

Quaternium-15 found in creams, lotions, shampoos, and other cosmetics and skin care products.

Colophony - found in adhesives, sealants, shoe wax, lacquers, gums, varnishes, pine oil cleaners, cosmetics, wart remedies, skiwax, dental floss, modelling clay, paints, resins, athletic rubs, and many industrial products. High quality gloss paper may be coated with colophony.

Well! We came to the conclusion that my chronic dermatitis of the hands (at this stage, and certainly consistently since my late teens) was caused by contact with resin steering wheels. The irritation was particularly obvious during the hot summer months. During the week following my diagnosis I wore cotton gloves when driving. I have had no recurrence of the problem since then (approximately 7 years now). My car has a pure sheepskin steering wheel cover - my husband can't stand the feel of it, yet I can't stand to drive the car without it. I must admit I was amazed to discover the cause after all those years! - by email, Canberra

[314] 13 years of intolerance to soy (April 2004)

I am soy intolerant. More specifically I suffer from a legume intolerance which is only now apparent after 13 years of suffering and frustration. My intolerance manifests itself in the form of hives, large red itchy welts that, in a severe attack can cover almost all of the body, be unbelievably itchy and uncomfortable to say the least. In my situation, my symptoms got worst and extended to lethargy, aching and swelled joints, sleepless nights and eventually an emotional feeling of hopelessness of ever being able to stop the relentless onslaught. My condition was medically referred to as Chronic (severe - never ending) Idiopathic (origin or cause unknown) Urticaria (hives). See the rest of this story on the website...

MORE INFORMATION

Available in Sue Dengate’s books, Fed Up and The Failsafe Cookbook, our DVD (Fed Up with Children's Behaviour), available through the website www.fedup.com.au and selected bookstores, and The Failsafe Booklet, available for download from Failsafe Eating on the website. See also Friendly Food by Anne Swain and others, available from bookstores.

www.fedup.com.au

The information given is not intended as medical advice. Always consult with your doctor for underlying illness. Before beginning dietary investigation, consult a dietician with an interest in food intolerance. Write for our list of supportive dietitians (confoodnet@ozemail.com.au)

© Sue Dengate update July 2006