Do dietary exclusions improve atopic dermatitis?

In the Journal of Allergy and Clinical Immunology, an international team of researchers reviewed the benefits and harms of dietary elimination as a treatment for atopic dermatitis (AD). They analyzed 10 randomized controlled trials with dietary eliminations ranging from two to 32 weeks. The studies evaluated the effect of dietary elimination on eczema severity using SCORAD, for which an 8.7-point improvement was considered a minimally important difference. Among 547 patients, a greater portion of those who participated in dietary elimination achieved this minimally important difference than those who did not eliminate foods (50% vs. 41%). Three studies found that dietary elimination slightly improved skin pruritus compared with no elimination, although the researchers noted that the results had low certainty.

Considering the slight effect that dietary elimination had on eczema severity, through ingestion or contact, food may be a minor contributor to the causes and perpetuation of AD, with allergic or nonallergic mechanisms, according to the researchers. The researchers concluded that patients need to be fully informed as they weigh the modest benefits in eczema severity, pruritus, and sleeplessness that may come with dietary elimination against its potential risks.