Dietary Plan for Atopic Dermatitis (AZS)

Atopic dermatitis, also known as eczema or atopic rash, is a chronic inflammatory skin condition with a genetic predisposition, characterized by an exaggerated immune response. Symptoms include dry, rough skin that is often scaly and reddened. Intense itching leads to scratching, which worsens the condition. In some individuals, symptoms subside during adolescence, while others struggle with the disease lifelong. AZS increases the risk of asthma, allergic rhinitis, and chronic conjunctivitis. The condition frequently affects children who exhibit hypersensitivity to minimal allergen exposure. Additionally, disruptions in ceramide production, dysfunction of sebaceous glands, and filaggrin deficiency contribute to the development of atopic eczema. Children with eczema are more prone to food allergies and sensitivities to food additives. Research indicates that a diet high in processed foods, sugar, and refined oils, but low in vegetables and fruits, promotes the onset and exacerbation of AZS.

The pathogenesis of atopic dermatitis (AZS) is multifaceted and not yet fully elucidated. Experts identify key factors, including genetic predisposition, particularly mutations in the gene encoding filaggrin – a protein regulating skin hydration and elasticity; as well as external influences. Factors promoting AZS include excessive hygiene, environmental pollution, smoking during pregnancy or exposure to secondhand smoke, chronic stress in pregnant women, and dietary deficiencies.

Diagnosis requires confirmation of at least three of the specified major criteria, including itching, characteristic location of skin lesions (in infants on the cheeks, head, torso, and buttocks; in adults on joint flexures, hands, and cheeks), positive family history, and chronic progression of the condition. Additionally, at least two of the minor criteria must be identified, such as early onset of symptoms, elevated IgE antibody levels, positive skin test results, recurrent inflammation of the skin, conjunctiva, or nasal passages, hyperkeratosis and dry skin, intensified itching after rest or irritation, and exacerbation of symptoms following stress. Another crucial diagnostic step is testing for food allergies, as allergen elimination can significantly improve the patient's skin condition.

Dermatological therapy involves a multifaceted treatment approach, encompassing both topical and systemic interventions, as well as anti-inflammatory and skin-strengthening measures. In topical therapy, the following are utilized: – Glucocorticoids, which exhibit strong anti-inflammatory, anti-proliferative, and immunosuppressive effects; – Calcineurin inhibitors with anti-inflammatory properties; – Tacrolimus and pimecrolimus with potent immunosuppressive actions. For systemic therapy, the following are administered: – Antihistamines to alleviate itching; – Cyclosporine and glucocorticoids, which are increasingly used sparingly due to adverse effects. In supportive therapy, the following are employed: – Phototherapy. UV radiation with appropriate wavelengths demonstrates immunosuppressive effects; – Preparations containing gamma-linolenic acid; – Psychotherapy; – Balneotherapy; – Antiviral, antifungal, or antibiotic therapy in cases of secondary skin infections; – Avoidance of factors exacerbating symptoms, such as high temperatures, allergens. Treatment often involves the concurrent use of multiple preparations, emollients, adherence to a suitable diet, and lifestyle modifications. Achieving remission requires discipline from both the patient and their family. The literature increasingly reports on potentially effective treatment methods. It is crucial to consult with a physician before using any medication or supplement. Only continuous monitoring by a qualified specialist ensures effective symptom management.

To alleviate the symptoms of AZS, several simple dietary adjustments should be implemented to effectively support the primary treatment prescribed by the doctor. Nutrition is a crucial therapeutic approach that should not be overlooked during AZS treatment. It is an essential component of the healing process, and skin improvement is challenging without modifying dietary habits. Expectant mothers with a family history of AZS or partners with a positive familial predisposition should prioritize their child's health before conception and maintain healthy eating habits throughout pregnancy. Key principles include: – avoiding food allergens – in cases of confirmed allergy, the triggering food should be replaced with an alternative offering similar nutritional benefits but without allergenic effects. AZS patients most commonly exhibit allergies to cow's milk, eggs, citrus fruits, strawberries, carrots, and cross-allergies; – regular consumption of vegetables and fruits – daily intake of approximately 700 g of fresh vegetables and fruits is recommended, which reduces the risk of asthma as a consequence of AZS due to the high content of vitamins and antioxidants. Variety should be ensured by incorporating them into soups, salads, and raw vegetable dishes; – increasing intake of healthy fatty acids – optimal consumption of polyunsaturated fatty acids, particularly omega-3 in a ratio of 1:2 or 1:4 to omega-6. Omega-3 is found in fatty marine fish, seafood, nuts, rapeseed and soybean oil, almonds, and pumpkin seeds, while omega-6 is present in oils from flaxseed, evening primrose, sunflower, corn, sesame, and avocado; – enriching the diet with probiotics – fermented products such as yogurt, kefir, buttermilk, sauerkraut, and pickles improve gut flora and reduce the risk of AZS in children by 21%. Adults may consider supplementing with Lactobacillus casei and paracasei strains; – providing vitamins and minerals – adequate intake of vitamin D and antioxidants, including vitamins C and E, selenium, retinol, and beta-carotene, is essential to alleviate inflammatory skin conditions and support skin regeneration. Vitamin E is found in plant oils, fatty fish, nuts, and seeds, beta-carotene in carrots, bell peppers, spinach, and morels, and vitamin C in citrus fruits, bell peppers, broccoli, blackcurrants, and chokeberries. Selenium is present in Brazil nuts, garlic, mushrooms, and lentils; – avoiding processed foods – highly processed foods, fast food, preservatives, and artificial colors should be avoided as they may exacerbate skin symptoms. The diet should be based on natural products; – hydration – adequate hydration is vital to maintain skin hydration from within. Consuming at least 1.5 liters of mineral water daily is recommended, increasing to up to 2.5 liters during physical exertion or high temperatures.

In addition to dietary factors, researchers emphasize the importance of other aspects that can significantly improve skin health. These include: – quitting smoking – smoking exacerbates inflammation, impairs wound healing, and enhances the harmful effects of free radicals, negatively impacting skin condition. Additionally, smoking, even passively during pregnancy, significantly increases the risk of AZS in the baby; – limiting alcohol consumption – alcohol causes dehydration, contributing to dry skin and increased itching; – using emollients – appropriately selected moisturizers support skin hydration, relieve itching, and protect against pathogens. Products without preservatives, dyes, or fragrances should be preferred to avoid irritation. A dermatologist can recommend a suitable cream or an individualized pharmacy blend; – wearing appropriate clothing – clothing made of natural, soft materials that are breathable and loose prevents friction and improves air circulation. Wool and linen should be avoided as they can irritate the skin; – proper skincare – cleansing the skin with mild, moisturizing agents in lukewarm or cool water. The skin should be patted dry with a soft, clean towel or paper towels; – stress reduction – stress is a key factor exacerbating skin symptoms. Relaxation techniques or psychotherapy can help; – following additional guidelines: – thoroughly washing new clothes before wearing them; – maintaining proper room humidity; – avoiding allergens such as dust, pet dander, or mites; – ensuring adequate hydration during physical activity and using appropriate skincare products post-workout. These simple measures can prevent flare-ups.

Atopic dermatitis is becoming an increasingly prevalent health issue in our society. This condition is characterized by a complex pathogenesis and necessitates a multifaceted therapeutic approach. A well-balanced diet can not only enhance the efficacy of pharmacological treatment for AZS but also contribute to overall well-being. Therefore, it is advisable to seek the expertise of a clinical dietitian who can develop a personalized nutrition plan tailored to the patient's needs.