Sensitivity to gluten, the main protein found in wheat, rye and barley grains, is an allergic condition that triggers an immune system reaction in sufferers whenever they eat food containing even small amounts of gluten. In celiac disease, the immune system reaction occurs primarily in the digestive tract and causes severe stomach pain. Gluten sensitivity reactions may occur on the skin, however, and appear as an eczema-type rash called dermatitis herpestiformis, or DH. Although research about DH has increased in the 21st century, the only cure for this immune system food reaction remains avoidance of the food triggers.
Skin reactions to gluten often start slowly as itchy rashes that may start as blisters on the knees, elbows or back. As exposure to gluten continues, the eczema worsens as blisters form lesions, new blisters form and the rash spreads across more of the skin. In severe disease, prodromal symptoms, which consist of itchy sensations before the blister formation, develop. Removal of all gluten from the diet, though, prevents new blisters, relieves the itch and heals the existing lesions.
Immune Reaction to Gluten
In people with gluten sensitivity, whether celiac or DH, the body's immune system overreacts to the gluten protein after it is eaten. In people with DH, immunoglobulin A levels in the skin layers increase and lead to the itchy eczema flares. Although in 2011, DH is not considered a precursor to celiac symptoms, high levels of immunoglobulin A are present in the digestive system also, and some people may experience stomach upset and other digestion problems along with the eczema.
Hidden Gluten Sources
Treating eczema from gluten sensitivity is not as simple as avoiding bread and pasta. Products that do not intuitively contain grains may have hidden gluten or be contaminated with gluten grains. For example, oats are often processed in the same machines as other grains so that packaged oats become contaminated with gluten products. Gluten may be found in unusual places, including multivitamins and soy sauces. Since 2007, the US Food and Drug Administration has provided guidance on how to label a food product as gluten free, and gluten-free products are becoming more accessible in the United States as awareness of celiac disease and gluten sensitivity increases. People with gluten sensitivity should continue to read labels on each product at every purchase to safely avoid all gluten.
Eczema Skin Care
Although DH is only resolved by gluten avoidance, attentive skin care can minimize symptoms and hasten healing in the early stages of a gluten-free diet. Lotion to moisturize and vaseline or thick creams as a protective barrier both soothe the skin. Oatmeal baths reduce itch and coat the skin as well. For more severe lesions, oral dapsone, a prescription sulfone medication, may be prescribed in addition to skin care regimens to lower immunoglobulin A levels, leading to an improvement in lesion healing times. Any topical or by mouth treatment should be approved by a health professional before being used to ease eczema from gluten sensitivity.