Eczema and Gut Health: A Root Cause Approach to Skin Healing
Guest: Julia Chien, RD
Eczema is often treated as a surface-level skin condition but if you’ve ever struggled with flare-ups, you know it’s so much deeper than that.
The itching, inflammation, and unpredictability can feel frustrating, overwhelming, and at times, all-consuming.
And while topical treatments can provide temporary relief, many people are left wondering: Why does it keep coming back?
The answer often lies beneath the surface in the gut, the immune system, and the nervous system.
Eczema Isn’t Just Skin Deep
Eczema is closely tied to the immune system and a large part of that immune system lives in the gut.
In fact, about 70–80% of your immune system is housed in your gut microbiome.
When the gut is balanced, it helps regulate immune responses. But when there’s an imbalance (known as dysbiosis), the immune system can become overactive.
This is what we often see in eczema:
Increased inflammation
Heightened immune response
More frequent or intense flare-ups
This gut–immune-skin connection is why eczema often requires a deeper approach.
What’s Happening Inside the Body
When the immune system is dysregulated, it can trigger inflammation that shows up on the skin.
Some contributing factors may include:
Gut imbalances (bacterial or fungal overgrowth)
Nutrient deficiencies
Chronic stress
Digestive symptoms (bloating, constipation, diarrhea)
These internal factors can manifest externally as eczema, making it important to look beyond just topical treatments.
Key Nutrients That Support Skin Health
While food isn’t the only piece of the puzzle, it plays an important role in supporting the body’s ability to heal. Some commonly supportive nutrients include:
Vitamin D – often low in individuals with eczema and linked to immune regulation
Omega-3 fatty acids – support inflammation reduction
Zinc – important for skin repair and immune function
Magnesium – supports stress response and nervous system
Of course, before focusing on these micronutrients, it’s important to ensure you’re eating adequate energy and macronutrients. If meals are typically balanced, it can have the trickle down effect of micronutrient adequacy!
That said, focusing on these key nutrients can ensure your body is getting enough of what it needs for skin function.
What About Probiotics?
Probiotics are often marketed as a quick fix for eczema. While research shows certain strains may be helpful, not all probiotics are created equal. What matters more is:
Choosing evidence-based strains for your condition
Looking at overall diet quality first - this will have a much stronger impact on your gut and skin function
Probiotics can be supportive, but they’re not a standalone solution and should be individualized.
The Most Overlooked Eczema Trigger: Stress
If there’s one underlooked factor that consistently impacts eczema, it’s the nervous system. Prolonged stress can increase inflammation, disrupt the gut microbiome and trigger or worsen flare-ups!
And while many people know stress plays a role, actually supporting the nervous system is often the missing piece. This might look like:
Slowing down your pace of life
Incorporating small moments of rest
Practicing mindfulness or gentle movement
Even small shifts can make a meaningful difference over time.
When “Healthy Eating” Becomes Stressful
One of the most common patterns seen in eczema healing is over-restriction. Many people try multiple elimination diets, cut out large groups of foods and begin to fear certain ingredients.
While this often comes from a desire to heal, it can backfire. It can lead to disordered eating and worsen your skin and gut function through nutrient gaps, wreaking havoc on your health!
Healing isn’t about removing everything - it’s about improving your nutritional quality of meals, and rebuilding safety and nourishment.
A More Sustainable Approach
Instead of jumping into another restrictive protocol, a more supportive approach includes:
1. Stabilize Your Blood Sugars
When it comes to eczema, one piece that often gets overlooked is blood sugar stability. Large swings - where blood sugar rises quickly and then drops - can make skin flare-ups more noticeable for some.
This tends to happen when meals are heavily based on refined carbohydrates, when protein and fats are missing, or when there are long gaps between eating. It’s not about a single food causing a reaction, but more about the overall pattern your body is experiencing throughout the day.
This also doesn’t mean you need to cut out carbs. In fact, carbs are an important part of a balanced diet. The goal is simply to build meals in a way that helps your body process them more steadily.
For example, having something like toast on its own may lead to a quicker spike and crash, whereas choosing whole grain, and pairing it with eggs or nut butter can help slow digestion and keep energy (and blood sugar) more stable.
It can also help to avoid going long stretches without eating, as this often leads to bigger fluctuations once you do eat. Keeping meals and snacks relatively consistent throughout the day gives your body a more stable environment to work with.
2. Add in More Food Variety with Key Nutrients for Skin Barrier Support
Some nutrients may also support skin healing and help the body better manage inflammation over time. Rather than focusing on supplements first, it can be helpful to think about how to naturally build these into your day through food and lifestyle.
Here’s what that can look like in practice:
Vitamin D — This often comes down to sun exposure and consistency. A short daily walk outside, especially midday when possible, can help support levels alongside food sources like eggs and fortified dairy or alternatives. That said, in Canada it’s recommended to include a daily supplement in the dark winter months.
Omega-3 fatty acids – Aim to include fatty fish like salmon or sardines a few times per week, or plant-based options like chia seeds or walnuts added into smoothies, oatmeal, or yogurt!
Zinc – Can be built in through simple additions like pumpkin seeds on salads or oats, legumes in soups or bowls, or regular inclusion of protein sources like meat, eggs, or tofu.
Magnesium – Often supported through foods like leafy greens, nuts, seeds, and whole grains. It can also show up in simple habits like having a handful of nuts as a snack or adding greens into meals where you can.
The goal isn’t perfection or tracking every nutrient, it’s creating a consistent baseline of nutrient-rich foods that support your body’s ability to recover, while keeping meals realistic and sustanable.
Building a Supportive Care Team
Eczema often benefits from a multi-disciplinary approach. This may include:
A medical provider, doctor or Nurse Practitioner (for diagnosis and symptom management)
A dietitian (for nutrition and gut health support)
A mental health practitioner (for emotional and stress support)
Complementary therapies (like acupuncture or traditional medicine, if aligned)
This kind of support allows for both symptom relief and healing.
The Bottom Line
Eczema healing isn’t linear and it isn’t about doing everything perfectly.
It’s about:
Understanding your body
Supporting your gut and immune system
Reducing stress, not adding more
Letting go of all-or-nothing thinking
There is no single “fix” - but with the right support, there is a path forward.
And most importantly: you don’t have to figure it out alone.
Want Personalized Support for Eczema?
If you’re dealing with eczema and feel stuck in a cycle of flare-ups, elimination diets, or conflicting advice, this is exactly what our 1:1 nutrition coaching is designed for.
Instead of guessing what to cut out, we focus on understanding your body as a whole system - including gut health, nutrition adequacy, stress patterns, and daily habits that may be influencing your skin.
In our 1:1 support, we help you:
Identify your personal food and lifestyle triggers (without overly restrictive dieting)
Build balanced, nutrient-dense meals that support skin and gut health
Improve blood sugar stability and digestion in a sustainable way
Support nervous system regulation to help reduce flare frequency
Rebuild confidence with food so eating feels less stressful and more predictable
You’ll work directly with a Registered Dietitian in a personalized, practical way that fits your lifestyle, not a one-size-fits-all protocol. Direct billing for dietitians available.
👉 Book a free 15-minute consultation to see if 1:1 support is right for you.
