Allergic Skin Reactions: A Functional Medicine Approach to Identifying and Treating Root Causes

Allergic skin reactions like hives and eczema occur when your immune system responds to an allergen, which may lead to irritation in the skin. This can result in various skin rashes like hives, swelling, itchy red patches, and irritation, and may sometimes be accompanied by other allergic symptoms like wheezing, rhinitis, and conjunctivitis. 

The interaction of genetics, environmental factors, and the balance of the microbiome in the gut and skin all impact an individual’s susceptibility to allergic skin reactions. Some common triggers of allergic skin rashes include proteins found in food, pollen, latex, and medications.

A functional medicine approach to allergic skin reactions considers how various factors can contribute to immune system responses and inflammation. This allows for a personalized and targeted approach to managing allergic skin reactions and supporting quality of life.

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Understanding Allergic Skin Reactions

When exposed to certain triggers, some people’s immune systems may trigger an allergic response that affects the skin. Types of allergic skin reactions include hives, angioedema, and dermatitis like eczema and contact dermatitis.

Hives or urticaria are red itchy raised welts on the skin that can appear after exposure to an allergen like a food, insect sting, medication, or after an infection in a susceptible person. Hives can resolve after a short period or be chronic, lasting for more than six weeks. 

If an allergic reaction in the skin causes the leaking of fluid from small blood vessels into the tissues below the inner layer of skin (dermis), allergic angioedema can result. Common triggers for allergic angioedema include reactions to food (especially fish, shellfish, tree nuts, and peanuts), latex, insect stings, and medications such as ACE inhibitor medications (ACEIs) that are used to manage high blood pressure or heart issues or non-steroidal anti-inflammatory agents (NSAIDs) like ibuprofen and naproxen. Allergic angioedema in the skin is frequently accompanied by other allergic symptoms like hives, rhinitis (nasal inflammation), diarrhea, coughing, wheezing, and eye redness (conjunctivitis).

Dermatitis results in red, scaly, itchy, and sometimes painful skin rashes due to inflammation. Atopic dermatitis (allergic eczema) and contact dermatitis are two common types of dermatitis. 

Atopic dermatitis is the most common type of eczema in people with a personal or family history of other allergic conditions. This common allergic skin reaction results in red, itchy, and inflamed patches on the skin that occur due to the interaction of genetic and environmental factors such as gut dysfunction and imbalances in the gut and skin microbiomes that may stimulate the immune system and disrupt the skin barrier. Common eczema triggers include pollen, animal dander, dust mites, sweat, infections, stress, or contact with irritants like wool or soaps.

Contact dermatitis can be caused when the skin comes into contact with an allergen or other irritant. This may trigger an immune response that results in inflammation and skin rash. Allergic contact dermatitis results when you come into contact with an allergen that triggers your immune system to respond. This can cause itchy, red, blistered skin reactions such as seen after touching poison ivy. Once this type of allergic reaction begins, it can sometimes take 14 to 28 days to resolve, even with management.

The Role of the Immune System in Allergic Reactions

Allergic skin reactions result due to the immune system responding to perceived threats. Your immune system plays an important role in your body by looking out for any potentially harmful substance, like infectious agents or toxins, and responding to manage and remove the threat. 

Allergic skin conditions, such as hives and angioedema, occur when the immune system reacts to an allergen. This response involves immune cells including mast cells that are found in the skin and other organs.  

When activated, they release mediators like histamine into the blood that can lead to the recruitment of inflammatory cells, activate sensory nerves in the skin, cause dilatation of blood vessels and plasma to leak out of blood cells, and result in the rashes characteristic of many allergic skin reactions.

To help manage excessive allergic skin reactions, balancing the immune system and levels of allergic mediators like histamine is crucial. Imbalances in the microbes that make up the gut and skin microbiomes (dysbiosis) can contribute to immune dysregulation and skin inflammation.  

In addition, some people develop allergic skin reactions due to chronically elevated histamine and IgE levels. This mediator can be elevated due to chronic stimulation of mast cells such as occurs when you have unrecognized food allergies. Histamine may also stay around longer in your body if you have certain genetic single nucleotide polymorphisms (SNPs) in genes such as DAO, HMNT, and MTHFR that can influence how quickly and effectively your body can break down and clear histamine.

Identifying Triggers Through Functional Medicine

Functional medicine diagnostics can assist with the process of identifying allergic triggers. This allows for pinpointing each individual’s unique triggers of allergic skin reactions, including environmental, dietary, and stress-related factors.

Foods are common sources of allergic triggers that may contribute to allergic skin reactions. A comprehensive medical history focusing on allergic symptoms and reviewing a food diary can help to recognize how certain foods may be triggering allergic skin reactions. 

In addition, a complete physical examination and food allergy laboratory tests can be helpful when identifying individual triggers. Blood testing can look for IgE antigens. For example, Mosaic Diagnostics has a 93-item IgE Food Allergy Advanced Test, which measures the IgE response to 93 commonly consumed foods.

Skin prick testing (SPT) or scratch testing applies a liquid food antigen solution to patches of skin that are scratched to allow the solution to get below the skin. If a skin reaction like a white raised bump or wheal forms after thirty minutes or so, this indicates an allergic reaction may be present and should be confirmed with clinical assessment and other testing. 

In some circumstances, a food allergy may be assessed with an oral food challenge or elimination diet. This involves eliminating common food allergens or suspected foods for roughly 30 days and then gradually reintroducing them one by one for three days while assessing for reappearance or worsening of symptoms.

A major factor in immune system dysregulation and inflammation that may underlie allergic skin reactions is an imbalance in the microbes within the gut (dysbiosis). Diagnostic Solutions’ GI-MAP + Zonulin Test measures the balance of microbes in the gut along with markers of inflammation, immune function (secretory IgA), and leaky gut (zonulin) to help pinpoint factors that may be contributing to allergic skin reactions. 

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Dietary and Nutritional Interventions

Nutritional support for skin health can help manage inflammation and minimize allergic skin reactions. Eating an individualized diet focusing on nutrient-dense, low-histamine foods that work for your unique body can help your body come back into balance and your skin to be less reactive.

An anti-inflammatory diet for allergic skin reactions can help balance the immune system and manage inflammation. This way of eating focuses on nutrient-dense plant foods including colorful fruits and vegetables, whole grains, nuts, seeds, herbs, and spices. These foods provide a wide range of antioxidants and other anti-inflammatory phytonutrients that may help to manage chronic inflammation.

In addition, eating to reduce allergic skin reactions involves avoiding ultra-processed foods, chemical additives, simple sugars, alcohol, and factory-raised animal products that can provoke inflammation in the gut and skin. It is also important to avoid foods to which you are allergic or sensitive to help support gut and skin health. Common allergens such as gluten, dairy, eggs, and soy should be eliminated if you react to them. This approach may help to manage inflammation and allows the microbiome, intestinal barrier, and skin to start to heal and become less reactive.

Many people with allergic skin reactions also find it helpful to eliminate high-histamine foods. Avoiding foods including cured meats (like sausage, bacon, salami, and fermented ham), alcohol, and artificial preservatives and food dyes can help reduce the amount of histamine your body has to process. In addition, eliminating whole foods that are higher in histamine like tomatoes, eggplant, spinach, mushrooms, citrus fruit, banana, pineapple, avocado, any overly-ripe fruits, shellfish, tuna, mackerel, mahi-mahi, anchovy, sardines, herring, bluefish, amberjack, and marlin, bone broth, collagen, and fermented foods and beverages for some time can help you identify if they are contributing to your allergic skin reactions. It is also best to prepare foods fresh at each meal since leftovers can contain greater levels of histamine due to bacteria that produce these mediators over time.

Lifestyle Modifications to Reduce Allergic Reactions

Lifestyle changes for skin allergies can also make a difference. Identifying your triggers allows you to work towards reducing allergen and irritant exposure. In addition, lifestyle practices such as stress reduction techniques, sleep improvement strategies, and gentle skincare routines can help to reduce the frequency and severity of allergic skin reactions.

Identifying triggers like food and environmental allergens and other contributing factors such as dysbiosis in your gut and/or skin microbiomes provides a roadmap to guide management to bring the body back into balance. It is crucial to avoid known triggers of allergic skin reactions as much as possible. This might involve following an anti-inflammatory low-histamine diet that eliminates your food allergens. It can also be helpful to take steps to keep your indoor air free of airborne allergens like pollens and pet dander by using a high-quality HEPA air filter and removing your shoes and outerwear upon entering the house to avoid carrying in pollens and molds from outside.

Washing your clothing and bedding frequently with gentle, non-chemical detergents and soaps without fragrances or dyes can reduce your exposure to allergens. A similar approach to avoiding irritating fragrances and chemicals is important when choosing personal care products.

Stress can contribute to immune system dysregulation, impact the microbiome, and affect the gut, potentially worsening allergic skin reactions, so it is important to integrate meaningful stress management practices into your life. Regularly using breathwork, yoga, meditation, prayer, or other mind-body practices can help manage the impacts of chronic stress and improve skin reactivity. 

Getting adequate restorative sleep is also important for managing allergies and supporting skin health. Try to go to bed at a regular time and get at least 7-9 hours of sleep each night. This can help with managing stress, keeping your gut healthy, and maintaining skin health. 

Physical activity is another powerful way to manage stress and keep your skin healthy. Regularly exercising helps to regulate inflammation, reduce chronic stress, support gut health, and balance hormones like estrogen that can contribute to increased histamine and allergic reactions. 

Integrative Therapies and Supplements

Integrative therapies and supplements can also assist in managing allergic skin conditions. Targeted supplements for skin allergies like vitamin C, DAO, quercetin, probiotics, and omega-3 fatty acids may help to alleviate symptoms. 

To help balance histamine levels and manage allergic reactions that result in skin conditions like hives, angioedema, and eczema, certain supplements may play a role. Vitamin C, quercetin and diamine oxidase (DAO) may help balance histamine levels in the body to manage allergic skin reactions. 

Vitamin C may assist with degrading histamine and can help to increase levels of DAO enzymes that break down histamine in the gut for elimination from the body. Opt for vitamin C from whole food sources if you tolerate citrus fruits or look for supplements produced without fermentation. 

Quercetin is a natural polyphenol with antioxidant and anti-allergy functions. It may help to inhibit the production of histamine and other pro-inflammatory mediators, stabilizing mast cells and managing allergic skin reactions. 

Another nutrient that can support a balanced inflammatory response and manage allergic skin reactions is omega-3 fatty acids. Omega-3 polyunsaturated fatty acids (PUFAs) are metabolized into substances known as resolvins that have anti-inflammatory effects, which may help manage allergic and inflammatory responses. 

The health of your digestive tract and the balance of microbes in your gut are involved in inflammation, immune responses, and the metabolism of histamine. Therefore, restoring balance to the gut with probiotic supplementation may improve allergic skin conditions. Probiotic supplementation with Lactobacillus rhamnosus and Lactobacillus reuteri together may improve skin symptoms in children with eczema and reduce the development of eczema in children when given to breastfeeding women prenatally. Other probiotic strains such as Bifidobacterium adolescentis, Bacteroides thetaiotaomicron, Bacteroides fragilis, and Lactobacillus rhamnosus may help breakdown histamine and reduce the occurrence of chronic allergic skin conditions like hives. 

In addition to oral probiotic supplements, topical probiotics may improve allergic skin reactions like eczema. These beneficial organisms can be applied topically directly to the skin to help restore balance to the microbes living there and reduce allergic skin symptoms.

The Importance of a Personalized Treatment Plan

Personalized management for skin allergies is important for supporting balance in the skin, gut, and body overall to manage allergic skin reactions. Functional medicine takes a careful personal and family history, performs a thorough physical examination, and uses laboratory testing to pinpoint underlying factors of allergic reactions. These can then be targeted as part of a personalized management plan that considers the unique triggers and lifestyle factors of each individual.

Taking this type of holistic strategy for managing allergic skin conditions allows you to address underlying imbalances. In the long term, this supports skin and overall health by helping your body maintain balance. Functional medicine integrates dietary, lifestyle, and integrative approaches as part of a comprehensive approach to skin inflammation and allergies. 

Monitoring allergic skin reactions with ongoing evaluation can allow for careful adjustment in the management approach at regular intervals. This is important for achieving optimal outcomes and lasting healthy skin.

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Allergic Skin Reactions: Key Takeaways

Achieving relief from skin allergies requires investigating underlying factors that may be contributing to immune responses, excess histamine, and inflammation. This allows for a targeted and personalized management approach to achieve long-term relief and support skin health. 

Functional medicine for skin health offers a personalized approach that integrates dietary, lifestyle, and integrative medical management to support the gut and skin and manage allergic reactions that result in skin rashes. Eliminating allergens in your diet, home, and lifestyle may reduce the triggering of immune responses that contribute to allergic skin reactions. Integrative therapies like oral and topical probiotics and supplementation with vitamin C, quercetin, and DAO may help manage allergic reactivity and support skin health.