Eczema Elimination Diet: Australian Researchers Register Diet Trial for Adults With Eczema

|Ren Karen Fischer

Images: Researcher Ren Karen Fischer presenting with severe eczema and hives in 2018; and Fischer with clear skin in 2020.

Patients with eczema are turning to self-directed elimination diets in growing numbers, driven by a perception that food may worsen their symptoms (Nosrati, 2017). While a link between eczema and food allergy is well documented in the literature (Christensen, 2023), approximately 94% of Australians make poor dietary choices (ABS, 2022), therefore, clinical guidance is advised when eliminating foods from the diet.

This highlights an unmet need for an evidence-based dietary intervention that addresses nutrition and food intolerance beyond what standard allergy testing can identify. To fill this gap, we registered a randomised controlled trial (RCT) investigating whether a structured dietary intervention can reduce eczema severity and improve quality of life in adults with moderate-to-severe eczema.

The trial incorporates a structured meal plan and two supplements to address potential nutritional gaps.

Common allergens associated with eczema, including dairy, egg, wheat, soy and peanut (based on research by Christensen et al., 2023) are avoided during an initial elimination phase, alongside limitation of salicylates and histamine (based on research by Fischer et al., 2025), followed by systematic reintroduction to identify individual triggers. 

Image: Ground turmeric powder is anti-inflammatory and features in the diet study. 

The diet emphasises fresh, minimally processed whole foods, including beef, chicken, fish, brown rice, oats, blueberries, extra virgin olive oil, a selection of vegetables, turmeric, to name a few.

Following the six-week dietary intervention, oral food challenges will be conducted to determine the prevalence of intolerance/tolerance to the omitted foods.

Image: Blueberries are rich in antioxidants and included in the diet study. 

The intervention has been designed by nutritionist Ren Karen Fischer for practical clinical application, enabling patients to follow the protocol under the guidance of their doctor or other health professional. The protocol is anticipated for publication in 2026. The clinical trial is currently on hold pending resources.

For trial inquiries, contact Bond University, Faculty of Health Sciences and Medicine. 

ANZCTR Clinical trial registration ID: ACTRN12624001394538. Ethics approval: Bond University HREC ID 2023_9378.

FAQ

Is there research on eczema elimination diets?
 At present there is limited eczema elimination diet research, particularly studies addressing food chemical intolerance rather than standard food allergy. Most existing research focuses on common allergens such as dairy, egg and nuts, while food chemical intolerance—a separate, non-immune mechanism—remains comparatively under-studied. This is part of the gap our registered diet study aims to address.

What is the difference between food allergy and food intolerance in eczema?
Food allergy involves an immune (IgE-mediated) reaction and can be identified through standard allergy testing, though these tests are often inconclusive and may lead to unnecessary food avoidance. Food intolerance, including salicylate and amine intolerance, is non-immunological, dose-dependent and cumulative, meaning it cannot be detected by allergy tests. This distinction is important, as many people with eczema test negative for allergies yet still react to certain foods. The most accurate way to diagnose food intolerance is through a supervised oral challenge, to determine whether you genuinely react to a food and whether it is affecting your eczema.

 

References: Nosrati A, et al. Dietary modifications in atopic dermatitis: patient-reported outcomes. J Dermatol Treat. 2017;28(6):523–538. Christensen MO, et al. Prevalence of and association between atopic dermatitis and food sensitivity, food allergy and challenge-proven food allergy: A systematic review and meta-analysis. J Eur Acad Dermatol Venereol. 2023;37(5):984–1003. Australian Bureau of Statistics (ABS). A. Dietary behaviour. ABS Website, accessed 24 January 2024 https://wwwabsgovau/statistics/health/health-conditions-and-risks/dietary-behaviour/latest-release. 2022. Fischer K, Jones M, O'Neill HM. Prevalence of intolerance to amines and salicylates in individuals with atopic dermatitis: a systematic review and meta-analysis. Nutrients. 2025;17(10).

Frequently asked questions

About the author

Ren Karen Fischer is a nutritionist, mother of two and author of seven health books, including The Eczema Diet and The Eczema Detox. Fischer is also a published researcher and is currently completing eczema research as part of a Master's by Research Degree at Bond University. Combining clinical research with real-world experience, she is dedicated to advancing evidence-based care for eczema.
My child will complain if I don't put junk food in their lunchbox. How do I get them to eat healthier foods?

Yes, they probably will complain, so you need to have a smart response. I had the same issue with my daughter. She came home from school one day complaining how her friends got white bread and lollies in their lunchbox, while she got carrot sticks, grainy bread sandwiches and homemade muffins. I replied "Your poor friends, their parents don't know about brain foods that help you concentrate and be smart at school. You're so lucky I know what to put in your lunchbox."  (my daughter wanted to be smart so this was linked to a goal of hers, other goals may be being better at sport etc). She looked baffled but did not argue. I was not lying or tricking her. It's a fact that the additives in lollies and white bread can hamper concentration and make kids act like crazy. I added, "How about I cut the crusts off your sandwiches so you enjoy them more?" She was happy with this compromise as she often complained about the crusts being too dry. So work out a little compromise: it may be a white marshmallow in their lunchbox along with the healthy options.
Is bread bad for eczema and is it okay in my child's lunchbox?

Wheat can trigger eczema flareups in 22% of people with eczema according to research (Christensen, 2023), so it depends if you or your child are sensitive to wheat as to whether you should avoid it. There is another issue with store-bought bread: Propionate preservatives in bread (numbers 280–283) are mould inhibitors linked to behavioural problems, irritability and sleep disturbances. So if your child has behavioural issues, ADHD, sleep problems or itchy skin, check your bread. I fed my 5 year old daughter store-bought bread one day and soon after she began to repeatedly bang her head on the concrete payment in front of the shop that sold us the bread. It was alarming. Your child might not have such a severe or immediate reaction but if they have eczema, the bread in their lunchbox is worth investigating.
Does food allergy trigger eczema?

Food allergy and eczema are closely linked, and allergies can absolutely make eczema worse, but they're often not what starts it in the first place. In fact, research suggests the reverse may be more accurate: eczema itself may come first and increase the risk of developing food allergies, rather than the other way around (Tsakok et al. 2016). One study found that babies with eczema were up to six times more likely to become
sensitised to foods compared to those without eczema. In children with established eczema, up to 66% showed food sensitisation, with confirmed food allergy in up to 81% of cases (Tsakok et al. 2016).

If you or your child has a diagnosed food allergy, those foods should be avoided for now. For additional guidance, the Food Intolerance Diagnosis (FID) Program in The Eczema Detox book can help identify food intolerances that do not show up in allergy tests (see next FAQ).
Do food allergy tests help eczema?

Skin prick tests and other food allergy tests including blood tests and patch tests can be unreliable on their own, so an oral food
challenge (supervised by an allergy specialist if you are prone to anaphylaxis), is the most accurate way to confirm whether you or your child is reacting to a particular food. For additional guidance, the FID Program in The Eczema Detox book can help you to identify your personal triggers.
Are there specific food additives I should avoid?

See this blog: Food Additives to avoid in your child's lunchbox for more information.

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The Eczema Detox is Karen Fischer's latest best-selling eczema manual designed to help you find relief. Through her work she found some patients needed a special program to identify personal triggers, so the FID Program was created. The Eczema Clear Skin Toolkit combines gut health and nutrition with soothing, barrier repairing skincare and supplements to calm the itch and support skin repair, the immune system and more. If you’ve tried everything and nothing has worked, this is the skin calming toolkit you've been praying for.

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Eczema Elimination Diet: Australian Researchers Register Diet Trial for Adults With Eczema

Eczema Elimination Diet: Australian Researchers Register Diet Trial for Adults With Eczema

|Ren Karen Fischer
Patients with eczema are turning to self-directed elimination diets in growing numbers, driven by a perception that food may worsen their symptoms. We registered a randomised controlled trial investigating whether...

References

References: Worst Lunchbox Foods For Eczema

Fischer K, et al. Prevalence of intolerance to amines and salicylates in individuals with atopic dermatitis: a systematic review and meta-analysis. Nutrients. 2025;17(10):1628.

Christensen MO, et al. Prevalence of and association between atopic dermatitis and food sensitivity, food allergy and challenge-proven food allergy: a systematic review and meta-analysis. J Eur Acad Dermatol Venereol. 2023;37(5):984-1003.

Fischer, K, 2014, The Eczema Diet, Second Edition.  

Loblay, R.H. and Swain, A.R., 2006, ‘Food Intolerance’, Recent Advances in Clinical Nutrition.

Sausenthaler, S., et al., 2007, ‘Maternal diet during pregnancy in relation to eczema and allergic sensitization in the offspring at 2 years of age’, American Journal of Clinical Nutrition.

Bolte, G, et al., 2001, ‘Margarine consumption and allergy in children’, American Journal of Respiratory and Critical Care Medicine.

Malakar S, et al. Naturally occurring dietary salicylates: a closer look at common Australian foods. J Food Compos Anal. 2017;57:31-9.

Tsakok, T., et al. (2016). Does atopic dermatitis cause food allergy? A systematic review. Journal of Allergy and Clinical Immunology, 137(4), 1071-1078.
References: Why Healthy Foods Can Be Unhealthy For Eczema: Th2 Explained

Abrahamsson, T., Sandberg, M., Forsberg, A., Bjorksten, B. and Jenmalm, M., A., 2011, Th1/Th2-associated chemokine imbalance during infancy in children developing eczema, wheeze and sensitization.

Park, J.H., Jung, J.H., Yang, J.Y. and Kim, H.S., 2013. Olive leaf down-regulates the oxidative stress and immune dysregulation in streptozotocin-induced diabetic mice. Nutrition research, 33(11), pp.942-951.

Shin HS, See HJ, Jung SY, Choi DW, Kwon DA, Bae MJ, Sung KS, Shon DH. Turmeric (Curcuma longa) attenuates food allergy symptoms by regulating type 1/type 2 helper T cells (Th1/Th2) balance in a mouse model of food allergy. Journal of Ethnopharmacology. 2015 Dec 4;175:21-9.

Han, S.N., Wu, D., Ha, W.K., Beharka, A., Smith, D.E., Bender, B.S. and Meydani, S.N., 2000. Vitamin E supplementation increases T helper 1 cytokine production in old mice infected with influenza virus. Immunology, 100(4), pp.487-493. 

Niki, E., Noguchi, N., Tsuchihashi, H. and Gotoh, N., 1995. Interaction
among vitamin C, vitamin E, and beta-carotene. The American journal of
clinical nutrition, 62(6), pp.1322S-1326S.

Stephensen, C.B., Jiang, X. and Freytag, T., 2004. Vitamin A deficiency increases the in vivo development of IL-10–positive Th2 cells and decreases development of Th1 cells in mice. The Journal of nutrition, 134(10),
pp.2660-2666.

El-Baky, H.A., El-Baz, F.K. and El-Baroty, G.S., 2004. Production of antioxidant by the green alga Dunaliella salina. Int. J. Agric. Biol, 6(1), pp.1560-8530.

Xue, L.X., 1993. [Experimental study on extract of Dunaliella salina in
preventing NSAR-induced cancer of proventriculus in mice]. Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine], 27(6), pp.350-353.

Douglas Shytle, R., et.al, 2012. Optimized turmeric extract reduces β-Amyloid and phosphorylated Tau protein burden in Alzheimer’s transgenic mice. Current Alzheimer Research, 9(4), pp.500-506.

Ukil, A., Maity, S., Karmakar, S., Datta, N., Vedasiromoni, J.R. and Das, P.K., 2003. Curcumin, the major component of food flavour turmeric, reduces mucosal injury in trinitrobenzene sulphonic acid‐induced colitis. British journal of pharmacology, 139(2), pp.209-218.