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Is gluten-free truly the way to be? It seems more and more people are experiencing ill effects to gluten and report that they are intolerant to this common protein found in grains like wheat, barley and rye. Gluten has been associated with variety of health problems ranging from digestive issues to autoimmune and inflammatory conditions in the body. But what effects does gluten have on the skin?
“There are definitive links between gluten and bowel disease, and gluten and skin disease,” says Dr. Adam Mamelak, board certified dermatologist in Austin, Texas. “However, in some ways, we are only scratching the surface in understanding the effect of this compound on the skin and body.”
Celiac disease (AKA celiac sprue) is a gastrointestinal disorder that occurs in certain individuals that cannot tolerate gluten. When these individuals ingest gluten, it stimulates an autoimmune reaction where the body starts attacking and destroying the cells that line the small intestine. This results in abdominal pain, a change in bowel habits, weight loss, nutrient deficiencies, and can even predispose to the development of some cancers.
Dermatitis Herpetiformis is the condition that results in the skin when a gluten-sensitive individual consumes these grains. As mentioned, gluten produces an autoimmune reaction in these patients. The patients subsequently produce antibodies that are involved in the reaction in the gut. However, these antibodies can also buildup underneath the skin, causing an extremely itchy eczema-like reaction. “Often we will see irritated, excoriated or even blistering areas of skin, particularly over the back, buttocks, knees and elbows,” says Dr. Miriam Hanson, a board-certified Dermatologist at Sanova Dermatology in Austin, Texas.
While groups of small sores or blisters can be observed in this condition, Dermatitis Herpetiformis is not related to the herpes simplex virus, or any other infection for that matter. “Patients are often concerned that this may be herpes-related, but it only mimics the symptoms,” Dr. Mamelak shares. “If there’s any doubt, your dermatologist can help diagnose these conditions, and ensure you are treated properly.”
“When a patient is affected by Dermatitis herpetiformis, their initial complaint is usually excessive itching,” says Dr. Hanson. What makes this more difficult is that these areas usually contain blisters, which can be opened by scratching. As with eczema, this condition also creates patches of dry skin that effect both sides of the body evenly. Dermatitis Herpetiformis is most commonly found in 30-40 year old men and women.
A few diagnostic tests can help definitively diagnose Dermatitis Herpetiformis and gluten sensitivity in the skin. The dermatologist might recommend a skin biopsy, or a blood test to look for the presence of antibodies. In some cases, an infection will need to be ruled out before a treatment plan is made. “A combination of topical and oral medications can be used to effectively treat the physical effects of this condition,” says Dr. Mamelak. “However, probably an equally effective strategy, is to start on a gluten-free diet!”
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