Help clients break away from breakouts
By Shelley Burns
Originally published in Skin Deep, May/June 2009. Copyright 2009. Associated Skin Care Professionals. All right reserved.
Your client has tried a comprehensive protocol that includes prescription medication, supplementation, and topical skin treatments to clear her acne, eczema, or other inflammatory skin condition. These treatments all work well until she stops using them. Then her skin condition reappears. Sound familiar?
It could be you are not addressing the root cause of the skin condition, which may be a food allergy. By eliminating the allergen, your client's skin condition may clear.
There are several ways medical professionals can use to test for food allergies, from blood and serum tests, to skin prick and scratch tests, to elimination and rotation diets. Blood or serum tests for antibodies identify immunoglobulin E (IgE). (Immunoglobulins are antibodies.) Skin prick or scratch tests for antibodies associated with allergic reactions identify immunoglobulin G (IgG).
Immediate vs. Delayed
An IgE reaction occurs any time within 24 hours of ingesting an offending food. This is considered a type I immediate hypersensitivity reaction, causing a histamine release. A histamine response can manifest as congestion, constriction of airways, redness, and swelling. In the extreme, it may result in anaphylactic shock, which is potentially fatal.
An IgG reaction can occur any time within 72 hours. This makes it more difficult to pinpoint whether there is a true food allergy. As a type III delayed hypersensitivity reaction, the test can cause inflammation wherever the immune complex (IgG antibody/allergen) is deposited. This inflammatory process can result in acne, asthma, eczema, headaches, joint pain, and psoriasis. An IgG reaction is considered a chronic reaction. (There is a type II reaction, but it is not related to food allergies.)
There are two types of blood and serum tests for detecting food allergies. Blood spot tests will detect IgG reactions. Serum, which is the clear, watery part of blood, will test for both IgG and IgE reactions. Blood tests can be easier, more accurate, and safer than skin and scratch tests.
The skin prick/scratch test is the most common one for an IgE-mediated allergic reaction. A small amount of the suspected allergen is placed on the skin (usually the back or forearm), then scratched so the substance penetrates the skin. Signs of a reaction may include redness and swelling. Skin tests are most commonly used to elicit reactions to insects, penicillin, and respiratory agents. A skin test for an IgE-mediated reaction is almost never used for potential food allergies because of the high risk of causing severe allergic reactions.
Elimination/rotation tests are the gold standard for food-allergy testing, but they are time-consuming and difficult. Suspect foods are avoided for several weeks, then reintroduced one at a time, allowing 72 hours between each reentry. Signs and symptoms of potential allergies are monitored.
So what does this have to do with skin? Acne, dry skin, eczema, itchiness, and psoriasis are chronic inflammatory skin conditions that may be IgG immune-mediated. Food allergy testing and subsequent elimination of allergenic foods can result in complete resolution of a skin condition. This is truly getting to the root cause.
Shelley Burns, a doctor of naturopathic medicine, completed studies at the Canadian College of Naturopathic Medicine and has certification in complementary and integrative medicine from Harvard University. She can be reached at the Scienta Health Centre at 416-222-5880 or email@example.com.