The skin is highly affected by patients with untreated gluten intolerance. Dermatitis herpetiformis is widely recognized as being associated with CD/GI, however there are other skin issues that can result, but often go unnoticed.

Dermatitis herpetiformis is a skin condition affecting at least 25% of patients with celiac disease. It is caused by IgA deposits in the papillary dermis (right underneath the top layer of skin). These deposits are the result of epidermal tranglutaminase auto-antibodies. The rash is usually extremely itchy, and can be painful. The red skin eruptions are described as being on the limbs, trunk and scalp- that covers pretty much EVERYWHERE on your body. Like celiac disease, DH is often undiagnosed. In a study by Pfeiffer in 2006 says, “Suspecting and then searching for dermatitis herpetiformis is often clinically challenging, as the disease is a true chameleon with many clinical faces.”

Other skin issues in celiac disease can also be the result of multiple deficiencies. Zinc is essential for the repair and renewal of skin cells. Zinc deficiency can lead to eczema, psoriasis, acne, nasal polyps, and darkening skin. Zinc is also needed for the conversion of essential fatty acids into other compounds. Deficiency of omega-3 fatty acids can lead to dry skin and hair, which can be mistaken as eczema, as well as hard, dry, itchy papules called prurigo nodularis. Vitamin A deficiency can lead to pityriasis rubra pilaris, a type of dermatitis leading to thick, scaling skin and often associated with anemia. Iron deficiency can lead to a pruritic skin rash, a fancy term for “itchy skin”.

Still, untreated celiac disease can lead to even more skin issues not related to deficiencies. Scleroderma, causing hyperpigmented, taut shiny skin that looks like you had facial chemical peel gone wrong.  Seborrhea, a sebaceous gland disorder causing scaly patches and bumps on the skin. Vitiligo and the permanent loss of melanocytes. Erythema nodosum. Ichthyosis. Melanoma. Each of these skin disorders have a much higher prevalence rate in untreated celiac disease.

Skin conditions can be slow to heal on a gluten free diet, but strict adherence is successful in clearing up the painful and itchy issues in most cases. Skin conditions caused by deficiencies are the quickest to heal. The good news? A gluten free diet will, at the very least, halt the progression of the condition.

If you have an itchy rash, or unidentified skin condition anywhere on your body, we recommend getting tested for celiac disease and trying a gluten free diet.

Posted by Nadine Grzeskowiak, RN

Nadine is a 'food is medicine’ activist and is very proud of her work to educate all people about the power of food in health and wellness. Nadine is an expert consultant, professional speaker with over 1500 lectures to date, author of DOUGH NATION: A Nurse's Memoir of Celiac Disease From Missed Diagnosis to Food and Health Activism, podcaster, mom and former emergency/trauma/critical care nurse. Nadine is co-authoring her next book on the science of celiac disease.

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