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Gluten Causes Keratosis Pilaris (a.k.a. “Chicken Skin”): Fact or Myth?

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Gluten Causes Keratosis Pilaris
(a.k.a. “Chicken Skin”): Fact or Myth?

According to “Dr. Google,” the tiny bumps popularly known as ” chicken skin” that occur on the backs of arms and oncheeks and thighs can be cured by eliminating gluten from the diet. Is there truth to that claim or is it yet another Internet myth? Found in up to 50% of the world’s population, and known in medical terms as keratosis pilaris, these tiny bumps can be cosmetically unappealing but don’t typically cause other symptoms or harm. But their presence can cause significant emotional distress for some, especially at times of flare-ups due to their undesirable cosmetic appearance.
My patients often ask me what causes these common little bumps, if gluten or an allergy is to blame, and how to get rid of them.

 

Keratosis Pilaris Explained
Keratosis pilaris occurs due to overproduction or build up of keratin, a protective protein found on the skin. The bumps can be surrounded by redness, a sign of inflammation that is also seen when they are examined microscopically. Keratosis pilaris occurs more often in people with eczema or dry skin and gets worse in cold or dry weather. As expected, you will find it associated with other inflammatory conditions such as allergies and asthma.

 

More common in youth but adults get it too
Keratosis pilaris affects 50-80% of adolescents and up to 40% of adults. It may flare up during puberty and lessen with age. There is a strong genetic component so it often runs in families. Symptoms typically come and go throughout the year. Picking at the bumps will only make them cosmetically more significant and increase scarring and discoloration, leaving them darker.
Causes of Keratosis Pilaris
Although it is known to have a genetic factor, scientists do not know the true cause of keratosis pilaris. It is seen more commonly in inflammatory conditions such as asthma and allergies, and is associated with dry skin, vitamin A and essential fatty acid deficiency. Exacerbations and remissions may occur with times of hormonal change such as pregnancy.
Gluten as a cause
There are no studies indicating a direct correlation between gluten ingestion and keratosis pilaris. However, it can be caused by vitamin A deficiency or essential fatty acid deficiency, both of which can occur with impaired absorption. If you have celiac disease or gluten sensitivity you theoretically might suffer from keratosis pilaris flare-ups if you are consuming gluten and have ongoing inflammation or malabsorption.

 

Treatment

Hydration and lubrication of the skin is the mainstay of treatment. Mild cases can be treated with over-the-counter lubricating creams, easily found at the drugstore or with an Internet search.  There is a laundry list of dermatologic therapies such as alpha-hydroxy creams, retinoic acid therapies and steroids that dermatologists may prescribe and compounded combination therapies that can be formulated.  Further specific medications are beyond the scope of this article but can be found here. For more severe cases, laser therapy and dermabrasion may be used.

 

Integrative Therapies
The most commonly used integrative therapy is to supplement the diet with omega-3 fatty acids or fish oil. In addition to providing the essential fatty acids that may be lacking, these supplements also have a strong anti-inflammatory effect. Dietary manipulations such as gluten-free or dairy-free, anti-inflammatory, sugar-free, Paleo or various autoimmune diet protocols are often implemented. A variety of ‘gut healing’ regimens are also prescribed, but as with most therapies surrounding keratosis pilaris, there is no evidence to support or refute them.
Topical therapies may include coconut oil, olive oil or vitamin A capsules. Finally, exfoliants such as baking soda, oatmeal, or sugar or salt scrubs are sometimes helpful in reducing keratin build-up. Most people do not seek treatment for keratosis pilaris unless it is cosmetically significant, so home therapies are a popular approach.

 

Diet

Despite the lack of studies indicating a correlation between diet and keratosis pilaris, aside from the aforementioned vitamin A and EFA deficiency, there are many anecdotal reports, including from my patients, of improvement with dietary manipulation. Increasing essential fatty acid intake by consuming more coldwater fish such as sardines, mackerel and salmon may bring improvement. Walnuts are a great vegan source of essential fatty acids.
Food for thought
Although I have seen patients in my office improve their keratosis pilaris with gluten elimination, there is no evidence that everyone who suffers from it would benefit by avoiding gluten. It would be interesting to see a scientific study exploring whether there is a direct correlation between gluten consumption and keratosis pilaris, but since there are no known long-term health consequences of the condition, it may be low on the priority list for research funding. If a patient has been appropriately tested for celiac disease, however, a trial of a gluten-free diet is harmless as long as adequate nutritional intake is maintained.
Because keratosis pilaris is inflammatory in nature it also makes sense that anti-inflammatory diet protocols and lifestyle changes such as stress reduction, mindfulness techniques and proper sleep hygiene would have a positive effect on remission. While it is unlikely anyone will be rushing to do those studies soon, there is no reason that you  can not implement changes to decrease inflammation on your own. It may just have the additional benefit of improving your keratosis pilaris.
Sincerely,

Dr. Amy

Dr. Amy Burkhart

AmyBurkhart M.D., R.D.
Please do not rely on the information on this website as an alternative to medical advice from your doctor or other professional or health care provider. If you have any specific questions about a medical matter, consult your doctor or other professional health care provider. If you think you may be suffering from any medical condition you should seek immediate medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this newsletter or Dr. Burkhart’s website or social media sites.
Past columns by Dr. Burkhart:

April/May 2016: Reasons People Follow a Gluten Free Diet: 7 Types of Gluten Free Dieters 

March 2016: Ten Positive Aspects of a Celiac Disease Diagnosis

February 2016: Gluten Causes Keratosis Pilaris (a.k.a. “Chicken Skin”): Fact or Myth?

January 2016: Fingernail Changes in IBS,Gluten Disorders and Celiac Disease “A window to health”

December 2015: 20 Gluten-Free Gift Ideas: From Budget to Luxury, Sentimental to Practical & More

November 2015: Cold Sores, Canker Sores and Gluten

October 2015: Celiac Disease and Gluten Sensitivity Research: Snippets from ICDS 2015 (Part 2)

September 2015: Celiac and Gluten Sensitivity Research: Ten Snippets from ICDS 2015

July/August 2015: A New Home Test To Monitor Gluten Exposure

June 2015: Six Reasons to Test for Celiac Disease Before Starting a Gluten-Free Diet

May 2015: POTS, Celiac Disease and Gluten: An Undiscovered Connection?

February/March/April 2015: Arsenic in the Gluten-Free Diet: Facts and Tips

December 2014/ January 2015: The Microbiome and Celiac Disease: A Bacterial Connection

November 2014: Celiac disease and gluten sensitivity: The doctor-patient disconnect

October 2014: Should You Trust Gluten-Free Labels?

September 2014: Triggers for celiac disease: One possible answer

July/August 2014: Ten Tips for a Healthier Gluten-Free Diet

June 2014: Back Pain and Gluten

May 2014: Self-Diagnosis of Gluten Sensitivity: Four Alarming Trends

April 2014: Update on Restaurants and Gluten-Free Dining

March 2014: Histamine Intolerance: Could it be causing your symptoms?

February 2014: Celiac Disease and Non-Celiac Gluten Sensitivity (Reprinted with permission from Sonoma Medicine)

January 2014: Four Vitamin Toxicities on a Gluten-Free Diet

December 2013: Move Over Gluten-Free, Low FODMAP is Next

November 2013: SIBO, Gluten and IBS: What Is The Connection?

October 2013: Pesticides, Wheat and Gluten Sensitivity: What is the Connection?

September 2013: Is gluten really the culprit in gluten sensitivity?

August 2013: Clarifying the Gluten-Free Labeling Rule

June/July 2013: No such thing as Mild Celiac Disease

May 2013: Magnesium Deficiency

April 2013: Six Reasons to test for celiac disease before starting a gluten-free diet

March 2013: Why am I having migraines?

February 2013: What is fructose malabsorption?

January 2013: Educating doctors about celiac disease

December 2012: Are supplements to digest gluten safe and useful?

November 2012: Top 5 reasons for persistent symptoms after Going Gluten Free

 

Photo by www.michaelandersongallery.com

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3 months ago

Last camp post until next yr! If your child lives in Northern CA and has celiac disease or follows a strict gluten-free diet consider the camp for next year. It is life changing for these kids and is free of charge as we are all volunteer. Thus, children who might otherwise not be able to attend for financial reasons are given the opportunity of a lifetime. If you would like to support the camp you can do so by making a donation to Celiac Community Foundation of Northern California or The Taylor Family Foundation. The donations allow the camp to continue. Thank you for your support. ... See MoreSee Less