How Sugar Impacts Eczema: Reduce Flare-Ups With Smart Sugar Choices

By Diane Angela Fong, ND

Eczema is a chronic inflammatory skin condition that can be influenced by various factors, including diet and blood sugar regulation. While eczema’s root causes are multifactorial, emerging research suggests that high sugar intake and poor blood sugar control could worsen symptoms. This blog will explore the relationship between sugar, blood sugar levels, and eczema, supported by scientific studies, and provide actionable tips to help manage blood sugar for healthier skin.

What Is Sugar? Why Is It Important?

Sugar is a type of carbohydrate that occurs naturally in many foods, such as fruits (fructose), vegetables, and dairy (lactose). It is also added to foods in the form of table sugar (sucrose), honey, syrups, and processed sweeteners. In its simplest form, sugar is composed of glucose and fructose, two molecules that the body uses as a primary source of energy.

Why Sugar Is Important: Sugar, particularly glucose, is essential for bodily functions. The brain, muscles, and organs rely on glucose as their main fuel. When you eat carbohydrates, your body breaks them down into glucose, which is then used to produce energy or stored for later use.

Glucose is vital for:

• Brain function: The brain uses around 20% of your body’s total energy, most of which comes from glucose.

• Energy for muscles: During physical activity, glucose stored in muscles as glycogen is converted back into glucose for energy.

• Cellular metabolism: Glucose is used in cellular respiration, a process that produces ATP, the energy currency of the cell.

However, while sugar is necessary for life, consuming too much—especially from refined and processed sugars—can have serious health implications.

Why Is Too Much Sugar So Bad For Eczema?

Though sugar is essential for energy, excessive intake, particularly from processed foods, can lead to a host of health problems. The main issue with overconsumption of sugar is how it impacts blood sugar levels and contributes to chronic inflammation, which can exacerbate eczema and other inflammatory conditions.

Causes Blood Sugar Spikes

When you consume foods high in sugar, your blood sugar levels spike rapidly. The body responds by releasing insulin, a hormone that helps cells absorb glucose from the bloodstream. However, frequent spikes in blood sugar can cause insulin resistance over time. Insulin resistance leads to higher levels of circulating glucose, which can fuel inflammation and contribute to conditions like eczema.

A study published in Mo Med showed that high sugar consumption is linked to insulin resistance, hyperinsulinemia, and metabolic syndrome, all of which are associated with systemic inflammation and chronic diseases, including type 2 diabetes and coronary heart disease (DiNicolantonio & O'Keefe, 2022).

Promotes Inflammation

High sugar intake has been directly linked to increased inflammatory markers, including cytokines. Cytokines are small proteins that regulate inflammation in the body. When there is an excess of sugar, it triggers the production of pro-inflammatory cytokines, which can exacerbate eczema and damage the skin barrier.

A systematic review and meta-analysis published in Nutrients found that higher dietary sugar intake, particularly from added sugars, was significantly associated with increased levels of inflammatory biomarkers, such as C-reactive protein (CRP), highlighting sugar's role in promoting inflammation and chronic diseases (Della Corte et al., 2018).

Leads to Insulin Resistance and Metabolic Dysfunction

Consistently high sugar consumption can lead to insulin resistance, where cells no longer respond properly to insulin. This causes higher blood sugar levels, which over time can lead to metabolic disorders such as type 2 diabetes. Insulin resistance is also linked to oxidative stress and chronic inflammation, both of which can worsen eczema.

A study published in Liver International found that adult patients with atopic dermatitis, a common form of eczema, have a higher risk of developing type 2 diabetes mellitus. The study suggests a connection between eczema and metabolic dysfunction, driven by chronic inflammation and insulin resistance (Lee et al., 2023).

Affects Gut Health

Excess sugar disrupts the balance of bacteria in the gut, leading to an overgrowth of harmful bacteria and yeast. This imbalance, known as dysbiosis, is linked to increased intestinal permeability (leaky gut), which allows inflammatory compounds to enter the bloodstream and trigger eczema flare-ups.

Research published in Frontiers in Microbiology suggests that high sugar intake alters the gut microbiome, reducing microbial diversity and contributing to systemic inflammation (Sonnenburg et al., 2016).

Contributes to Weight Gain and Obesity

High-sugar diets, especially those rich in sugary beverages and processed foods, contribute to weight gain by providing excessive calories without essential nutrients. Obesity is a known risk factor for insulin resistance and inflammation, both of which can worsen eczema.

A meta-analysis published in The American Journal of Clinical Nutrition concluded that sugar-sweetened beverages are strongly associated with weight gain and obesity, which are risk factors for chronic inflammation (Malik et al., 2013).

What is the Right Amount of Sugar and the Right Types of Sugar to Consume to Support Eczema Healing?

While it’s important to minimize excessive sugar intake for better blood sugar control and inflammation management, especially during eczema flare-ups, not all sugars are created equal. Understanding how much sugar to consume, choosing the right types, and balancing your meals with fiber, protein, and fat can make a significant difference in your skin health.

How Much Sugar Should You Consume?

According to the American Heart Association (AHA), the recommended daily intake of added sugars is:

• For Women: No more than 25 grams (6 teaspoons) of added sugar per day.

• For Men: No more than 36 grams (9 teaspoons) of added sugar per day.

However, if you are experiencing an eczema flare-up, I recommend eliminating all added sugars from your diet and focusing solely on naturally occurring sugars from whole foods like fruits and vegetables.

How Balancing Sugar with Fiber, Protein, and Fat Stabilizes Blood Sugar

One key strategy for preventing sharp blood sugar spikes and crashes is to balance your intake of carbohydrates (including sugars) with fiber, protein, and healthy fats. Here's why these macronutrients play an important role in stabilizing blood sugar:

Fiber: Fiber, especially soluble fiber, slows down the digestion and absorption of sugar into your bloodstream. When you consume high-fiber foods (such as vegetables, fruits, and legumes), they help prevent quick spikes in blood sugar and insulin levels. The fiber acts as a buffer, allowing the sugar to be absorbed more gradually.

Example: Pairing fruit (which contains naturally occurring sugars) with a high-fiber food, like a small handful of chia seeds or nuts, can help slow down the release of glucose.

Protein: Protein also slows down the digestion of carbohydrates and sugars. Consuming protein-rich foods with your meals and snacks helps keep blood sugar levels more stable and reduces post-meal spikes. Protein also increases feelings of fullness, which can prevent overeating and further blood sugar fluctuations.

Example: Eating a piece of fruit with a protein source, such as a few almonds or seeds, can help stabilize blood sugar more effectively than eating the fruit alone.

Healthy Fats: Healthy fats, like those found in avocados, nuts, seeds, and olive oil, slow down digestion and prevent sharp increases in blood sugar. Fats also help regulate the release of sugar into the bloodstream, promoting longer-lasting energy and better control over blood sugar levels.

Example: Adding avocado or olive oil to a meal that contains carbohydrates (like a salad or whole grains) can help moderate the impact of the sugars in those carbohydrates.

Practical Tip: When you eat naturally occurring sugars from fruits and vegetables, make sure to pair them with a source of protein, fiber, or fat to help stabilize your blood sugar. For example, having an apple with a handful of walnuts or carrots with hummus can prevent rapid blood sugar spikes.

Eating Macronutrients in the Right Order

Another effective strategy to control blood sugar is to eat your macronutrients in a specific order during meals. Research has shown that the sequence in which you consume protein, fat, fiber, and carbohydrates affects how your body processes glucose:

1. Start with Fiber and Vegetables: Eating high-fiber vegetables first, such as leafy greens, broccoli, or other non-starchy vegetables, helps slow the digestive process and provides a buffer for sugar absorption. The fiber creates a protective barrier in the gut, allowing sugar from carbohydrates to enter the bloodstream more slowly.

2. Next, Eat Protein and Healthy Fats: Protein and healthy fats further slow down the digestive process and help regulate blood sugar. By eating these macronutrients after the fiber-rich vegetables, you continue to blunt the blood sugar response from any carbohydrates consumed later.

3. Finish with Carbohydrates or Sugars: By the time you eat carbohydrates, such as fruits, grains, or starchy vegetables, your body will be better prepared to manage the sugar load. The fiber, protein, and fats you consumed first will help prevent a rapid spike in blood sugar. This sequence can be especially beneficial for those prone to blood sugar imbalances or inflammation during eczema flare-ups.

   
   

Research Insight: A study published in Diabetes Care found that consuming protein and vegetables before carbohydrates led to significantly lower post-meal glucose levels compared to eating carbohydrates first (Shukla et al., 2015). This approach can be particularly helpful for managing blood sugar levels in individuals with eczema, as stable blood sugar is key to reducing inflammation.

Examples of Foods with Naturally Occurring Sugars (No Added Sugars)

During flare-ups, aim for naturally occurring sugars from whole, nutrient-dense foods. Below are examples of foods and how much naturally occurring sugar they contain:

1. One Medium Apple (95 calories):

   • Naturally occurring sugar: 19 grams

   • Apples are rich in fiber, which helps slow the absorption of sugar and stabilize blood sugar levels.

2. One Cup of Blueberries (85 calories):

   • Naturally occurring sugar: 15 grams

   • Blueberries are packed with antioxidants and provide vitamins along with their natural sugar content.

3. One Medium Banana (105 calories):

   • Naturally occurring sugar: 14 grams

   • Bananas are an excellent source of potassium and fiber, which also helps regulate blood sugar.

4. One Cup of Unsweetened Coconut Yogurt (120 calories):

   • Naturally occurring sugar: 1-2 grams

   • Coconut yogurt is a great dairy-free option, rich in healthy fats, and often contains probiotics for gut health, which may support skin health during eczema flare-ups.

5. One Medium Carrot (25 calories):

   • Naturally occurring sugar: 5 grams

   • Carrots provide essential vitamins and minerals, including beta-carotene, which is important for skin health.

     
     

Practical Tip: A good guideline for those experiencing eczema flare-ups is to aim for no more than 15-20 grams of naturally occurring sugars per meal, primarily from whole fruits and vegetables. Spread these out throughout the day to avoid a large sugar load at any one time.

What to Avoid During Eczema Flares

When you are experiencing an eczema flare-up, it’s critical to eliminate all added sugars to reduce inflammation and blood sugar spikes. Added sugars are typically found in:

• Sodas, fruit juices, and other sugary drinks

• Packaged snacks, like cookies, cakes, and candy

• Processed breakfast cereals and granola bars

• Flavored yogurts and condiments like ketchup or BBQ sauce

Instead, focus on whole foods with naturally occurring sugars, which come with fiber, vitamins, and minerals that help your body process sugar more effectively without triggering inflammatory responses.

Practical Example for a Sugar-Conscious Meal:

• Breakfast: One cup of unsweetened coconut yogurt with a handful (1/2 cup) of blueberries, and a sprinkle of chia seeds (Total sugar: 8 grams naturally occurring).

• Lunch: A mixed salad with leafy greens, one grated carrot (5 grams of sugar), avocado, and a protein source like grilled chicken, and a medium apple on the side (19 grams of sugar).

• Snack: One medium banana with a small handful of almonds (14 grams of sugar).

This gives you a balanced intake of naturally occurring sugars (without added sugars), fiber, protein, and fats that will provide nutrients and energy without causing rapid blood sugar spikes.

By balancing naturally occurring sugars with fiber, protein, and fats, and eating macronutrients in a strategic order, you can help prevent blood sugar spikes and better manage inflammation, which is key during eczema flare-ups.

How to Test for Blood Sugar Dysregulation To Support Eczema Healing

If you suspect that blood sugar dysregulation is contributing to your eczema, testing can provide valuable insights into how well your body is managing glucose levels. There are several ways to evaluate blood sugar, from blood tests to continuous glucose monitoring. Below are the recommended tests, reference ranges, and what to look for when monitoring your glucose levels.

1. Fasting Blood Glucose Test

• What it Measures: This test measures your blood sugar levels after fasting for at least 8 hours. It’s used to diagnose diabetes and insulin resistance.

• Healthy Reference Range: 70-99 mg/dL

• Prediabetes Range: 100-125 mg/dL

• Diabetes Range: 126 mg/dL or higher

What to Look For: Fasting blood glucose should be below 100 mg/dL in a healthy individual. Higher readings may indicate insulin resistance, a common precursor to diabetes and a contributor to systemic inflammation.

2. Hemoglobin A1c (HbA1c) Test

• What it Measures: HbA1c reflects your average blood sugar levels over the past 2-3 months. It’s often used to monitor long-term glucose control.

• Healthy Reference Range: Below 5.7%

• Prediabetes Range: 5.7%-6.4%

• Diabetes Range: 6.5% or higher

What to Look For: An HbA1c below 5.7% is considered normal. If your HbA1c is elevated, it could indicate prolonged periods of high blood sugar, contributing to inflammation and worsening eczema symptoms.

3. Oral Glucose Tolerance Test (OGTT)

• What it Measures: This test evaluates how well your body processes glucose by measuring blood sugar levels before and after consuming a glucose-rich drink.

• Healthy Reference Range: Below 140 mg/dL two hours after the glucose drink

• Prediabetes Range: 140-199 mg/dL two hours after the glucose drink

• Diabetes Range: 200 mg/dL or higher two hours after the glucose drink

What to Look For: The OGTT helps identify impaired glucose tolerance, which may not show up in fasting glucose tests. If your blood sugar remains elevated two hours after the test, it indicates insulin resistance and poor glucose regulation, both of which can worsen eczema.

4. Continuous Glucose Monitoring (CGM)

• What it Does: CGMs are wearable devices that track your blood sugar levels in real-time, offering insight into how food, activity, and stress affect glucose.

• Healthy Blood Sugar Ranges:

  • Morning (Fasting): 70-90 mg/dL

  • Post-Meal (1-2 hours after eating): Below 140 mg/dL

  • Daily Average: Ideally, your average glucose should remain below 100 mg/dL throughout the day.

What to Look For: A CGM allows you to track blood sugar trends throughout the day and identify spikes after specific meals or activities. Consistently elevated blood sugar levels, especially after meals, can contribute to inflammation and eczema flares. If you notice that your blood sugar regularly exceeds 140 mg/dL after meals, this could signal insulin resistance and inflammation.

5. HOMA-IR (Homeostasis Model Assessment of Insulin Resistance)

• What it Measures: This calculation is derived from fasting blood glucose and fasting insulin levels. It provides a more direct estimate of insulin resistance.

• How It’s Calculated:

  • HOMA-IR = (Fasting Insulin in µU/mL) × (Fasting Glucose in mg/dL) ÷ 405

• Healthy Reference Range: A HOMA-IR score of less than 1.0 is considered optimal.

What to Look For: A HOMA-IR score of 2.0-2.9 indicates early-stage insulin resistance. Scores above 3.0 suggest more advanced insulin resistance and a higher risk of metabolic dysfunction.

5. Fasting Insulin

• What it Measures: This test measures the amount of insulin in your blood after fasting for at least 8 hours. Elevated insulin levels can indicate insulin resistance.

• Healthy Reference Range: 2-25 µU/mL

What to Look For: Fasting insulin levels above 10 µU/mL can indicate the presence of insulin resistance. Ideally, fasting insulin should be under 10 µU/mL for healthy glucose regulation.

Understanding Insulin Resistance

If any of the above tests indicate insulin resistance, it means your cells are struggling to respond properly to insulin, leading to higher blood sugar levels. Insulin resistance is linked to chronic inflammation, oxidative stress, and metabolic dysfunction—all of which can exacerbate eczema symptoms. Testing for these markers, especially fasting insulin, HOMA-IR, and glucose tolerance, can provide a clearer picture of your metabolic health.

Practical Tip: Combining fasting blood glucose and fasting insulin tests will give you a more accurate assessment of insulin resistance than using either test alone. If you suspect blood sugar dysregulation, these tests can help you identify the root causes of inflammation that may be contributing to your eczema.

Achieve Lasting Eczema Relief With Smart Sugar Choices

Managing eczema involves more than just topical treatments—it’s about addressing the root causes, and blood sugar regulation plays a crucial role in managing inflammation and preventing flare-ups. As we’ve discussed, excessive sugar intake and insulin resistance can lead to chronic inflammation, which can worsen eczema symptoms. By balancing sugar intake, choosing the right types of foods, and following strategic eating habits, you can support your skin health from the inside out.

If you're dealing with eczema and suspect that blood sugar or other root causes might be contributing to your symptoms, you don’t have to figure it out on your own. At Cleanbody, we specialize in helping individuals identify the underlying factors affecting their skin health.

Take our free Eczema Root Cause Assessment or join our free live workshop to start your healing journey today!

GOT QUESTIONS?

Dr. Fong is going live to discuss this topic on her weekly Live with the Eczema Doc on Wednesday, October 23, at 12:30 PM PST! Watch the live or check out the replay here:

References:

1. DiNicolantonio JJ, O'Keefe JH. Added Sugars Drive Insulin Resistance, Hyperinsulinemia, Hypertension, Type 2 Diabetes and Coronary Heart Disease. Mo Med. 2022 Nov-Dec;119(6):519-523. PMID: 36588634; PMCID: PMC9762218.

2. Della Corte KW, Perrar I, Penczynski KJ, Schwingshackl L, Herder C, Buyken AE. Effect of Dietary Sugar Intake on Biomarkers of Subclinical Inflammation: A Systematic Review and Meta-Analysis of Intervention Studies. Nutrients. 2018 May 12;10(5):606. doi: 10.3390/nu10050606. PMID: 29757229; PMCID: PMC5986486.

3. Seung Won Lee, Jiwon Park, Hayeon Kim, Jaebong Jang, Kyung Mook Choi, Yoo Sang Baek, Myeong Gyu Kim, Kyungim Kim, Risk of type 2 diabetes mellitus in adult patients with atopic dermatitis, Diabetes Research and Clinical Practice, Volume 204, 2023, 110883, ISSN 0168-8227.

4. Sonnenburg, E. D., & Sonnenburg, J. L. (2016). Starving our microbial self: The deleterious consequences of a diet deficient in microbiota-accessible carbohydrates. Frontiers in Microbiology, 7, 1435.

5. Malik, V. S., et al. (2013). Sugar-sweetened beverages and weight gain in children and adults: A systematic review and meta-analysis. The American Journal of Clinical Nutrition, 98(4), 1084-1102.

6. Merschel, M. (2023, October 30). Why sugar matters – and how to cut back if you're eating too much of it. American Heart Association News.

7. Shukla AP, Iliescu RG, Thomas CE, Aronne LJ. Food Order Has a Significant Impact on Postprandial Glucose and Insulin Levels. Diabetes Care. 2015 Jul;38(7):e98-9. doi: 10.2337/dc15-0429. PMID: 26106234; PMCID: PMC4876745.

About the Author:

Dr. Diane Angela Fong, ND, is a naturopathic doctor specializing in eczema and chronic inflammatory conditions. She is the CEO and founder of Cleanbody, a wellness company dedicated to treating and preventing chronic diseases. Dr. Fong developed the Cleanbody Method, a transformative three-step process: Evaluate (uncovering the root causes of chronic disease through lab testing and comprehensive assessments), Optimize (strengthening health foundations by addressing nutrition, lifestyle, and toxic exposures), and Support (restoring optimal organ function through targeted healing protocols). Driven by a mission to educate and empower individuals with eczema and other chronic inflammatory diseases, Dr. Fong provides comprehensive support to help patients achieve lasting relief and better health. Learn more at www.cleanbody.health.

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