The Hidden Connection Between Blood Sugar Imbalances and Eczema

By Dr. Diane Angela Fong, ND and Tori Taggart, MS, CNS

Eczema, a chronic inflammatory skin condition that affects millions globally, has long been associated with genetic factors, environmental triggers, and more recently, microbiome imbalances (click see our previous blog posts!). However, recent studies have unveiled a lesser-known culprit: blood sugar imbalances. Research indicates that fluctuations in glucose levels and insulin resistance can significantly impact the severity of eczema symptoms. This connection is not limited to individuals with diabetes but extends to anyone experiencing blood sugar spikes and dips due to dietary and lifestyle choices. Understanding this link is essential for managing eczema effectively and achieving healthier skin.

In this blog, we explore the relationship between blood sugar imbalances and eczema, providing valuable insights and practical tips for maintaining stable blood sugar levels to support skin health.

Blood Sugar Imbalances and Their Impact

Blood sugar levels are regulated by insulin, a hormone that helps cells absorb glucose from the bloodstream. When carbohydrates are broken down and absorbed as glucose, they enter the bloodstream, and a signal is sent out in which the pancreas responds by releasing insulin. Insulin works like a key that opens the doors of each cell which then allows the glucose to enter, which removes the glucose from the blood. The pancreas controls how much insulin is released and the cells respond. Conversely, when blood sugar levels drop, such as between meals or during physical activity, the pancreas releases glucagon which is a hormone that prompts the liver to release stored glucose into the bloodstream, which prevents glucose levels from becoming too low. Together, insulin and glucagon maintain a delicate balance, ensuring that cells receive a steady supply of glucose for energy while also preventing harmful spikes or drops in blood sugar levels. This regulation is crucial for overall health and supports the proper functioning of organs and bodily systems.

Both the insulin release and the cell’s reception of this insulin can be impaired for various reasons, often due to poor diet and lifestyle habits. This metabolic imbalance doesn't just affect glucose regulation; it also triggers inflammatory responses throughout the body. Chronic inflammation is increasingly recognized as a contributing factor to various skin conditions, including eczema.

Research Insights: The Connection Between Eczema and Blood Sugar

Studies have found that individuals with insulin resistance and metabolic syndrome (a cluster of conditions including high blood sugar, high blood pressure, and obesity) are more likely to experience inflammatory skin conditions like eczema (Brunner et al., 2017). There are many ways that imbalanced blood sugar contributes to eczema. Here are a few:

1. Insulin Resistance and Inflammation:

After time, cells can become less responsive to insulin, resulting in higher blood sugar levels and increased insulin production. Think of this as a solicitor that knocks on your door every single day at noon. Eventually when you hear the knock, you decide to stop answering the door. This same thing happens with our cells. The pancreas releases insulin in response to high glucose in the blood and this happens so often, that the cells stop responding. This is referred to as “insulin resistance.” This results in even higher glucose levels in addition to higher insulin levels.

Elevated blood sugar and insulin resistance then triggers systemic inflammation, which may exacerbate inflammatory skin conditions like eczema.

2. Immune Dysregulation:

The immune system's role in eczema involves responses that can either promote or mitigate inflammation. Insulin resistance and elevated blood sugar levels, commonly associated with conditions like diabetes or metabolic syndrome, can impair immune function. This impairment compromises the body's ability to regulate inflammatory responses effectively, potentially exacerbating eczema symptoms.

When immune function is compromised due to insulin resistance and elevated blood sugar levels, the body may exhibit heightened allergic reactions and increased sensitivity to environmental triggers. These triggers can include allergens, irritants, or microbial agents that stimulate the immune system and worsen inflammation in eczema-ridden skin.

Additionally, chronic inflammation associated with insulin resistance can disrupt the skin barrier function, making it more permeable and susceptible to external triggers. This compromised barrier function not only exacerbates eczema symptoms but also creates a cycle where inflammation leads to further skin damage and discomfort.

The immune system's dysregulation due to insulin resistance and elevated blood sugar levels can contribute significantly to the development and worsening of eczema. Managing these metabolic factors through lifestyle changes may help mitigate eczema symptoms by supporting better immune function and reducing inflammatory responses in the skin.

3. Glycation and Advanced Glycation End-products (AGEs):

Elevated blood glucose levels can lead to a process called glycation, where sugars bind to proteins in the skin, forming something called “AGEs.” Advanced Glycation End-products are compounds that form when sugars in the body react with proteins or fats without the help of enzymes. This process happens naturally as we age, but it speeds up when blood sugar levels are chronically high. AGEs can change how proteins work and make tissues like skin, blood vessels, and joints stiffer and less flexible. Elevated levels of AGEs are associated with various chronic diseases and conditions, including skin disorders like eczema.

AGEs contribute to oxidative stress and inflammation, both of which are implicated in eczema. AGEs can also cross-link collagen and elastin fibers in the skin, leading to stiffness and reduced elasticity, which are characteristic features of aged and inflamed skin as often seen in eczema cases (Danby, 2010).

While the exact role of AGEs in eczema still needs to be fully understood, emerging evidence suggests a potential link between elevated AGE levels and the severity of eczema symptoms. Individuals with eczema may have increased levels of AGEs in their skin, which can contribute to chronic inflammation, impaired skin barrier function, and accelerated skin aging processes characteristic of eczema (Rincon-Arevalo et al., 2021).

How AGEs Affect Skin:

Inflammation: AGEs contribute to inflammation by stimulating the production of pro-inflammatory cytokines and reactive oxygen species (ROS) in the skin cells. This inflammatory response can exacerbate existing inflammatory skin conditions like eczema (Danby, 2010).

Skin Aging: AGEs play a significant role in skin aging. They cross-link with collagen and elastin fibers in the dermis, leading to reduced elasticity, increased stiffness, and the formation of wrinkles. These structural changes are similar to those observed in aged skin and can contribute to the clinical appearance of eczema-prone skin (Liu & Shi, 2012).

Barrier Function: AGEs can impair the skin barrier function by altering the structure and function of proteins involved in maintaining the integrity of the skin barrier. This compromised barrier function makes the skin more susceptible to allergens, irritants, and microbial imbalances, which are triggers for eczema flare-ups (Lan, 2018).

4. Dehydration:

High blood sugar levels can exacerbate symptoms of eczema, particularly by contributing to dehydration and affecting skin moisture levels. When blood sugar levels are elevated, the kidneys work harder to remove the excess glucose from the blood by increasing urine output. This increased urination can lead to dehydration, as more water is lost from the body.

Dehydration is problematic for eczema-prone skin because it reduces the skin's ability to retain moisture. In individuals with eczema, the skin barrier is usually compromised, making it more susceptible to dryness and irritation. When dehydration occurs due to high blood sugar levels, the skin can become even drier, worsening symptoms such as itching, redness, and flaking.

High blood sugar levels can also impair circulation and affect the delivery of nutrients and oxygen to the skin cells. This can further compromise the skin barrier function and exacerbate inflammation, making eczema symptoms worse.

Managing blood sugar levels through a balanced diet, regular hydration, lifestyle changes and skincare routines that focus on moisturizing and protecting the skin barrier are crucial for individuals with eczema. By controlling blood sugar levels and ensuring adequate hydration, it's possible to mitigate the impact on skin health and improve eczema symptoms.

Physical activity plays a crucial role in maintaining the body's defense system, known as the immune system. Research has shown that regular exercise acts as a boost to the immune system, enhancing defense activity and promoting metabolic health. Nieman and Wentz (2019) highlight the inverse relationship between moderate exercise training and the risk of illness, indicating that regular physical activity can lower the susceptibility to infections and other immune-related disorders.

Individuals with eczema may face challenges in maintaining adequate levels of physical activity due to various factors, including discomfort from lesions, fatigue, and sleep disturbances associated with the condition. Consequently, reduced physical activity levels can have detrimental effects on immune function, potentially exacerbating eczema symptoms.

Regular exercise has been shown to have an anti-inflammatory influence, mediated through multiple pathways within the body. By reducing systemic inflammation, exercise can help alleviate symptoms associated with inflammatory conditions like eczema. Conversely, a lack of physical activity may contribute to chronic inflammation, which can further compromise immune function and worsen eczema symptoms

Maintaining an active lifestyle is essential for supporting immune function and managing conditions like eczema. Movement can start with simple walking as any increase in activity is helpful! By understanding the link between physical activity, immune health, and eczema, individuals can take proactive steps to optimize their overall well-being.

5. Microbial Dysbiosis on the Skin:

Changes in blood sugar levels can also influence the skin's microbiome, which refers to the diverse community of microorganisms (bacteria, fungi, and viruses) that live on the skin's surface and within its layers. When blood sugar levels fluctuate, it creates an environment that can favor the growth of harmful bacteria or yeast/fungi.

Elevated blood sugar levels can feed certain microorganisms, allowing them to thrive and multiply. This imbalance can disrupt the normal balance of the skin microbiome, where beneficial bacteria typically help maintain skin health by competing with harmful organisms and modulating immune responses.

As harmful bacteria or fungi/yeast increase in number on the skin, they can trigger inflammatory responses. This inflammation can manifest as redness, swelling, and itching. Some microorganisms may directly contribute to skin infections or worsen existing skin conditions by releasing toxins or inducing immune responses, such as Staphylococcus aureus which we often see in eczema cases.

Maintaining stable blood sugar levels with nutrition and lifestyle choices is essential for minimizing these disruptions to the skin microbiome. Additionally, practicing good skincare habits can help support a healthy balance of microorganisms on the skin and reduce the risk of inflammation and skin complications associated with blood sugar fluctuations.

6. Stress:

Managing chronic conditions such as eczema can indeed be stressful, and stress can impact blood sugar levels through hormonal pathways. When we experience stress, the body releases hormones like cortisol and adrenaline as part of the "fight-or-flight" response. Cortisol, in particular, plays a key role in increasing blood sugar levels by stimulating the liver to release glucose into the bloodstream.

For individuals with eczema, stress-induced elevation of blood sugar levels can potentially worsen symptoms. Elevated blood sugar levels can impair immune function and skin barrier integrity, making the skin more vulnerable to inflammation and irritation. In eczema-prone individuals, this can manifest as increased itching, redness, and flare-ups of eczema lesions. This in itself can then increase stress!

Stress can indirectly exacerbate eczema by triggering behaviors that worsen the condition, such as scratching, neglecting skincare routines, or having increased anxiety. Additionally, stress can disrupt sleep patterns, and inadequate sleep is known to affect immune function and exacerbate inflammatory skin conditions like eczema.

Managing stress is an extremely important aspect of managing eczema. Techniques such as relaxation exercises, mindfulness practices, regular physical activity, and adequate sleep can help mitigate stress levels. By reducing stress, individuals with eczema will also help stabilize blood sugar levels and improve overall skin health and comfort.

Managing Eczema and Blood Sugar Imbalances

Balancing blood sugar levels can help manage eczema with a comprehensive approach that addresses various aspects of health and lifestyle:

1. Healthy Eating Habits: Choosing a balanced diet that includes whole grains, fruits, vegetables, lean proteins, and healthy fats. Limit intake of refined sugars, processed foods, and high-glycemic index carbohydrates, as these can exacerbate both eczema and blood sugar fluctuations (Staevska et al., 2012). Protein and fiber are key aspects of healthy blood sugar. Make sure every meal includes both of these macronutrients.

2. Stress Reduction Techniques: Incorporate stress management techniques such as yoga, meditation, or deep breathing exercises into your daily routine. Lowering stress levels can help mitigate the impact on eczema and stabilize blood sugar levels.

Practice stress management techniques, such as deep breathing exercises, progressive muscle relaxation, mindfulness meditation, or yoga, to promote relaxation and reduce stress levels.
Identify sources of stress in your life and find healthy ways to cope with them, such as setting realistic goals, prioritizing tasks, delegating responsibilities, and seeking social support.
Make time for activities that you enjoy and that help you unwind, such as spending time outdoors, engaging in hobbies, listening to music, or spending quality time with loved ones.

3. Daily Movement: Walking, stretching, weight lifting, yoga… any type of movement is a key player in balancing blood sugar. Planning to walk, for even 5 minutes, after meals is incredibly impactful on reducing post-prandial glucose levels.

Incorporate a variety of physical activities into your routine, including cardiovascular exercises, strength training, flexibility exercises, and recreational activities you enjoy.
Find opportunities to be active throughout the day, such as taking the stairs instead of the elevator, walking or biking instead of driving for short distances, and participating in active hobbies or sports

4. Adequate Hydration: With elevated glucose levels, the kidneys work harder to remove the excess glucose from the blood by increasing urine output. This increased urination can lead to dehydration, as more water is lost from the body. Make sure you are consuming enough water each day and include electrolytes especially on days you are sweating a lot or working out, to ensure you are getting hydrated at a cellular level.

Stay hydrated by drinking an adequate amount of water throughout the day. Aim for at least half your weight in ounces of water daily, or more if you're physically active or in hot weather.
Carry a reusable water bottle with you to make it easier to stay hydrated wherever you go.
Monitor your urine color: pale yellow to clear urine indicates proper hydration, while dark yellow urine may indicate dehydration.

5. Work with a Professional: Every case is unique and working with someone to understand your individual situation is extremely important. Our team at Cleanbody would love the opportunity to help you!

Conclusion

Understanding the complex relationship between eczema and blood sugar imbalances empowers individuals to take proactive steps in managing their skin health and overall well-being. By addressing dietary factors, stress management, skincare routines, and seeking guidance when needed, individuals can potentially reduce the frequency and severity of eczema flare-ups. Remember, a comprehensive approach that considers both genetic predispositions and lifestyle factors is key to effectively managing eczema and promoting skin health. Attend Dr. Fong's next live Q&A session every Wednesday at 11:15 am PST to ask questions, or schedule a consultation to start your journey towards optimal health.

Contact us at Cleanbody today to book your Discovery Consultation. Find out if glucose regulation plays a role in your eczema and ways to bring back balance to your body!

GOT QUESTIONS?

We are going live to discuss this topic on Wednesday, July 24th at 11:15 AM PST! Watch the live or check out the replay here:

About the Authors:

Dr. Diane Angela Fong, ND, is the CEO and founder of Cleanbody, a wellness company dedicated to treating and preventing chronic disease. She is the creator of the Cleanbody Method, which follows a three-step process: Evaluate (digging into the root causes of chronic disease using lab testing and other evaluation tools), Optimize (enhancing health foundations by addressing nutrition, lifestyle, and toxic exposures), and Support (optimizing organ functions through healing protocols).

Tori Taggart, MS, CNS is a Cleanbody Nutritionist specializing in meeting people in their healthy journeys by digging into the root causes of various chronic diseases and conditions. Through the use of healthy food along with aspects of the natural world around us (sunshine, nature, clean water, stress management, relationships, etc), she helps to empower her clients to take charge of their own health and trust their bodies to thrive and heal.

References:

Bilgic, A., et al. (2021). Insulin resistance and skin diseases. Cutaneous and Ocular Toxicology. https://doi.org/10.1080/15569527.2021.1960111

Yang, L., et al. (2020). The impact of blood glucose level on skin barrier function in patients with type 2 diabetes mellitus. Journal of Cosmetic Dermatology, 19(10), 2565-2570. https://doi.org/10.1111/jocd.13302

Danby, F. W. (2013). Nutrition and aging skin: sugar and glycation. Clinics in Dermatology, 31(1), 126-129. https://doi.org/10.1016/j.clindermatol.2011.11.003

Staevska, M., et al. (2012). Role of diet in the development and management of atopic dermatitis. Journal of Clinical Medicine, 1(2), 64-74. https://doi.org/10.3390/jcm1020064

Sidbury, R., et al. (2014). Guidelines of care for the management of atopic dermatitis: Section 4. Prevention of disease flares and use of adjunctive therapies and approaches. Journal of the American Academy of Dermatology, 71(6), 1218-1233. https://doi.org/10.1016/j.jaad.2014.08.026

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