3 supplements for eczema: what the research actually shows

Eczema is one of those conditions that can make you want to try almost anything for relief. The itching, the red patches, the dry skin that cracks and bleeds, the sleep disruption when flare-ups wake you at 3am scratching unconsciously. I understand why people look beyond standard treatments.

The condition affects roughly 15 to 30 percent of children and around 10 percent of adults in developed countries. It’s not life-threatening, but the impact on quality of life is substantial. Anyone who’s dealt with severe eczema knows how much it can affect sleep and daily functioning.

Standard medical treatment typically involves moisturisers, topical corticosteroids, and avoiding triggers. But many people want to know: can supplements help? I’ve gone through the clinical evidence on the three most studied options, and here’s what the research actually shows.

What is eczema?

Eczema is an umbrella term for several types of skin inflammation, but when most people say “eczema,” they mean atopic dermatitis, the most common form. Other types include seborrhoeic dermatitis (often affecting the scalp and face), contact dermatitis (triggered by allergens or irritants), and nummular eczema (coin-shaped patches).

Atopic dermatitis typically appears in childhood, often within the first year of life, and many children grow out of it by adolescence. But not everyone. Some people develop it for the first time as adults, and others carry it from childhood into adulthood.

The condition runs in families and is closely linked to the “atopic triad” of eczema, asthma, and allergic rhinitis. If you have one, you’re more likely to develop the others.

What causes it?

The old view was that eczema was primarily a problem with the immune system, an allergic-type overreaction. The current understanding is more nuanced. There’s a defect in the skin barrier itself, particularly involving a protein called filaggrin, which normally helps keep skin cells tightly bound together and retains moisture.

When the barrier is compromised, moisture escapes (leading to dry, cracked skin) and irritants, allergens, and bacteria can penetrate more easily. This triggers inflammation, which damages the barrier further, creating a vicious cycle.

Genetic factors play a role, with mutations in the filaggrin gene found in many patients with severe eczema. Environmental factors matter too: low humidity, harsh soaps, certain fabrics, dust mites, pet dander, and sometimes foods can trigger or worsen symptoms.

1. Vitamin D

Vitamin D is perhaps the most overlooked supplement for eczema, which is odd given how much research now links deficiency to skin problems.

Vitamin D isn’t just about bones. It’s a hormone that affects immune function and helps maintain the skin barrier. When you consider that vitamin D deficiency is extremely common, particularly in northern latitudes, during winter, and among people with darker skin, it makes sense that researchers have investigated the connection to eczema.

What the research shows

A 2019 meta-analysis in the Journal of the European Academy of Dermatology and Venereology combined 11 studies and found that patients with atopic dermatitis had significantly lower vitamin D levels compared to healthy controls. The association was particularly strong in children.

The same analysis looked at intervention trials and found that vitamin D supplementation improved eczema severity scores (SCORAD and EASI, the standardised scales dermatologists use).

Another randomised controlled trial specifically in children with winter-related atopic dermatitis found that 1,000 IU daily of vitamin D for one month significantly reduced disease severity compared to placebo.

My honest assessment

The evidence for vitamin D is actually more consistent than I expected. Multiple studies point in the same direction: people with eczema tend to have lower vitamin D levels, and supplementation appears to help at least some patients.

The catch is that we don’t know the optimal dose, how long supplementation needs to continue, or which patients are most likely to benefit. If you’re deficient, correcting that deficiency makes sense on general health grounds anyway.

Getting your vitamin D level tested is reasonable before supplementing. Most guidelines suggest maintaining levels above 30 ng/mL (75 nmol/L), though opinions vary on what’s truly optimal.

2. Probiotics

Probiotics have become something of a trendy treatment for everything, and I’m generally sceptical of cure-all claims. But for eczema specifically, there’s a legitimate biological rationale.

The “gut-skin axis” is a real phenomenon. Your intestinal bacteria influence immune function throughout the body, and eczema is at its core an immune-mediated condition. The theory is that modifying the gut microbiome could shift immune responses in ways that calm skin inflammation.

What the research shows

A 2017 meta-analysis of randomised controlled trials found that synbiotics (probiotics combined with prebiotics) were effective for treating atopic dermatitis, particularly in children over one year of age. Mixed strains containing both Lactobacillus and Bifidobacterium species seemed to work better than single strains.

For prevention, the evidence is perhaps more compelling. A 2012 meta-analysis of 16 randomised controlled trials found that probiotics given during pregnancy and early infancy reduced the risk of eczema by about 39 percent in at-risk infants, meaning those with a family history of allergic disease. Again, mixed strains containing both Lactobacillus and Bifidobacterium were most protective.

The World Allergy Organization has conditionally recommended probiotics for pregnant women, breastfeeding mothers, and infants when there’s a family history of allergic disease, specifically to reduce eczema risk.

My honest assessment

The prevention data is stronger than the treatment data. If eczema runs in your family and you’re pregnant or planning to become pregnant, there’s reasonable evidence that probiotics during pregnancy and given to the infant early on could reduce your child’s risk of developing eczema.

For treating established eczema in adults, the picture is less clear. Some trials show benefit, others don’t. The inconsistency probably reflects differences in probiotic strains, doses, treatment duration, and patient populations.

If you want to try probiotics, look for products containing multiple strains including Lactobacillus rhamnosus GG, which has the most research behind it. Don’t expect dramatic results, and give it at least two to three months before judging whether it’s helping.

3. Omega-3 fatty acids (fish oil)

Omega-3 fatty acids reduce inflammation, which is why researchers have studied them for inflammatory skin conditions including eczema. The typical Western diet is relatively low in omega-3s and high in omega-6 fatty acids, and some theories suggest this imbalance contributes to inflammatory conditions.

What the research shows

A 2016 systematic review and meta-analysis examined whether omega-3 intake during pregnancy could prevent allergic diseases in offspring. Combining data from 20 studies, the researchers found that higher fish consumption or omega-3 supplementation during pregnancy was associated with reduced risk of atopic eczema, egg allergy, and positive skin prick tests in children.

For treating existing eczema, the evidence is more mixed. A Cochrane review of dietary supplements for established eczema found that the evidence for fish oil supplements was limited and inconsistent. Some small trials showed improvement, others didn’t.

One interesting finding from individual studies: the effect may depend on baseline omega-3 status. People who are deficient might benefit more than those already consuming adequate amounts through diet.

My honest assessment

Like vitamin D, the prevention evidence is more compelling than the treatment evidence. If you’re pregnant and eczema runs in your family, eating fatty fish two to three times per week or taking a fish oil supplement is reasonable based on current evidence.

For treating existing eczema, I wouldn’t expect fish oil alone to clear your symptoms. It might help modestly as part of a broader management strategy, particularly if you don’t eat much oily fish. But it’s not a substitute for moisturisers, trigger avoidance, and medical treatment when needed.

Other supplements sometimes mentioned

Evening primrose oil

Evening primrose oil is rich in gamma-linolenic acid (GLA), an omega-6 fatty acid that’s paradoxically anti-inflammatory. It was popular for eczema in the 1980s and 1990s, and some older trials showed benefit.

However, larger and better-designed recent trials have been disappointing. A Cochrane review found no convincing evidence that evening primrose oil is effective for eczema. I wouldn’t recommend it specifically for this condition, though it’s generally safe if you want to try it.

Vitamin E

Vitamin E is an antioxidant that helps protect skin cells from damage. Some small studies have shown modest improvements in eczema symptoms with supplementation, but the evidence isn’t strong enough to make a definitive recommendation.

Zinc

Zinc is important for skin health and wound healing, and deficiency can worsen skin conditions. However, there’s limited evidence specifically for zinc supplementation in eczema unless you’re actually deficient.

What won’t help

Eliminating foods

Many people with eczema try elimination diets, cutting out dairy, gluten, eggs, or other foods suspected of triggering flares. The reality is complicated.

True food allergies do occur more commonly in people with eczema, particularly children. If you have a genuine IgE-mediated food allergy (the kind that causes hives, swelling, or anaphylaxis), avoiding that food is clearly necessary.

But most people with eczema don’t have true food allergies, and broad elimination diets without proper testing can lead to nutritional deficiencies, particularly in children. The NHS and most dermatology guidelines recommend against elimination diets without proper allergy testing first.

High-dose anything

More isn’t better. High doses of vitamin D can cause toxicity. High doses of fish oil can increase bleeding risk. Stick to reasonable doses unless specifically advised otherwise by a healthcare provider who’s monitoring you.

Putting it together

Based on the evidence, here’s what I’d suggest:

For prevention (if eczema runs in your family and you’re pregnant or have an infant):

• Consider probiotics containing Lactobacillus and Bifidobacterium strains during pregnancy, while breastfeeding, and for the infant
• Eat fatty fish two to three times weekly or consider fish oil supplements during pregnancy
• Ensure adequate vitamin D intake

For managing existing eczema:

• Get your vitamin D level checked and correct any deficiency
• Probiotics might help modestly, particularly mixed-strain products, but don’t expect dramatic results
• Fish oil is unlikely to make a major difference but is reasonable as part of overall healthy eating
• Don’t neglect the basics: moisturise frequently, avoid known triggers, and use prescribed treatments as directed

The honest truth is that no supplement is going to “cure” eczema. These might help at the margins, particularly if you’re deficient in something. But good skincare, trigger avoidance, and appropriate medical treatment still matter more than any supplement.

If your eczema is significantly affecting your quality of life, see a dermatologist. There are effective treatments available, including newer options like dupilumab for severe cases, that work far better than any supplement.

Related reading

• Probiotics: benefits, side effects, and what to know
• Fish oil: benefits and contraindications
• Supplements for allergies: what works?

References

1. Peroni DG, et al. Correlation between serum 25-hydroxyvitamin D levels and severity of atopic dermatitis in children. Br J Dermatol. 2011;164(5):1078-82. PMID: 21087229

2. Hattangdi-Haridas SR, et al. Vitamin D Deficiency and Effects of Vitamin D Supplementation on Disease Severity in Patients with Atopic Dermatitis: A Systematic Review and Meta-Analysis in Adults and Children. Nutrients. 2019;11(8):1854. PMID: 31405041

3. Camargo CA Jr, et al. Randomized trial of vitamin D supplementation for winter-related atopic dermatitis in children. J Allergy Clin Immunol. 2014;134(4):831-835.e1. PMID: 25056825

4. Chang YS, et al. Synbiotics for Prevention and Treatment of Atopic Diseases: A Meta-analysis of Randomized Clinical Trials. JAMA Pediatr. 2016;170(3):236-42. PMID: 27886563

5. Pelucchi C, et al. Probiotics supplementation during pregnancy or infancy for the prevention of atopic dermatitis: a meta-analysis. Epidemiology. 2012;23(3):402-14. PMID: 22253485

6. Best KP, et al. Omega-3 long-chain PUFA intake during pregnancy and allergic disease outcomes in the offspring: a systematic review and meta-analysis of observational studies and randomized controlled trials. Am J Clin Nutr. 2016;103(1):128-43. PMID: 26980381

7. Bath-Hextall FJ, et al. Dietary supplements for established atopic eczema. Cochrane Database Syst Rev. 2012;(2):CD005205. PMID: 22592695

8. NHS. Atopic eczema. Available at: https://www.nhs.uk/conditions/atopic-eczema/

9. Weidinger S, Novak N. Atopic dermatitis. Lancet. 2016;387(10023):1109-1122. PMID: 26377142