One in three eczema patients may react to dietary amines and over half to salicylates.
Most people have no idea. They flare. They suspect food but allergy tests come back negative or inconclusive. Healthy diets don't seem to help, or they make symptoms worse.
That's a classic sign of food chemical intolerance. You eat healthier and your skin gets worse. Sometimes much worse.
Foods That Bite: What is Salicylate Intolerance?
Our research identified high rates of food chemical intolerance in people with eczema (Fischer et al., 2025).
The systematic review and meta-analysis showed that salicylate intolerance may affect 53% of people with eczema (95% CI: 44–62%). This means regular, healthy foods can make eczema flare, and these foods won't show up on allergy tests. That's because they are non-immune mediated, meaning they are not triggered by an immune response. Instead, they are a pharmacological response, similar to an adverse reaction to a drug, only triggered by a natural food chemical.
What Are Common Foods High in Salicylates?
Rich sources of dietary salicylates include dates, seasonings, sauces, broccoli, some dark leafy greens, avocado, coconut, beets, kiwi fruit, grapes, cacao/chocolate, apple and most teas, to name a few.
Image: Broccoli and many dark leafy greens are rich in salicylates and other natural food chemicals which can make eczema itchy.
How Common Is Salicylate Intolerance in Eczema?
Pooled results from our review indicate that salicylate intolerance may affect 53% of people with eczema (95% CI: 44–62%), with no observed heterogeneity across double-blind, placebo-controlled challenge trials using acetylsalicylic acid.
Given how common this may be, these findings suggest caution may be warranted when prescribing salicylate-containing medications to eczema patients, and teething gels for infants should be salicylate-free.
I once worked with the parents of a baby with eczema, and together we identified that a salicylate-containing teething gel was causing her skin to bleed and weep. Once it was removed, the child's skin began to heal.
Look for (and avoid) teething gel and mouth ulcer gel ingredients like salicylic acid or choline salicylate, which is the salicylate found in teething gels such as Bonjela.
What is Amine Intolerance And Does it Affect Eczema?
Amines and histamine follow a similar pattern. Our review estimated amine intolerance at 32% (95% CI: 16–48%) and histamine intolerance at 31% (95% CI: 20–41%) in people with eczema. Like salicylates, these are naturally occurring food chemicals rather than allergens, so standard allergy testing won't pick them up. Common sources include sausage, avocado, canned fish, cheese and fermented foods like sauerkraut and yoghurt.
You can read the full systematic review here.
Figure 1. Graphical abstract. When food allergy is suspected but allergy tests are negative or inconclusive, consider pharmacological food intolerance as a differential diagnosis.
How to Test for Salicylate Intolerance?
Because reactions are non-immunological, dose-dependent and cumulative, they cannot be detected by allergy testing. This makes dietary elimination and oral challenge the most reliable diagnostic approach. The Food Intolerance Diagnosis (FID) program from The Eczema Detox book can help you identify intolerances to salicylates amines/histamine, and more.
Is Eczema Caused by Food?
Food isn't the only trigger for eczema, but for many people it plays a bigger role than they realise. If your skin flares after eating "healthy" foods like avocado or fermented vegetables, food chemical intolerance may be part of the picture. The best way to know for sure is a structured elimination and testing process, ideally with support from a health professional.
What Causes Salicylate Intolerance? The Liver Detox Issue
Salicylate intolerance works via a different mechanism than food allergy. Salicylates are deactivated in the liver so liver detoxification processes need to be working properly so salicylates don’t build up in your gut and bloodstream.
Children under age two naturally have under functioning livers, that is why they are often born with jaundice, and this is why they may grow out of their eczema at age two – when their liver function kicks in. At age two if their liver function improves as it should they are less reactive to salicylates and other chemicals and the eczema naturally subsides. However, using topical corticosteroids long term is linked to fatty liver which may cause the eczema to not resolve at age two, so it's important to treat salicylate intolerance when the child is still young, and find other ways to calm the skin without the use of steroids.
A healthy liver needs nutrients to assist with detoxification of chemicals including salicylates, via the glycination pathway. Skin Friend AM was designed with this purpose in mind as it contains all of the nutrients needed to support the glycination pathway, including taurine, magnesium and glycine to name a few.
The Skin Friend supplement was initially designed for my daughter who had eczema 25 years ago as she had salicylate intolerance and eczema. It was then prescribed to my patients for many years before we launched it online so it was available for everyone. You can find more information here.
How Do I Find the New Low Salicylate List?
We know how exhausting it is to search for answers when your skin won't settle, so we've put together a new, updated low salicylate food list in a printed shopping guide, ready for you when you need it. It comes free with The Eczema Detox Bundle.
Some low salicylate foods include oats, unseasoned meats, blueberries, iceberg lettuce and some other types of lettuce, bok choy, ginger, garlic, turmeric, basil and many more.
After twenty years working alongside eczema patients, we've learned that a food list on its own isn't enough or mentally healthy for a person with eczema. So I have not supplied a list here as it would be too long and can lead people down "rabbit holes" they are not equipped to handle. You also require balanced recipes that taste good, and without the right nutritional support, it's easy to feel restricted and end up with gaps in your diet instead of relief.
Many lists online are inaccurate and can do more harm than good, mainly because they don't help you work out whether you're one of the 53% with salicylate intolerance in the first place. It's important to find a program that walks you through an elimination phase and a salicylate testing phase (plus guidance on testing other common foods), so you can find out for yourself, at your own pace, whether food chemicals are playing a role in your eczema.
Again, please don't remove foods from your diet without support from a complete program and/or a health professional who understands food chemical intolerance, as it's easy to create gaps in your diet when avoiding whole food groups. And that can lead to worsening eczema.
You can feel supported through this process, not alone with a list and no recipes to get you started. We created the Eczema Detox Gut + Skin Bundle to give people with eczema a complete, guided program, so they can move forward with guidance and success rather than guesswork. The bundle contains two supplements that may also reduce salicylate intolerance by supporting the glycination pathway in the liver. Learn more here.
If I have Salicylate Intolerance Am I On This Diet For Life?
No. The good news is, your body can learn to love these foods again, once your eczema settles and once you replenish your liver nutrients, food intolerances often fade. I know mine did as did my daughters and many of my patients.
So take heart, if you are reacting to salicylates and/or amines it's not a lifetime diet of avoidance, just detective work to find out what is right for you and your skin. We have an online Eczema Diet Membership that helps you every step of the way, with food lists and a search tool so you can look up any food and see the chemical content. And the good news is, the membership is free when you buy the Eczema Detox Bundle. Click here to learn more.
Article by Karen Fischer, lead author of the systematic review discussed in this blog.
Reference:
Fischer K, Jones M, O'Neill HM. Prevalence of intolerance to amines and salicylates in individuals with atopic dermatitis: a systematic review and meta-analysis. Nutrients. 2025;17(10).
