Is Histamine Intolerance the Culprit Behind Your Skin Condition?

Updated: Mar 25

If you have a chronic skin condition or symptoms like itchiness, rashes, or redness, histamine intolerance might be at the root.


Hives, itchiness, redness, and flushed skin are some of the most common symptoms of histamine intolerance (1). Research has also linked excess levels of histamine to some of the most common inflammatory skin conditions, including atopic dermatitis (eczema), chronic urticaria (hives), psoriasis, and rosacea (2, 3, 4).

Symptoms like hives or itchiness might seem to come out of nowhere, and are often thought to be allergy symptoms, even though allergy tests may come back negative or allergens cannot be identified.


Common skin conditions, including eczema and urticaria or hives, tend to be conventionally treated with creams, ointments, or steroidal medications. These treatments, at best, provide some symptom relief. In other cases, they don’t work, and may cause side effects. In any event, they do not get to the root cause of the skin inflammation.


On the other hand, I often find that addressing histamine intolerance can lead to skin health improvements from the inside out.


If you’re interested in finding out more about the connection between histamine and skin conditions and what you can do to improve your skin health, read on.

Why Does Histamine Intolerance Manifest Through Skin Conditions?


As you may already know if you are reading this article, histamine is a chemical that plays a natural role in inflammatory immune reactions, but it can become problematic when its levels build up in excess. (See a full explanation of histamine intolerance here.)


Histamine is produced in all tissues of the body, but especially in the skin, lungs, and digestive tract. Looking at the skin in particular, too much histamine can compromise the skin barrier by loosening the junctions between cells which are usually bound tightly together (5).


This can be problematic because when the skin barrier is impaired, it is less effective at providing protection from harmful substances you come into contact with in your environment, like bacteria, allergens, and irritants. Once these harmful substances enter the body, the immune system launches an inflammatory response to dispel them. Skin conditions like eczema are often signs of this inflammatory response.


There is also another correlation between histamine and skin conditions, involving gut health. Histamine and gut health are closely linked in a number of ways, as explained in this article. When the bacterial balance in the gut is upset (dysbiosis) or the lining of the gut is compromised (leaky gut), histamine may build up in the body. The excess histamine and resulting inflammation may then manifest as various skin conditions, particularly if the histamine receptors in the skin are activated.

In turn, gut health is also linked to skin health through a pathway known as the ‘gut-skin axis.’ This pathway is bidirectional, meaning that changes to the gut affect the skin, and changes to the skin affect the gut.


The multiple histamine-gut-skin connections are confirmed by research linking gastrointestinal disorders such as SIBO and leaky gut to both histamine intolerance (6) and skin conditions like eczema (7), psoriasis (8) and acne (9).


How to Address Histamine Intolerance and Improve Your Skin


How can you determine whether or not histamine intolerance underlies your skin condition? The best way is to follow a low histamine diet for several weeks, and observe any changes or improvements in symptoms.


If improvements are seen following this trial, a more complete histamine intolerance protocol can begin. This involves following the low histamine diet, as well as avoiding environmental toxins and lifestyle-related triggers of excess histamine release. It may also involve supplementation, including with the DAO enzyme.


More information can be found here on what foods are to be included vs. avoided with a low histamine diet, and this article outlines additional factors that contribute to excess histamine.


Research focused on whether a low histamine protocol can help with skin conditions is promising. For example:


  • Research has shown that when people have atopic dermatitis (eczema) that is not tied to known food allergies, their symptoms generally improve after following a low-histamine diet (10).

  • A low histamine diet has been shown to help treat symptoms of chronic spontaneous urticaria (hives) (11, 12).

  • Supplementation with DAO, the enzyme that helps to break down dietary histamine, has also been shown to improve hives (13).


In addition to following a low-histamine diet and avoiding external triggers for histamine release, consult with your physician about how certain medications may also come into play. Some medications block DAO, the enzyme responsible for breaking down histamine (this relationship is explained here). When this happens, an imbalance occurs (low DAO/high histamine), and skin conditions may be exacerbated.


Finally, if you are suffering from an ongoing skin condition, focus on keeping your gut microbiome healthy. This article provides several suggestions on how to do that.

For more personalized guidance, request a functional medicine consultation with Dr. John Gannage, MD.