Dermatitis Herpetiformis in Celiac Disease

Gluten and Itchy Skin - Dermatitis Herpetiformis in Celiac Disease

Updated December 19, 2023

When we think about celiac disease, gluten-free muffins, and other dietary adjustments often come to mind. But what many people don't know is that celiac affects more than just the stomach. It impacts the body's largest organ - the skin! 

Join us as we explore the fascinating connection between the digestive celiac disease and a lesser-known skin condition. Skin irritation, thy name is Dermatitis herpetiformis.
So sit back, relax, and let's uncover the intriguing relationship between gut health and skin.

What is celiac disease? 

Dermatitis Herpetiformis Diagram

Celiac disease is an autoimmune disorder that impairs the body's ability to digest gluten, a protein found in grains such as wheat, barley, and rye.


Individuals with celiac disease have a compromised immune system that attacks the small intestine upon consuming gluten. This results in damage to the villi, which are essential for proper nutrient absorption from food.

Celiac disease is hereditary and can develop at any age after gluten consumption begins. Malnutrition caused by untreated celiac disease can have severe consequences. This is particularly true for children, which can lead to stunted growth and development.
The condition is more common in people of Northern European descent. Also for those with a first-degree relative with celiac disease. Treatment involves following a strict gluten-free diet.
Gluten Free Diet

What is dermatitis herpetiformis? 

Dermatitis herpetiformis (DH) is a skin condition that affects around 10% of celiac disease patients.
It is a chronic, intensely itchy rash characterized by small clustered papules and vesicles. They typically appear symmetrically on the elbows, knees, buttocks, scalp, face, and groin.
Dermatitis Herpetiformis on the leg 
DH is caused by the skin accumulation of immunoglobulin A (IgA). This triggers further immunologic reactions resulting in lesion formation. It is an external manifestation of an abnormal immune response to gluten.
DH is diagnosed through a skin biopsy. Granular IgA deposits in the skin reveal epidermal transglutaminase antibodies. Following a gluten-free diet is essential for managing DH as it is gluten-sensitive. Treatment options include topical ointments and medication such as dapsone.

The connection between celiac disease and dermatitis herpetiformis

Dermatitis herpetiformis (DH) is a direct result of celiac disease. Both conditions share specific autoantibodies in serum and small bowel mucosa, but DH patients also have IgA-TG3 in their skin.
Dermatitis herpetiformis affects approximately 1 in 10,000 people. This makes it less common than celiac disease itself.
Gastrointestinal symptoms may or may not be present in dermatitis herpetiformis patients. Notably, dermatitis herpetiformis can also occur in individuals without celiac disease. However, it is often associated with the condition. Individuals with a family history of autoimmune disorders are also at higher risk. These conditions include anemia, thyroid disease, vitiligo, Type 1 diabetes, and alopecia.
Following a gluten free diet (GFD) is crucial for managing both conditions. While DH may occur in individuals without celiac disease, most DH patients have celiac disease. This means that individuals with DH should be evaluated for celiac disease and vice versa.

Is dermatitis herpetiformis related to the herpes virus?

Dermatitis herpetiformis is unrelated to the herpes virus, despite its name. "herpetiformis" refers to bumps and blisters resembling herpes lesions. However, the condition itself is caused by gluten sensitivity, not herpes.
As mentioned above, this chronic skin condition directly manifests as celiac disease. It affects 10% to 25% of people diagnosed with celiac disease. Although the condition can affect anyone at any age, it most likely affects individuals between 30 and 40.
People of Northern European descent and those with a family history of autoimmune conditions are also more at risk. Treatment for dermatitis herpetiformis involves strict adherence to a gluten-free diet.

Diagnosis and treatment of dermatitis herpetiformis 

Diagnosis of dermatitis herpetiformis (DH) relies on a combination of findings. These include clinical, histopathologic, and immunopathologic data.

Polymorphic lesions and small blisters are almost always accompanied by intense itching. The most specific diagnostic tool is direct immunofluorescence, which detects granular IgA deposits. Detection of autoantibodies against epidermal transglutaminase may also serve as a clue. The primary treatment for DH usually consists of strict adherence to a gluten-free diet, as DH is a skin manifestation of celiac disease.

Dermatitis Herpetiformis
This diet can alleviate symptoms and prevent further outbreaks. Topical creams and oral antihistamines may also be prescribed. These can control itching and inflammation.
A standard solution is hydrocortisone cream or cortisol. These products contain corticosteroids or topical steroids. They have been shown to have harmful side effects if used for long periods.
Adverse skin conditions like thinning, wrinkles, and addiction can occur with extended use. Topical steroids are also not practical for those who need fast relief. Corticosteroids can take weeks to provide relief.
One of the most effective options is Dermeleve®. Because Dermeleve® is free of dangerous corticosteroids, it is safe to use long-term. Even better, a single application begins working immediately and lasts many hours.
Tube of Dermeleve amongst bread
Dermeleve®'s proprietary formula means you can use it as often as you like, for as long as you want! It absorbs quickly and provides long-lasting relief from itching and inflammation.
In severe cases, a doctor may prescribe medications such as dapsone or sulfapyridine.
However, these have potential side effects and are typically reserved for more severe cases. Individuals with DH should work closely with their healthcare provider to manage their condition. Their doctor can also ensure proper treatment. Topical clobetasol ointment or dapsone may also be applied to control the disease quickly.
Patients must seek proper treatment to alleviate symptoms and avoid further inflammation. They should also consult with their dermatologist before using any medication to treat DH.

The importance of gluten-free diets 

You probably get tired of reading this over and over. Yet, the importance can't be stressed enough. Following a gluten-free diet is essential for managing celiac disease and dermatitis herpetiformis.
Foods With Gluten
Gluten proteins trigger an autoimmune reaction in the body. This reaction damages the small intestine and causes inflammation and skin irritation. Avoiding gluten entirely is the only way to prevent further damage and manage symptoms effectively.
This lifestyle adjustment usually involves reading food labels carefully. It also involves avoiding cross-contamination during food preparation. It also consists of seeking gluten-free alternatives to everyday foods.
Even though it may be frustrating for some, strict adherence to a gluten-free diet can also improve the overall quality of life. It reduces complications risk and improves symptom control. It's best to work with a healthcare provider or registered dietitian to meet all nutritional needs.
Dermeleve® Cream


Understanding the connection between celiac disease and dermatitis herpetiformis is critical. It is necessary for effective management and treatment.
While research is ongoing about the relationship between celiac disease and skin health, one thing is sure. Avoiding products that contain gluten is essential for celiac disease patients.
Adhering To A Gluten Free Diet
It's worth noting that not all itchy skin conditions are related to celiac disease or the result of gluten. Severe skin symptoms that don't respond to treatment may warrant further investigation. Speaking with a healthcare provider is critical if you experience any of the symptoms discussed here.
Appropriate diagnosis and treatment can improve your quality of life. It can also reduce the risk of other complications associated with celiac disease.
Regardless if your skin condition is caused by celiac disease or not, you deserve to live in comfort. For immediate and long-last relief, let Dermeleve® soothe your itchy skin.
Visit Dermeleve®'s website to learn more.

Q: What is gluten, and how does it affect your skin?

A: Gluten is a wheat, barley, and rye protein. It can cause skin problems like eczema, dry skin, psoriasis, and chronic urticaria in sensitive people.

Q: Is there a skin condition linked to celiac disease? 

A: Yes. Dermatitis herpetiformis is a skin condition that causes an itchy, scaly, and blistering rash that typically appears on the elbows, knees, neck, and head.

Q: Can gluten cause skin problems?

A: Gluten consumption can cause skin problems in people diagnosed with coeliac disease or gluten intolerance. A gluten-free diet may improve your symptoms.

Q: How can you diagnose a gluten-sensitivity-related skin problem?

A: You can test for celiac disease with a blood test that detects antibodies to gluten. A skin biopsy may confirm the diagnosis of dermatitis herpetiformis if the test is positive.

Q: Can eliminating gluten from your diet improve your skin condition?

A: Yes. Eliminating foods that contain gluten from your diet may improve skin conditions linked to celiac disease. It is recommended to consult a nutritionist before changing your diet.

Q: How long does a gluten-free diet take to improve skin problems?

A: It may take up to 10 weeks to see improvement in your skin condition after eliminating gluten from your diet.

Q: Does gluten cause alopecia or hair loss? 

A: Gluten intolerance may cause alopecia areata, which involves sudden hair loss in patches or hair loss due to malabsorption. However, it is not a common symptom of celiac disease.

Q: Can gluten cause hives?

A: Gluten consumption may trigger hives in people with non-coeliac gluten sensitivity. These people are sensitive to gluten but don't have celiac disease.

Q: Are skin conditions common in Psoriasis patients? 

A: Yes, psoriasis can affect your skin and cause scaly, dry patches or red, itchy rashes. However, psoriasis is not directly linked to gluten consumption.

Q: What are the risks of skin problems related to celiac disease? 

A: People with celiac disease are at higher risk of developing skin conditions linked to gluten intolerance. Eliminating gluten from their diet may reduce the risk.

Q: When should you see a doctor if you have itchy skin or other skin problems? 

A: You should see a doctor as soon as you notice symptoms like rash, itchiness, dry and scaly skin, or hair loss, especially if they persist or worsen. A doctor can help you diagnose skin problems and recommend the proper treatment.

Q: What is dermatitis herpetiformis?

A: Dermatitis herpetiformis is a skin condition associated with celiac disease. It results in an itchy, blistering rash.

Q: What is the link between gluten and dermatitis herpetiformis?

A: Dermatitis herpetiformis is directly linked to celiac disease and gluten intolerance. Consuming gluten can lead to immune system reactions, which trigger skin rashes.

Q: Is dermatitis herpetiformis contagious?

A: No, dermatitis herpetiformis is not contagious. It is a chronic autoimmune disorder that only occurs in celiac disease patients.

Q: What are the symptoms of dermatitis herpetiformis?

A: Dermatitis herpetiformis symptoms include itching, burning, blisters, and bumps on the skin. This condition may appear on any part of the body but commonly on the back of the neck, elbows, knees, and buttocks.

Q: Can a gluten-free diet help with dermatitis herpetiformis?

A: Yes, a gluten-free diet is the best way to manage dermatitis herpetiformis. Avoiding gluten-containing foods reduces the risk of immune system reactions. This, in turn, reduces the symptoms of this skin condition.

Q: What products contain gluten?

A: Wheat, rye, barley, and their derivatives are familiar gluten sources. Gluten-containing products include bread, pasta, cereals, beer, and baked goods.

Q: How is celiac disease diagnosed?

A: Celiac disease is usually diagnosed through a combination of techniques and measures. These include reviewing medical history, physical exam, blood tests, and a small intestine biopsy. Confirmation of celiac disease may take several months.

Q: Can celiac disease cause other skin conditions?

A: Yes, celiac disease and gluten sensitivity can result in other skin conditions, such as eczema and chronic urticaria.

Q: Is there a cure for dermatitis herpetiformis?

A: There is no cure for dermatitis herpetiformis, but it can be managed through a strict gluten-free diet and medication. Any form of treatment may be long-term and require ongoing monitoring by a healthcare professional.

Q: What is the link between celiac disease and alopecia areata?

A: Research has shown an increased risk of alopecia areata in individuals with celiac disease. The exact link between the two conditions is unknown and more research is needed. However, the immune system is believed to attack hair follicles due to gluten intolerance.

Q: What are the symptoms of Dermatitis Herpetiformis?

A: Dermatitis Herpetiformis is a rash with red, raised bumps and blisters. The rash is usually very itchy and widespread, appearing on the elbows, forearms, knees, buttocks, scalp, and back. Some individuals may also experience gastrointestinal symptoms. These include bloating, abdominal pain, diarrhea, or constipation.

Q: Is Dermatitis Herpetiformis a form of eczema or chronic urticaria?

A: Dermatitis Herpetiformis is a condition unrelated to eczema or chronic urticaria. It is a medical condition that requires a diagnosis and treatment by a dermatologist or a gastroenterologist.

Q: Is it true that if I have a gluten intolerance, I will develop Dermatitis Herpetiformis?

A: No. Not everyone with gluten intolerance or celiac disease will develop Dermatitis Herpetiformis. However, it is common in individuals with celiac disease or gluten intolerance.

Q: How is Dermatitis Herpetiformis diagnosed?

A: Dermatitis Herpetiformis is diagnosed through a skin biopsy. The biopsy must be taken from the skin near the rash and reviewed under a microscope by a dermatologist. Patients may also be tested for celiac disease using blood tests. Sometimes, an intestinal biopsy may be required to confirm celiac disease.

Q: Can I still eat gluten if I have Dermatitis Herpetiformis?

A: No, people with Dermatitis Herpetiformis should avoid gluten entirely as it triggers the rash and other symptoms. Following a gluten-free diet may alleviate symptoms. Additionally, it can promote healing of the inflammation, and help prevent further damage to the skin.

Q: Can Dermatitis Herpetiformis cause dry skin?

A: Yes, it is common for individuals with Dermatitis Herpetiformis to experience dry skin in addition to the rash. Gluten malabsorption can lead to essential fatty acids and vitamin deficiencies. These are important in helping to maintain healthy skin and avoiding itchy bumps and blisters.

Q: What does the rash from Dermatitis Herpetiformis look like? 

A: The rash is one of the itchiest and most annoying rashes you might ever experience. The rash includes small, water-like blisters and red bumps. These tend to be symmetrically distributed on the body. The rash often appears on the elbows, knees, and buttocks and can spread to the scalp and back. The blisters can leave spots that darken over time.

Q: Is there any other itchy rash that looks similar to Dermatitis Herpetiformis?

A: Yes, there is a skin condition called Bullous Pemphigoid, which can look similar to Dermatitis Herpetiformis. However, there is a critical difference between the two. Bullous Pemphigoid is unrelated to gluten intolerance or celiac disease.

Q: How long does the Dermatitis Herpetiformis rash take to go away?

A: Once gluten is removed from the diet, it can take anywhere from five to 10 weeks for the rash to subside. Medication such as dapsone may be prescribed in conjunction with a gluten-free diet to help relieve the inflammation.

Q: Should I see a dietitian or nutritionist if I have Dermatitis Herpetiformis?

A: Yes, a dietitian or nutritionist may provide valuable support and knowledge on following a gluten-free diet. They can help ensure your diet is well-balanced and meets your nutritional needs.
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