The bumpy, rough skin that is often found at the tops of arms is often called keratosis pilaris (KP) or follicular keratosis and can be one soft sign that you or your child isn’t getting enough omega 3 fatty acids or Vitamin A in their diet.
This “chicken skin” can also be found on the face, cheeks, torso and tops of the legs and we find that when it spreads over the body there are generalised problems synthesising and absorbing omega 3 and this skin issue may mean supplementing on top of an omega 3 rich diet.
A lack of omega 3 has far-reaching consequences and may impact neurodevelopment as well as play a role in metabolic health, gut health and immunity as well as helping to dial down inflammation.
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Diet Sources & Supplementation
Omega 3 is found in oily fish like salmon, mackerel, sardines, trout and prawns as well as omega 3-rich eggs, organic full-fat milk and grass-fed beef. There is a little omega 3 in chia seeds, hulled hemp seeds, flax seeds and walnuts too. Easy ways to boost up omega 3 intake include fish cakes, kedgeree, walnut pesto, fish pate spread on crackers or adding chia seeds to cereal. Switching eggs to omega-3 eggs and buying blue top organic milk and grass-fed mince for bolognaise will help too.
Omega 3 supplements can make a good addition to the diet, especially for fussy eaters and those not keen on eating fish. Many good quality brands are sustainable and have been purified to ensure they do not contain any mercury, heavy metals or plastics (PCB’s). They can help to restore the balance of omega 3 faster than diet alone.
Omega 3 is an important nutrient that feeds the brain, the immune system and the gut microbiome. It also helps us to regulate our nervous system which in turn helps with emotional regulation and stress management.
Link with Gluten
Many people with coeliac disease (an autoimmune condition related to the ingestion of gluten) or gluten intolerance (non-coeliac gluten sensitivity) report that their chicken skin clears up within a few months of going gluten-free and the smoother skin is a barometer that malabsorption is no longer present. I suspect this is because they are able to absorb Vitamin A and omega 3 from their diet more easily once the gut is less burdened by the gluten. There is no clear research yet that coeliac disease directly causes keratosis pilaris even though there are demonstrable links with other more significant skin conditions such as dermatitis herpetiformis, atopic dermatitis (eczema), psoriasis and alopecia (hair loss).
My findings from over 20 years of practising naturopathy are that keratosis pilaris is likely to be a generalised soft sign that a person is not efficiently absorbing or assimilating the key nutrients that feed the skin such as omega 3 fatty acids and vitamin A. As the gut heals, absorption is optimised and inflammation is dampened down and the KP starts to go. This phenomenon can be due to lots of reasons and not just coeliac or non-coeliac gluten sensitivity. However, gluten is one food group well known to be part of many people’s malabsorption issues, especially those who are more genetically susceptible to coeliac disease or have an autoimmune skew.
Link with Diabetes & a High BMI
Keratosis pilaris seems to be an early indicator of poor insulin control in some people and has been reported in the early stages of insulin resistance and the onset of diabetes. It has been found that young people who have both type one and type two diabetes are much more likely to experience keratosis pliaris as well as other skin conditions than young people without diabetes. It tends to be more likely in children and young people with type one diabetes who are also overweight or obese. KP is only one of many inflammatory skin conditions associated with diabetes.
Keratosis pilaris is also much more likely in people with a high Body Mass Index (BMI) and often comes along with dry skin on the legs and atopic conditions such as eczema. Since keratosis pilaris is described as an inflammatory skin condition, and obesity and diabetes are also both thought to be chronic inflammatory conditions, it would be prudent to assume that an overall anti-inflammatory approach to the diet may help. Omega 3 fatty acids are anti-inflammatory in nature and many studies have found that people who are overweight or obese are deficient in omega 3, so this all might well tie in and maybe a key piece in the puzzle.
Omega 3 Deficiency
This “chicken skin” is usually part of an overall checklist of fatty acid deficiency signs such as excess thirst, frequent urination, dry hair, dandruff, dry skin, and brittle nails and omega 3 deficiency seems to be much more common in kids with learning difficulties like dyslexia and dyspraxia as well as neurodevelopmental conditions like attention deficit disorder and autism. Kids with eczema and asthma, poor glucose balancing and other inflammatory conditions often get this sandpaper-rough skin too.
These deficiency signs have been cited in research from both Oxford University as well as internationally, and not all cases of follicular keratosis mean low omega 3. Some studies have also cited this may happen due to a Vitamin A deficiency and can mean you need both Vitamin A and additional omega 3. Vitamin A can be found in yellow butter, mango, carrots, sweet potato and pumpkin. Cod liver oil contains both Vitamin A and Omega 3 fatty acids, so this works on the skin from two angles at once.
Omega 3 deficiency is a common finding in children who are struggling with their learning and development. I can often spot the kids with learning difficulties or behavioural challenges from 10 feet away, as the follicular keratosis is pretty obvious – the rough skin is mainly on their cheeks which look red and ruddy and it’s on their upper arms as well. In our clinic, we analyse the diet and run a fatty acid test to see whether the child is low in omega 3 and we often find quite significant omega 3 deficiencies in these kids. It takes time to correct and we generally find that the skin improves over a few months through dietary modification and supplementation.
Eating oily fish 2-3 x a week can really help, but in some cases, a child needs a lot more than that to catch up, and this is why an omega 3 fish oil supplement can make quite a difference. Plant-based kids and fish dodgers need A LOT more omega 3 than fish eaters as the omega 3 in flax, chia and walnuts don’t convert that well into the DHA form of omega 3 that is needed for the growing brain. Luckily there are now vegan omega 3 supplements made from marine algae and these are probably just as good as fish oils.
Why do some kids need more omega 3 than others? It’s complicated but suffice to say that some digest and absorb it better than others and genetics play a role too – that’s where a NatureDoc practitioner can help you unravel things, if upping the omega 3 doesn’t make a difference within a few months. My blog ‘Omazing’ Omega-3 – Fab Fats For Health & Brain Power also explains things in a bit more depth.
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- Omega-3 Polyunsaturated Fatty Acids in Youths with Attention Deficit Hyperactivity Disorder: a Systematic Review and Meta-Analysis of Clinical Trials and Biological Studies
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- Vitamin A deficiency producing follicular hyperkeratosis
- Skin diseases associated with atopic dermatitis
- Gluten intolerance and skin diseases
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- Gluten-Free Diet in Children with Dermatologic Pathology
- The relation of deficiencies of vitamin A and of essential fatty acids to follicular hyperkeratosis in the rat
- High body mass index, dry scaly leg skin and atopic conditions are highly associated with keratosis pilaris
- Skin disorders in overweight and obese patients and their relationship with insulin
- The prevalence of cutaneous manifestations in young patients with type 1 diabetes
- Obesity and the skin: skin physiology and skin manifestations of obesity
- Association between Obesity and Omega-3 Status in Healthy Young Women
- Omega-3 fatty acids in obesity and metabolic syndrome: a mechanistic update
- Role of Omega-3 Fatty Acids on Lipid Profile in Diabetic Dyslipidaemia: Single Blind, Randomised Clinical Trial