Oh, we shouldn’t have…. What exactly happens to our bodies after we just consumed the largest holiday meal of the year? Those excess calories from carbohydrates, proteins, and fats that are not used for daily body metabolic activity ultimately get converted to body fat – eek. But for some people, the skin can show food consumption in other ways aside from just showing our love handles.
First, excess lipid or fats can deposit in our skin and other organs, but not in the way we ordinarily think. There are some genetic and metabolic syndromes and even medications that cause very high levels of cholesterol circulating in our system. These cholesterol levels or triglycerides can deposit right in our upper layers of skin causing distinctly yellow-orange small pea-sized bumps in certain parts of our body such as near the eyelids, palms, knees, elbows, arms, and legs. We call these skin lesions xanthelasma if involving the eyelids and xanthomas if involving the rest of the body skin. Though often reversible by diet and cholesterol -lowering medication, some of these skin lesions can sometimes be permanent.
Next, we always think of gout as being a disease of older men, a painful condition traditionally causing large painful skin nodules on the big toes or ear cartilage or elbows, knees, and wrists. Rich, meaty foods, such as red meats and certain types of fish and seafood, and alcohol (beer, liquors) have high purine contents. If you consume these foods regularly and drink over two alcoholic beverages a day, or if you are on certain medications, the uric acid levels get high enough to crystallize out of the blood circulation into distant areas of our body, causing painful skin nodules with arthritis and kidney stones. The treatment is taking medication to lower uric acid levels and for pain control. Lifestyle changes include avoiding rich foods and alcohol and consuming more dairy products, complex carbohydrates, and fluids. Steady weight loss will help as well.
Salt lovers beware. Those who consumed too much salt probably felt it the next morning from tight clothing and rings. Unfortunately, those with heart failure cannot handle the extra fluid volume from salt and subsequent water retention. One skin manifestation from this is leg swelling. Long-standing leg swelling can make the skin of the lower legs itchy, reddish-purplish, and eventually hard. For those with heart failure, a low 2 gram sodium diet has to be followed.
Moderation is the key for everything including alcohol consumption. Chronic alcohol use can cause liver damage with end-stage cirrhosis as its worst outcome. Skin signs of alcohol-induced liver disease include yellowing of the skin and eyes, called jaundice, from excess bilirubin levels; the abdominal blood vessels are more pronounced on top of a swollen, fluid-overloaded belly; there are little smaller red superficial blood vessels that appear on the upper body called spider angioma; there is increased skin bruising and/or itching; and there are even nail changes. The only treatment for end-stage cirrhosis is surgery or liver transplant.
Lastly, there are some people who have severe gluten sensitivity, causing a gastrointestinal disease called Celiac Disease. These people are not able to tolerate wheat, rye, barley, and even some medications and food additives in their diets. A small subset of these patients get a skin rash called dermatitis herpetiformis consisting of broken itchy red blisters on the elbows and knees and lower back. A strict gluten-free diet is essential to treat both the skin and gastrointestinal condition.
Roopal Bhatt, MD is a Dermatologist opening up her office in the Four Points Area.
For questions about this topic or others, please e-mail her at contact@fourpointsdermatology.com
