Published January 27 2014
It’s quite common for people with thyroid and autoimmune thyroid conditions to have dry skin. But in addition to dry skin, other problems with the skin are common, such as acne, eczema, and psoriasis. Skin conditions are common in hypothyroidism and Hashimoto’s Thyroiditis, as well as in hyperthyroidism and Graves’ Disease. In this article I’ll discuss the relationship of some of the more common skin conditions with thyroid health.
Dry Skin. Although some of my patients with hyperthyroid conditions experience dry skin, this is more common in people with hypothyroid conditions. Thyroid hormone plays an important role in maintaining the health of the skin. So as the thyroid hormone levels begin to decrease, the integrity of the skin will be affected. As a result, with hypothyroidism and Hashimoto’s Thyroiditis, balancing the thyroid hormone levels usually will help with dry skin.
When someone with Graves’ Disease has dry skin, this typically is due to the autoimmune component of the condition, and not the imbalance in thyroid hormone levels (1). But many people with hyperthyroid conditions have the opposite problem, as their skin might appear to be more moist due to the excessive sweating (hyperhydrosis) which of course is a result of the increase in metabolism. In most cases, addressing the autoimmune component is the key in helping someone with Graves’ Disease who has skin problems.
Acne. Acne vulgaris is the most common skin disorder. Conventional medical treatment involves topical retinoids, topical antimicrobials, azelaic acid, oral antibiotics, and hormonal therapies (2). But to no surprise, in most cases, nothing is done to address the cause of the condition. In most cases, acne isn’t a direct result of a thyroid or autoimmune thyroid condition. Dietary factors can be huge, especially when it comes to dairy products (3) (4). So anyone with acne should completely eliminate the dairy from their diet, and in many cases this will greatly help. Hormone imbalances can also play a role in the pathogenesis of acne vulgaris (5). And of course many people with thyroid conditions have hormone imbalances. Getting back to dairy, keep in mind that this is a potential source of hormones. And while organic dairy and raw dairy won’t have growth hormone added, other hormones are still present, such as estrogens.
This isn’t to suggest that consuming dairy products is the sole cause of acne. Other factors can of course lead to hormone imbalances, thus causing acne. Insulin resistance can also be a factor, although this can also be related to dairy consumption (6) (7).
Eczema. There have been a few clinical trials which have looked at whether using dietary supplements and Chinese herbs can help with eczema. One study showed that there was no convincing evidence of the benefit of dietary supplements in eczema (8). Two randomized clinical trials showed that a mixture of Chinese herbs helped with treating eczema, but adverse effects were also reported (9). I personally have had a good amount of success dealing with eczema through dietary changes. With regards to herbs, certain herbs such as burdock and nettle leaf can also be beneficial in some cases.
Vitiligo. Vitiligo is an acquired skin depigmentation, and results from an autoimmune process directed against the melanocytes (10). There does seem to be a correlation between vitiligo and autoimmune thyroid disease (11). Vitiligo in autoimmune thyroid disease was most frequently found on dorsum hands and forearms, and usually preceded the onset of thyroid disease (11)(12). Because vitiligo is usually present before the development of a thyroid or autoimmune thyroid condition, it makes sense to run a test for thyroid antibodies in people with vitiligo. Although suppressing the autoimmune component is a key factor in helping people with vitiligo, there is some evidence that Ginkgo biloba can benefit people with this condition (13) (14).
Pretibial Myxedema. This occurs in some people with Graves’ Disease. This doesn’t only occur around the pretibial area, but it also can spread to other parts of the body, such as the ankle, dorsum of the foot, and even the elbows, knees, neck, and upper back (15). It occurs in up to 5 percent of patients with Graves’ disease and 15 percent of patients with Graves’ disease ophthalmopathy (16). Pretibial myxedema results from the accumulation in the dermis of glycosaminoglycans (GAG), especially hyaluronic acid, secreted by fibroblasts under the stimulation of cytokines, which arise from the lymphocytic infiltration (16). I’ve worked with some people who had pretibial myxedema, and I’ve had a good amount of success when having them improve their diet, eliminate common allergens such as gluten and dairy, and by addressing the autoimmune component of the condition.
Psoriasis. Some people with thyroid and autoimmune thyroid conditions have psoriasis. This is a common skin condition which causes skin redness and irritation (17). It has been suspected for many years that psoriasis is an autoimmune condition (18) (19) (20), although this still remains controversial. With that being said, addressing the autoimmune response in people with Graves’ Disease and Hashimoto’s Thyroiditis does seem to help with psoriasis. There also seems to be a relationship between H. Pylori and psoriasis (21) (22), and thus anyone with psoriasis should be tested for the present of this pathogen.
Rosacea. This is also known as “acne rosacea”, and it’s a chronic skin condition that makes your face turn red and may cause swelling and skin sores (23). Although rosacea might be associated with acne vulgaris, the two conditions are different. Some recommend treating this condition with beta blockers, such as atenolol (24). I personally would try to address this through diet, taking some natural supplements and herbs for inflammation (i.e. fish oils, turmeric, etc.), and of course for those people with Graves’ Disease and Hashimoto’s Thyroiditis I would address the autoimmune component. There also seems to be a correlation between acne rosacea and H. pylori (25).
Lichen Planus. Lichen planus is a chronic, inflammatory, autoimmune disease that affects the skin, oral mucosa, genital mucosa, scalp, and nails (26). As is the case with many other skin conditions, corticosteroids are commonly recommended by medical doctors. There’s not much evidence about the role of diet and supplements, although just as is the case with most other skin conditions I would have the person clean up their diet and take certain supplements. Green tea might also be beneficial in people with oral lichen planus (27). There does seem to be a correlation with oral lichen planus and thyroid conditions, especially with hypothyroidism and Hashimoto’s Thyroiditis (28) (29).
Urticaria. Chronic urticaria is defined by the presence of hives on most days of the week, for a duration of longer than six weeks (30). There does seem to be a significant association between chronic urticaria and thyroid autoimmunity (31) (32). The conventional medical treatment method usually involves using antihistamines, or the use of high-dose hydroxyzine or diphenhydramine when the antihistamines are ineffective, supplemented by H-2 antagonists and leukotriene antagonists (33). Severe cases may require treatment with low doses of steroids or cyclosporine (33).
In summary, skin conditions are quite common in people who have hypothyroidism and Hashimoto’s Thyroiditis, as well as those people with hyperthyroidism and Graves’ Disease. Although the imbalance in thyroid hormone can be responsible for the skin condition in some cases, many times the autoimmune response is what’s responsible for the skin condition. And as I mentioned in this article, sometimes the skin condition develops before the thyroid or autoimmune thyroid condition. Either way, the goal should be to eat a healthy diet consisting of whole foods, take supplements to help with the inflammation, and focus on suppressing the autoimmune component of the condition.