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Celiac Disease, Gluten and the Skin

Celiac is the Greek word for "bellyache."


Celiac is a disease that affects up to 1 in 100 people that cannot tolerate gluten. It is thought to be a genetic autoimmune disorder; and it is seen in higher rates in Caucasian females. 1 2 3


Gluten is a protein found in wheat, barley, and rye. It can also be found as a trace contaminate in other grains such as oats, as well as excipient ingredients derived from whole grains, grain flour and starch grain.4

Dermatitis herpetiformis

People with celiac disease or dermatitis herpetiformis (a form of celiac disease that affects the skin) are unable to consume gluten because it destroys the lining of their small intestine and therefore poor nutrient absorption results. The only treatment for celiac disease is the avoidance of consuming or ingesting the gluten protein.5

Dermatitis herpetiformis is a skin manifestation of celiac disease that mainly affects the elbows, knees, and scalp. It only affects about 1 in 4 people with celiac disease but can be mistaken for other more common skin disorders such as eczema, psoriasis, or other dermatitis.3

Dermatitis herpetiformis even after a gluten-free diet may take a period of time to resolve, and a follow up with your health care provider is imperative if other treatment is necessary.4

Gluten, being a protein, is a large molecule; in fact so large that it cannot be absorbed through the skin. Theoretically, if the gluten protein is not ingested it should not be problematic to celiac disease sufferers.

However, regardless of gluten’s large size, many people report reactions to topical products that are made with these proteins. They may be inadvertently ingested in products like lip balm or toothpaste. They may even be transferred to food from hands that have lotions or creams on them and subsequently ingested.4

Gluten-free skin care

We at Pharmaceutical Specialties, Inc. (PSI) have tested all of our products and to date we can safely say the presence of gluten was not detected using our testing methods. We consider our products "Gluten-Free" based on the FDA proposed guidelines in foods labeled gluten-free.6 If you suffer from celiac disease, we encourage you to learn more about our gluten-free skin care, and gluten-free hair care products.

The information included in this article is for educational purposes only. It is not intended, and in no way implies, to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition, diagnosis or treatment plan.


1 Maher KJ. Against the grain: a celiac disease review. MLO Med Lab Obs 2008;40:22,24-5.

2 American Gastroenterological Association. AGA Institute Medical Position Statement on the Diagnosis and Management of Celiac Disease. Gastroenterology 2006;131:1977-80.

3 Binder HJ. Disorders of Absorption. In: Kasper DL, Braunwald E, Fauci AS, et al., Eds. Harrison’s Principles of Internal Medicine, 17th edition.

4 Mangione RA, Patel PN. Caring for patients with celiac disease: the role of the pharmacist. J Am Pharm Assoc (2003) 2008;48:e125-e139.

5 Anon. What is celiac disease? American Society of Health-System Pharmacists. August 4, 2009).

6 FDA Proposed Rule-72 FR 2795, January 23, 2007: Food Labeling; Gluten-Free Labeling of Foods. Federal Register, 72 (14);2795-2817, 2007.

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