Mast Cells, Histamine & Your Skin

Skin Issues Because of Histamine

Mast cells are a type of white blood cell that protect the body by releasing chemical mediators, such as histamine, to fight off germs, parasites, and toxins.  Mast cells reside in many parts of the body, including the skin. In the process of protecting the body, mast cells release histamine and induce inflammation.  This process is essential for a healthy, healing body and building immunity to pathogens, but when it goes awry, it can contribute to sickness and skin conditions like Melasma, Acne, Rosacea and other skin issues.

• Acne: Because histamine causes skin irritation and inflammation, it can trigger and worsen acne breakouts.  Histamine also stimulates melanin production (darkening of skin).  This is the reason I absolutely DO NOT recommend anyone with acne seeking out the sun for acne treatment; UV exposure exponentially raises the chances of life-long acne hyperpigmentation scarring. 

• Melasma: In melasma, an increased number of mast cells (and histamine) are found in the affected skin, especially after sun exposure. When someone with Melasma gets sun, the melanocytes overproduce melanin, leaving them with dark patches of skin.  Both ultraviolet (UV) radiation and visible light (VL) from the sun contribute to this process, causing existing dark patches to deepen and new ones to form. Also, sun exposure damages skin cells and triggers inflammation, which further stimulates melanocytes to produce more pigment, creating a persistent cycle of discoloration.

• Rosacea: Mast cells and the histamine they release play a central role in the development of rosacea, influencing inflammation, vasodilation, and nerve activity. Research shows that people with rosacea have an increased number and activity of mast cells in their facial skin. Histamine released from these activated mast cells exacerbates flushing, while other released substances drive the inflammatory cascade and contribute to the development of skin thickening seen in advanced rosacea. 

• Cherry Angiomas: Mast cells also release tryptase, promoting the growth of new blood vessels (vascular proliferation) which show up on the skin as cherry angiomas or red moles.

• Eczema, dermatitis and Psoriasis: Studies have shown that histamine levels are elevated in the skin of patients with these conditions. Antihistamines have been investigated as a potential treatment, however because histamine is only one of many inflammatory mediators involved in these conditions, it’s not very effective in treating them.

Solutions for Better Skin

Diet: Consuming a low histamine diet helps dramatically reduce symptoms of histamine related skin conditions and other bodily symptoms of histamine overload.  The list of low and high histamine food is a general list; some people have higher and lower sensitivity to triggering foods and would have to do an elimination diet to find their exact triggers. 

AVOID:

• All fermented food: kefir, kombucha, Sauerkraut, yogurt, kimchi, tempeh, miso, apple cyder vinegar, some cheeses, olives, sour cream anything pickled, beer

• All aged/cured food: Aged cheeses, buttermilk, sour cream, aged/smoked/cured meats, sausage, bacon, pepperoni, wine & spirits, sourdough, vinegar, dried fruit, ALL PRESERVED FOOD (no fast food, TV dinners, left overs or boxed or canned food)

• Sea food (very high in histamine): ALL SEA FOOD, even sea food right out of the ocean has high histamine levels, but as they age, they are extremely high.

• Fruits and Vegetables: bananas, strawberries, all citrus fruit, tomato, avocado, pineapple, papaya, cherries, eggplant, spinach, squash, mushrooms

• Nuts: Walnuts, peanuts, cashews, chickpeas

• Bakery and Sweets: Chocolate, artificial sweeteners, yeast

• Spices: Allspice, anise, cinnamon, chili powder, clove, curry powder, cayenne, msg, nutmeg, paprika

• Supplements: Fish oil

ENJOY:

• Dairy & Alternatives: Pasteurized milk, butter, cream, mozzarella, ricotta, cottage, mascarpone, cottage cheese, Almond milk, Coconut milk, Rice milk and Oat milk

• Vegetables and Fruit: All but listed in “avoid”

• Protein/Meat: All fresh meat, eggs, lentils, red beans, soybeans/tofu. COOK or FREEZE RIGHT AWAY.

• Grains: Amaranth, arrowroot, buckwheat, millet, rice, quinoa

• Nuts: Almonds, Brazil nuts, Chestnuts, Coconut meat, Flax seeds, chia seeds, Hazelnuts, Macadamia nuts, Pecans, Pistachios, Pumpkin seeds, Sesame seeds, and Sunflower seeds

• Oils: Olive oil, coconut oil

• Sweets: Monk fruit, stevia, maple syrup, honey and sugar

Food Preparation

How and when you prepare and store your food is also a factor in the histamine content of a meal.  To reduce histamine in your food prep, prioritize using the freshest ingredients possible and minimize the time between cooking and eating. Histamine levels increase as food ages, and while freezing can slow this process, it does not stop it completely. You should freeze leftovers immediately, as well employing the following meal prep tips:

• Choose boiling and steaming. Studies show that boiling and steaming can decrease histamine levels, while high-heat methods like frying and grilling may increase them. An Instant Pot can also be a good option for faster cooking.

• Use low-histamine seasonings. Flavor your food with low-histamine herbs and spices, such as ginger, turmeric, oregano, and basil. Avoid spices like cinnamon, cloves, or curry powder, which are higher in histamine.

• Add "anti-histamine" foods. Incorporate ingredients that may have natural anti-histamine effects into your cooking, such as onions, garlic, apples, and blueberries. 

• Use glass or silicone containers. Use high-quality, airtight glass or silicone containers for storing prepped ingredients and frozen meals to prevent oxidation and chemical leaching from plastics.

• Cool food quickly. After cooking, cool food in small, shallow containers to reduce the time it spends at lukewarm temperatures, which promotes bacterial growth.

• Reheat frozen meals only once. Reheat frozen meals quickly, ideally straight from the freezer, and avoid reheating the same portion multiple times.

• Transport food safely. If you are taking food on the go, use an insulated bag with freezer packs to keep the temperature stable and minimize histamine increases. 

Natural anti-histamine supplements, herbs and teas:

• Supplements: Vitamin C, Bromelain, DAO enzymes, probiotics, B12, B6, Copper, Zinc

• Herbal supplements: Quercetin, butterbur, stinging nettle, mint, skullcap, turmeric, ginger, holy basil, rosemary

Anti-histamine blocker Medications

Benadryl,  provides relief from itching by inhibiting histamine's action on H1 receptors in skin tissues. These medications cause significant side effects, including drowsiness due to their ability to cross the blood-brain barrier. 

2nd generation anti-histamines are widely used to treat skin conditions like chronic hives, dermatitis and other allergic skin issues. These medications are preferred for skin conditions because they are less likely to cause drowsiness, as they do not readily penetrate the central nervous system. 2nd generation H1 histamine blockers are best for melasma because they have been shown to lessen pigment in the skin by suppressing melanin production through multiple signaling pathways.  My go-to for 2nd gen histamine blocker for skin issues is fexofenadine (Allegra), because it has fewer side effects.

3rd generation H1 blockers prevent inflammation without stopping the initial release of histamine. Third-generation H1 blockers are effective for treating skin conditions like hives and allergic reactions that cause itching and swelling. They have also been proven to help with acne and rosacea by limiting inflammation, redness and itching. Additionally, this type of medication reduces oil production in the skin, which helps reduce acne breakouts. My go-to 3rd Gen Histamine blocker for skin is Levocetirizine (Xyzal), because it has very few side effects.

H2 blockers are not the primary histamine blocker medication for skin issues, but when paired with H1 blockers, they are more effective at treating the inflammation and vasodilation that’s caused by Rosacea.  H2 blockers are medications that reduce stomach acid production by blocking histamine receptors. Famotidine (Pepcid) is my go-to H2 blocker for skin issues because it has fewer side effects.

Consult Your Physician!

This article is for informational purposes only.  Although these histamine blockers are OTC (over the counter) medications,they are still drugs and may interact with other medications or react poorly with current medical conditions.

Skincare Products if You’re Histamine Sensitive

For those with histamine sensitivity, using antioxidant rich skincare products can ease histamine symptoms of the skin.  Antioxidant skincare ingredients calm skin inflammation, alleviate redness and help strengthen barrier function.  Antioxidants can also be beneficial by neutralizing free radicals, which often trigger inflammation and lead to excessive histamine release. 

• Avoid products with ingredients that cause inflammations like: sulfates, alcohol, synthetic fragrances and lanolin. Also avoid formaldehyde-releasing preservatives like: DMDM Hydantoin, Diazolidinyl Urea, Imidazolidinyl Urea, Quaternium-15, Sodium Hydroxymethylglycinate, Bronopol.  These ingredients can strip the skin's protective barrier, cause irritation, disrupt its natural balance and/or trigger allergic reactions. 

Skincare Procedures if You’re Histamine Sensitive

There are few in-office skincare procedures that can help lessen a histamine reaction, L.E.D. Light Therapy is the #1 BEST thing you can do for inflamed, reactive skin. LED light therapy reduces skin inflammation by delivering specific light wavelengths that are absorbed by skin cells, triggering a process called photobiomodulation. Red and near-infrared lights promote circulation and reduce inflammation, while yellow and blue lights address other inflammatory conditions and bacteria. These lights interact with chromophores within skin cells, leading to beneficial cellular changes that decrease inflammation and improve skin health. 

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