Exploring Eczema in Filipino-Americans: Science, Causes, and Holistic Healing
A comprehensive, holistic look at eczema for Filipino-Americans
Eczema is a chronic condition that affects millions worldwide, but for Filipino-Americans, the prevalence and underlying causes may not always be as well-understood.
Through my work with Filipino-American patients in Los Angeles as a licensed naturopathic doctor and an in-depth look at scientific research, I've gained valuable insights into how eczema uniquely impacts this community.
In this post:
I’ll explore the findings from past and recent studies on eczema prevalence and risk in Filipino-Americans.
I’ll delve into what scientific research reveals about what causes eczema.
I’ll share what I’ve witnessed in my own practice: How addressing the root causes of eczema through holistic medicine could offer longer-lasting relief.
DISCLAIMER: THESE STATEMENTS HAVE NOT BEEN EVALUATED BY THE FOOD AND DRUG ADMINISTRATION. THIS POST DOES NOT CONSTITUTE AS MEDICAL ADVICE; IS NOT MEANT TO DIAGNOSE, PREVENT, TREAT, OR CURE ANY CONDITIONS OR DISEASE; AND IS MEANT FOR EDUCATIONAL PURPOSES ONLY. THE INFORMATION IN THIS POST DOES NOT REPLACE OR SUBSTITUTE THE ADVICE OF YOUR MEDICAL PROVIDER. SPEAK TO YOUR DOCTOR BEFORE STARTING ANY NEW TREATMENTS OR SUPPLEMENTS OR BOOK YOUR APPOINTMENT WITH ME TODAY.
The Numbers: Rate and Risk of eczema in Filipino-Americans
Eczema is a common concern within the Filipino-American community. Many of us either experience it ourselves or know someone who does. I’m among one of those affected, having struggled with eczema throughout childhood and early adulthood.
While eczema is widely spoken about amongst Filipinos, there is surprising research about Filipino-American eczema prevalence and risk. Here’s what scientists found:
2025 study: Filipino-Americans had the highest overall prevalence of eczema (specifically atopic dermatitis) at 12.5% out of 286,240 subjects in Northern California.
2024 study: Out of all Asian-American groups, Filipino-Americans had "higher prevalence of all allergic disease", with atopic dermatitis being one of them.
2021 study: Filipino-Americans had highest risk of eczema at 51% higher odds compared to other Asian-Americans.
1999 study: Filipino-Americans had the highest prevalence of eczema amongst other ethnicities in the San Diego area at 8.5%.
The data is striking, and shows that Filipino-Americans have the highest prevalence of eczema compared to other ethnicities and have the highest risk of eczema compared to other Asian-American groups.
So, WHY do Filipino-Americans’s have the highest prevalence and risk? Keep on reading to learn more.
The Complex causes behind eczema simplified
Plain and simple: The exact cause of eczema is still not fully understood, and scientists suggest that the cause of eczema could be multi-factorial. That means that there are several factors linked to the development of eczema that researchers discovered.
Scientists suggest that a combination of genetics and environmental factors play roles in eczema. So, let’s break it down and talk about genetics and the environment.
@drbryant.nd Replying to @ChocoTaco More eczema info & tips for Fil-Am’s: 1- Genetics: While the exact cause of eczema is not fully understood, literature suggests that the environment and genes for immune function and skin barrier function are contributing factors. 2- Chemicals: Researchers suggest that filaggrin gene mutations that disrupt skin barrier function may increase susceptibility to skin irritation from chemical exposures, with some chemical exposures spoken about including soaps, fragrance, and nickel. 3- Weather: Scientists found that weather that is too hot, too humid, or too cold exacerbates eczema through different suggested mechanisms that ultimately irritate eczema skin. 4- Nutrition & gut-skin axis: Data suggests that short chain fatty acids & dietary fiber may play supportive roles in skin barrier function. 5- Stress-skin axis: Research suggests that stress triggers the release of neuropeptides that may trigger itch. ➡️Want more info? On my page, you can find more info - I share more eczema info in a past post for Fil-Am’s in honor of Filipino American History Month & Eczema Awareness month. Check that out on my page when you have time. Disclaimer: This post does not constitute as medical advice; is not meant to diagnose, prevent, treat, or cure any conditions or disease; and is meant for educational purposes only. The information in this post does not replace or substitute the advice of your medical provider. Speak to your doctor before starting anything new. ## References: 1. Akbar A, Shreenath AP. High Fiber Diet. 2023 May 1. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 32644459. 2. Akdis CA, Akdis M, Bieber T, Bindslev-Jensen C, Boguniewicz M, Eigenmann P, Hamid Q, Kapp A, Leung DY, Lipozencic J, Luger TA, Muraro A, Novak N, Platts-Mills TA, Rosenwasser L, Scheynius A, Simons FE, Spergel J, Turjanmaa K, Wahn U, Weidinger S, Werfel T, Zuberbier T; European Academy of Allergology and Clinical Immunology/American Academy of Allergy, Asthma and Immunology. Diagnosis and treatment of atopic dermatitis in children and adults: European Academy of Allergology and Clinical Immunology/American Academy of Allergy, Asthma and Immunology/PRACTALL Consensus Report. J Allergy Clin Immunol. 2006 Jul;118(1):152-69. doi: 10.1016/j.jaci.2006.03.045. Erratum in: J Allergy Clin Immunol. 2006 Sep;118(3):724. PMID: 16815151. 3. Bae BG, Oh SH, Park CO, Noh S, Noh JY, Kim KR, Lee KH. Progressive muscle relaxation therapy for atopic dermatitis: objective assessment of efficacy. Acta Derm Venereol. 2012 Jan;92(1):57-61. doi: 10.2340/00015555-1189. PMID: 21879233. 4. Baker P, Huang C, Radi R, Moll SB, Jules E, Arbiser JL. Skin Barrier Function: The Interplay of Physical, Chemical, and Immunologic Properties. Cells. 2023 Nov 30;12(23):2745. doi: 10.3390/cells12232745. PMID: 38067173; PMCID: PMC10706187. 5. Bhimla A, Yap L, Lee M, Seals B, Aczon H, Ma GX. Addressing the Health Needs of High-Risk Filipino Americans in the Greater Philadelphia Region. J Community Health. 2017 Apr;42(2):269-277. doi: 10.1007/s10900-016-0252-0. PMID: 27639868; PMCID: PMC5337442. 6. Chan J, MacNeill SJ, Stuart B, Lo YTE, Roberts A, Mitchell D, Ridd MJ. Do temperature changes cause eczema flares? An English cohort study. Clin Exp Dermatol. 2023 Aug 25;48(9):1012-1018. doi: 10.1093/ced/llad147. PMID: 37130096. 7. Ghimire S, Cheong P, Sagadraca L, Chien LC, Sy FS. A Health Needs Assessment of the Filipino American Community in the Greater Las Vegas Area. Health Equity. 2018 Nov 27;2(1):334-348. doi: 10.1089/heq.2018.0042. PMID: 30506015; PMCID: PMC6263856. More references in comments. The caption is too long. #eczema #eczemaawareness #filipinoamerican #naturopathicdoctor ♬ original sound - drbryant.nd
Eczema genetics & Filipino-Americans
Eczema, specifically atopic dermatitis, is considered to be an issue that involves allergy/immune activity and an impaired skin barrier.
According to scientists, there are several genes that impact immune response and skin barrier function linked to eczema:
Immune response: Researchers found that there are several genetic mutations linked to aberrations in immune cell function that are linked to eczema.
Skin barrier: The skin barrier is the skin’s outermost protective layer that is meant to keep skin hydrated. Beyond skin cells, there are proteins that these cells make to keep skin hydrated, specifically with a protein called filaggrin. And, researchers found that filaggrin gene mutations that reduce the protein in the skin has been linked to eczema.
Now, is there research about Fil-Am eczema genetics?
The truth is: No. There is currently no research about Filipino-American eczema genetics. While there isn’t any research about this, it’s hard to say that there isn’t a genetic component in some Fil-Am’s with eczema.
In October 2024, I shared a post about Filipino-American and eczema on TikTok. In that post, I received comments from Filipinos who spoke about their own struggles with eczema and how they also have family members who struggle with it. Those comments signaled to me that genetics could play a role in some Filipinos with eczema.
Given these gaps and the disproportionate risk and prevalence of eczema that Filipinos face, hopefully more research comes out about genetics and eczema.
While genetics are important to consider when it comes to eczema, environmental exposures are critical to look at to. Keep on reading to learn about eczema and the environment.
Eczema and the Environment
As mentioned earlier, researchers suggest that that genetics and the environment may play contributing roles in eczema.
Now, let’s explore environmental factors, especially the ones I commonly hear Filipino-Americans talk about:
Chemicals
Climate/weather
Food/gut health
Stress
Chemicals from the environment
The first thing most people think about when it comes to environmental exposures and eczema is chemicals. Here’s what scientists found:
Scientists discovered that people with both eczema and filaggrin gene mutations have a higher risk of developing skin irritation and inflammation from chemical exposures.
Researchers suggest that chemicals found in soaps can irritate eczema skin. Other research suggests that chemicals, like fragrance, can irritate skin.
So, having a gene mutation with the skin barrier protein filaggrin increases risk of skin irritation, and there are several chemicals in the environment that can irritate skin.
Climate and weather
Do weather changes trigger your eczema?
I’ve heard some people say that cold weather triggers their eczema, while others say that humid weather does it. Here’s what researchers found:
Cold weather: One study found that people had higher eczema symptom scores in colder months, and had lower symptoms score in warmer months. Authors of that study suggest that colder temperatures contribute to decreased skin hydration via transepidermal water loss.
Humid weather: Scientists discovered that higher temperature, higher daily sun exposure, and higher humidity were all associated with poorer control of eczema. Those scientists suggest that sweating caused by warm and humid weather may irritate skin to play a role in poorer control of eczema.
The data appears to be conflicting, with one study showing that cold weather worsens eczema while another study showing that warm, humid weather does so too.
While the findings are conflicting and confusing, what is clear to me is that eczema skin appears to be sensitive to extreme ends of weather.
Food, nutrition, and gut health
Have you ever suspected that food and gut health might be impacting your eczema?
Most don’t think of food as an environmental exposure, but it is! There’s interesting science about how food, the gut, and eczema are linked to each other. Here’s what scientists found:
One study from 2021 found that higher intake of dietary fiber was linked to lower prevalence of allergy-related issues, like eczema.
A study from 2022 found that a high fiber diet supported skin barrier function in eczema-like skin inflammation through gut microbiome byproducts made from fiber, called short chain fatty acids.
A 2015 study reported that people with eczema have fewer beneficial gut bacteria that produce short chain fatty acids.
In another 2015 study, researchers found that lower level of short chain fatty acids occurs before onset of eczema in human subjects.
When looking at other gut issues linked to eczema, one study from 2021 discovered that people with constipation have a “2.31-fold greater risk” of eczema and another study found that irritable bowel syndrome (IBS) is linked to eczema.
So, these findings suggest that there’s a connection between eczema, food, and the gut. And, it seems like dietary fiber and gut microbiome-produced short chain fatty acids are important to consider when thinking about the gut-eczema connection.
Dietary fiber is commonly found in fruits, vegetables, and other edible plants. So, are Filipino-Americans getting enough of these foods? Here’s what scientists found:
One study showed that 99.5% of Fil-Am’s in the Philadelphia area did not meet the recommended dietary guidelines of at least 4-5 servings of fruits and vegetables per day.
Another study reported that less than 3% of Fil-Am’s in the Las Vegas region got the recommended amount of fruits and vegetables per day.
A study found that 90.3% of Filipino-Americans in California did not meet the fruit and vegetable consumption recommendation.
While the research on Filipino nutrition is limited, data suggests that Filipino-Americans are probably not getting enough fruits and vegetables a day.
Stress and eczema
Do you ever find yourself scratching your skin more when you’re stressed?
Scientists suggest that stress may trigger eczema flares by causing spontaneous scratching behavior in people with eczema. While the biochemical pathways are complex, a 2021 review suggests that stress makes skin itchier because of the release of neuropeptides during stressful moments.
When it comes to stress and mental well-being in the Filipino-American community, Fil-Am’s may not seek for professional mental health help despite facing high psychological stress.
A 2022 study found that there were several barriers that deterred Filipinos from seeking professional mental health help, such as “logistical barriers (i.e., immigration status, lack of health insurance, language difficulties) and culturally specific barriers (i.e., social stigma, shame, concern for loss of face, and adherence to Asian values).”
Holistic Approaches for Filipino-Americans
For many Filipino-Americans, the struggle with eczema goes beyond the surface. As mentioned so far, it's a reflection of deeper imbalances influenced by genetics, environment, diet, and stress. Because of their frustrations with repeat flares, many Filipino-Americans see me aiming to stop that cycle.
While conventional treatments often focus on topical relief, a holistic approach considers the unique cultural, dietary, and biological factors that may contribute to flare-ups in the Filipino community, which may end up offering more sustainable, long-term healing.
A holistic approach means 2 things:
Seeing the skin as a reflection of overall health
Identifying and addressing the root causes of someone’s symptoms
So, when it comes to holistic eczema care for Filipino-Americans, it’s crucial to explore how inner imbalances are affecting their skin and then addressing those root issues. Let’s talk more about this below.
Gut-skin axis healing
While root causes are unique from person-to-person, I commonly see that the gut plays a pivotal role in many of my Filipino-American patients. Recalibrating the gut in my Filipino-American patients is unique since there are special cultural considerations that come alongside gut health, such as food.
As a Filipino-American, I recognize how important food is to our community. From how Filipino food defines what being Filipino is to how food brings together friends and family, food is more than just food to Filipinos. It’s how we bond and show our love.
So, it’s crucial to be intentional what I suggest to patients so that they can start to heal their skin from within without alienating themselves.
Recalibrating the gut: Nutrition, Gut microBiome, and Testing
Recalibrating the gut starts with nutrition and looking at the gut biome. As mentioned earlier, researchers found that people with eczema have fewer beneficial bacteria that produce short chain fatty acids and that IBS and constipation are linked to eczema.
Because of the gut-eczema link, I speak to many of my Filipino-American patients about 2 things:
Foundational gut support that includes culturally-relevant nutrition modifications.
Targeted gut support that involves gut microbiome lab testing for more-personalized approaches.
When it comes to nutrition, many of my Filipino-American patients are surprised about the number of Filipino-friendly food options that are gut-supportive. When it comes to targeted gut support, the gut microbiome lab test helps gauge which specific gut bacteria populations need to be addressed.
Given the results of someone’s gut microbiome lab test, there are several natural approaches that could be suggested, like:
Targeted probiotic strain supplementation
Focused prebiotic supplementation
Herbal medicine
And more
Now, there are instances when someone’s gut test results and symptoms suggest that natural medicine are not enough. Since I am not able to prescribe pharmaceuticals due to limitations of scope of practice for licensed naturopathic doctors in California, I can refer to a provider who can prescribe.
Beyond supporting the gut directly, I also aim to support it holistically. By that, I mean looking at the other factors impacting the gut that should also be addressed. Within the context of Filipino-Americans, there are unique factors that could influence the gut, like blood sugar health and stress.
Approaching the Stress-eczema axis
A large percentage of my Filipino-American patients tell me that stress triggers their eczema. Conversations about stress triggers and stress coping strategies are crucial. There are several natural approaches to promote stress resilience, such as with lifestyle medicine, herbal medicine, and more. But, there are instances when these approaches alone are not enough.
Depending on someone’s level of acculturation, they may have different attitudes about how they want to approach their stress and mental well-being. And, there are instances when I speak to my patients about how having a professional healthcare team to support their stress resilience and mental health would be worthwhile.
More root factors influencing eczema
While we focused on gut health and stress, they’re only part of the bigger picture. Eczema can also be influenced by factors like iron deficiency, nutrient imbalances, and even daily skincare choices (as mentioned earlier).
In my practice, I look at each of those pieces and how they intersect with your lived experience, including cultural factors that shape your health. For Filipino Americans, these nuances matter, and they need to be part of the conversation.
That’s why I approach each patient as an individual, working to uncover what’s really driving their symptoms. Because at the end of the day, root-cause healing doesn’t just put out fires, it builds a foundation for lasting health.
If your eczema keeps flaring, it’s not random. It’s your body asking for deeper support. Your body is doing its best with what it has, but it might need more. I offer holistic, root-cause eczema care in Los Angeles that looks beyond the surface and addresses what’s driving your symptoms.
You can find me at The Things We Do in Downtown Los Angeles. When you're ready to break the cycle, book your appointment below.
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