How gluten intolerance skin bumps affect the skin

Here at Curology, we currently focus on the diagnosis and treatment of acne, rosacea, and anti-aging concerns. We do not treat many of the conditions mentioned in this article, namely dermatitis herpetiformis. This article is for information purposes. 

If you love bread or pasta, you’re definitely not alone. But sometimes, it doesn’t love you back—and even attacks. Dermatitis herpetiformis, (aka “gluten rash”), is a skin condition that typically affects people with celiac disease. A common symptom of gluten intolerance, skin bumps present as a blistering rash that can feel intensely itchy and very uncomfortable. Here we’ll tell you what you need to know about celiac disease, how dermatitis herpetiformis is diagnosed, and how it can affect the skin, including whether it’s linked to acne. 

What is celiac disease?

Celiac disease is an autoimmune disorder of the small intestine. Also called gluten-sensitive enteropathy, celiac disease is a condition in which the body responds to a structural protein called gluten with an inappropriate immune response. This can cause inflammation and damage in the small intestine, which may lead to poor nutrient absorption, which impacts the digestive system and overall health.¹

Gluten is a protein group that occurs naturally in grains such as rye, barley, and wheat. Gluten is found in many beloved carb-heavy foods, such as bread and pasta, but it’s also commonly found in supplements, soy sauce, beer, candy, chips, and cereal. Certain grains such as oats, corn, and rice are generally safe for people with celiac disease as long as they have not been cross-contaminated by ingredients that contain gluten. 

Up to 1% of the general population has celiac disease, and it’s becoming more prevalent over time. You’re more likely to have celiac disease if you have another autoimmune disorder, such as type 1 diabetes. There is also a genetic component, so if you have a close relative with it, your risk of developing the condition is greater.²

If you’re diagnosed with celiac disease, your healthcare provider may monitor the impact of malabsorption caused by the celiac disease by checking levels of iron, folate, ferritin, vitamin D, and other fat-soluble vitamins. They also may monitor your bone mineral density. Unfortunately, celiac disease is a chronic condition, and the only treatment (currently) is to avoid consuming gluten. 

Autoimmune diseases like celiac disease can cause the body to attack itself by mistake. This can result in the following symptoms:³

• Dermatitis herpetiformis: As we’ve discussed, this is a skin condition also caused by gluten intolerance that presents as an itchy rash.

• Anemia: Anemia, a condition in which your body lacks enough healthy red blood cells, can occur in people with celiac disease due to improper absorption of vitamin B12, iron, or folate.

• Coagulopathy: Excessive bleeding or impaired clotting can occur due to improper absorption of vitamin K.

• Osteoporosis: Celiac disease can increase the risk of osteoporosis, which is a condition characterized by weak and easily broken bones.

• Neurological symptoms: Celiac disease may result in muscle weakness, paresthesias (a tingling or prickling sensation often in the hands, arms, legs, or feet), seizures, and ataxia (poor muscle control).

• Gastrointestinal issues: Celiac disease is also associated with bloating, diarrhea, gas, abdominal pain, vomiting, or constipation.

What does a ‘gluten rash’ look like?

Gluten rash symptoms present as an intensely itchy, burning rash. The rash usually presents as erythematous (red) papules or vesicles/blisters (fluid-filled bumps). It is a chronic, autoimmune condition that typically affects extensor surfaces such as the knees and elbows. Severe itching often leads sufferers to scratch the affected area, which may puncture the blisters and leave marks on the skin.

“Gluten rash” (aka dermatitis herpetiformis) may be associated with the other symptoms of celiac disease outlined above. Depending on how it presents, “gluten rash” can also appear similar to other skin conditions such as eczema and scabies.⁴ 

“Gluten rashes” are most common among adults in their fourth decade, although children and seniors can also be affected. Dermatitis herpetiformis is more common in men, and those who develop “gluten rash” also display an increased risk of disorders such as type 1 diabetes, vitiligo, and Addison’s disease.⁵ People with “gluten rash” may also be at higher risk of developing lymphoma.⁶

How is gluten rash treated?

Significant scientific advancements have been made in diagnosing and treating “gluten rash” aka dermatitis herpetiformis. It is typically diagnosed based on a physical exam, skin biopsy, and serologic testing, a kind of blood test. A medical provider will take a blood sample to test for the presence of certain antibodies in the blood that is specific to this condition.⁷ Following diagnosis, here’s how to treat “gluten rash”:

• Following a gluten-free diet: If you’re experiencing “gluten rash”, your first line of defense and the treatment of choice is following a strict gluten-free diet. Our experts recommend consulting your healthcare provider or a dietitian. It can take your body time to respond to dietary changes, so “gluten rash” is often treated with medications as well.⁸

• Oral antibiotics: Dapsone is used for more rapid relief as your body adjusts to a gluten-free diet.⁹

• Topical steroids: Potent topical steroids may also be prescribed to keep the itchiness at bay initially, but these should not be used long-term.

How long does gluten rash last?

“Gluten rash” is a chronic condition, but remission is possible. If you follow a gluten-free diet long-term, you may be able to decrease or even discontinue oral antibiotic treatment. Studies show that adults over the age of 40 are more likely to enter remission and no longer experience the symptoms of dermatitis herpetiformis.¹⁰ 

How is gluten rash related to acne?

Acne is a common inflammatory skin condition. It can affect people of all ages, but most often teenagers and young adults, and is associated with various aggravating factors. Acne is signified by open or closed comedones (aka blackheads or whiteheads), and inflammatory lesions including papules, pustules, and cysts/nodules. Factors contributing to the development of acne include excess sebum (oil) production, bacteria (Propionibacterium acnes), and hormone fluctuation.¹¹

“Gluten rash” may be mistaken for acne in some cases because it appears as red bumps on the skin. The conditions, however, are unrelated. There is no solid evidence that gluten triggers acne breakouts or that following a gluten-free diet will help clear acne. 

What we do at Curology

Curology was founded in 2014 by board-certified dermatologist Dr. David Lorstcher, MD, to offer accessible and effective skincare. We help take the guesswork out of skin concerns such as acne, rosacea, and signs of aging.

Curology pairs members with an in-house dermatology provider, who will prescribe you a personalized prescription formula containing a mix of three active ingredients for your specific skin concerns. We use effective, high-quality, clinically researched ingredients such as tretinoin, niacinamide, and azelaic acid to help you achieve your skin goals.  

Our full line of skin care products will complete your routine, and they’re designed to be non-comedogenic, dye-free, and paraben-free. They’re made to keep your skin happy and healthy, and our team is here to answer your questions and guide you throughout your skincare journey.  

Ready to get started? Sign up for your trial today!.*

P.S. We did the homework so you don’t have to:

1. Posner EB, Haseeb M. Celiac Disease.StatPearls Publishing. (January 2022).

2. Posner EB, Haseeb M. Celiac Disease.StatPearls Publishing. Ibid.

3. Posner EB, Haseeb M. Celiac Disease.StatPearls Publishing. Ibid.

4. Caproni, M., et al. Celiac disease and dermatologic manifestations: many skin clue to unfold gluten-sensitive enteropathy. Gastroenterol Res Pract. (2012).

5. Mirza, H.A., et al. Dermatitis Herpetiformis. [Updated 2022 Aug 9]. In: StatPearls [Internet].

6. Reunala, T., et al. Dermatitis herpetiformis, lymphoma, and gluten-free diet. Journal of the American Academy of Dermatology. (1984).

7. Bolotin, D., Petronic-Rosic, V., Dermatitis herpetiformis. Journal of the American Academy of Dermatology. (2011).

8. Mirza, H.A., et al. Dermatitis Herpetiformis. StatPearls. Ibid.

9. Reunala, T., et al. Dermatitis Herpetiformis: An Update on Diagnosis and Management. Am J Clin Dermatol. (2021).

10. Mirza, H.A., et al. Dermatitis Herpetiformis. StatPearls. Ibid.

11. Zaenglein, A., et al.. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. (2016).

Elise Griffin is a certified physician assistant at Curology. She received her Master of Medical Science in physician assistant studies from Nova Southeastern University in Jacksonville, FL.

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Written by

Curology Team

Medically reviewed by

Elise Griffin, PA-C