Celiac disease can cause a person to develop an itchy, blistering rash on their skin, known as dermatitis herpetiformis. Following a gluten-free diet typically resolves symptoms of a celiac disease rash.

Celiac disease is an autoimmune disorder that causes the immune system to attack gluten in the digestive tract, leading to damage in the small intestine.

An estimated 1 in 100 people have celiac disease, but as few as 30% may have received a diagnosis.

Of those diagnosed, about 10–15% will develop dermatitis herpetiformis — also known as DH, or Duhring’s disease. Experts consider DH to be the skin manifestation of celiac disease.

This article reviews celiac disease rash, symptoms, triggers, diagnosis, treatment, and more.

DH is an itchy rash often associated with celiac disease or gluten intolerance.

Though not all people with celiac develop DH, most people with DH have celiac with about 20% having a normal intestinal biopsy.

When DH occurs, it causes an itchy, blistering rash. Typically, the rash appears on both sides of the body. It often affects the forearms near the elbows, but it can also appear around the:

  • knees
  • buttocks
  • hairline or scalp

DH gets its name due to its resemblance to herpes rashes. However, the herpes virus does not cause the rash.

Consuming foods or beverages that contain gluten can trigger the release of immunoglobulin A (IgA). The body then transfers these antibodies to the skin, which binds with proteins and produces a rash.

Some foods that contain gluten include:

  • wheat
  • barley
  • soy sauce
  • rye
  • Brewer’s yeast
  • malt products, such as malted milkshakes
  • pasta
  • bread
  • croutons
  • sauces and gravies
  • crackers
  • pastries
  • flour tortillas

Multiple gluten-free products are now available for people with celiac disease or other gluten sensitivities. The Food and Drug Administration regulates the term “gluten-free” on the packaging.

To label a food gluten-free, the company must prove its product contains less than 20 parts per million of gluten.

A person may find that working with a nutritionist or other certified healthcare professional may help them develop a diet to help avoid contact with gluten and answer specific questions about their diet.

DH may run in families. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) notes that an estimated 5% of people with DH will have a first-degree relative, such as a mother or father, with DH. Another 5% may have a first-degree relative with celiac disease.

Dermatitis herpetiformis often occurs in young adults but can occur in children and older people. It is rare in Black people and those of Asian descent.

Though it can occur at any age, it tends to start in adults between 30 and 40 years. It is also more likely to occur in males compared to females.

In other cases, other autoimmune diseases may trigger DH. The most common is hypothyroidism.

Diets or medications high in iodine may also cause the rash.

A person should consider going to an experienced dermatologist for a diagnosis.

Diagnosis typically involves the use of a skin puncture. A skin puncture removes a roughly 4-millimeter patch of skin near the lesion. Doctors then apply a dye to the sample to highlight a granular IgA pattern.

The medical professional should not take the sample from the lesion since the inflammation can destroy the IgA. Doctors often mistake DH lesions for eczema.

A doctor may also order a blood test to check for antibodies. A positive skin and blood test can generally diagnose celiac disease if it has not been previously diagnosed, with no need for additional screening.

Read more about eczema vs. DH.

The primary treatment for DH is following a gluten-free diet and avoiding all products that contain gluten. The lesions will typically clear once a person starts a gluten-free diet, even if they do not have celiac disease.

For the rash, a doctor may prescribe dapsone. The rash typically responds well within 48–72 hours from the first application. In some cases, a doctor may prescribe the medication for about 1–2 years to prevent breakout rashes.

Celiac disease causes damage to the small intestine. When damaged, the body cannot absorb nutrients, leading to various health issues and complications.

Some common symptoms associated with the condition include:

Celiac disease can cause an itchy, blistering rash known as DH. While not everyone with celiac develops DH, most people with DH have celiac.

The rash will typically improve when a person follows a gluten-free diet. A doctor may also prescribe medication to help the rash clear quickly. If a gluten-free diet is not enough, a doctor may recommend continued use of dapsone or reducing the amount of iodine in a person’s diet.

Once a person removes gluten from their diet, symptoms should start to clear, and the rash will not likely return.