Ep 401 – The Rogue Pharmacist: Allergies, Histamine, and Mast Cells

Summary

Podcast Summary: ASCP Esty Talk – Ep 401

Episode Title: The Rogue Pharmacist: Allergies, Histamine, and Mast Cells
Release Date: June 19, 2026
Host: Maggie Stasik (ASCP Program Director)
Guest: Ben Fuchs (Pharmacist, Skincare Formulator)

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Episode Overview

This episode dives deep into how allergies—especially those linked to histamine and mast cells—not only affect our respiratory system but significantly impact the skin. The conversation emphasizes the systemic nature of histamine responses, explores the digestive connection to skin flares, and provides practical advice for estheticians and individuals prone to allergies, rashes, and sensitive skin. Estheticians are guided on both internal and topical approaches for sensitive clients during allergy season.

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Key Discussion Points & Insights

1. The Role of Histamine and Mast Cells in Allergic Reactions

• Histamine as an Immune Modulator:

  • Histamine is primarily produced by mast cells and plays a critical role in activating and directing the immune response.
  • "Histamine is associated with vasodilation and itchiness and secretions." (Ben, 01:25)

• Digestive System Link:

  • Histamine is not just about respiratory allergies; a substantial source comes from the gut, especially with conditions like dysbiosis or leaky gut.
  • Seasonal allergies often reflect cumulative immune load rather than isolated triggers.

• Immune Load Concept:

  • The body can only tolerate so many immune activators before symptoms appear. Often, it’s not the pollen alone, but the accumulated internal histamine that leads to a visible or felt reaction.

2. Skin Manifestations of Histamine Responses

• Common Skin Symptoms:

  • Redness, rosacea, vasodilation, telangiectasia, itchiness, rashes, and even reactions to the sun or physical pressure (e.g., bra straps).
  • “If you find yourself getting red, rosacea red, or vasodilation or telangiectasia or itchiness or rashes ... it may have more to do with digestive health than it has to do with anything in the environment.” (Ben, 02:15)

• Histamine 'Party Trick':

  • "If you have high histamine levels, you can sign your name with your fingernail in your skin ... that's called dermographia." (Ben, 05:15)
  • Shows how reactive the skin can become in high histamine states.

3. Common Histamine Triggers in Food & Environment

• High-Histamine Foods:

  • Citrus fruits, fermented foods, leftovers, deli meats, avocados, bananas, tomatoes, shellfish.
  • "Those are good foods ... but they can be histamine activators or they can contain histamine." (Ben, 03:15)

• Surprising Triggers:

  • Physical stimuli (heat from showers, sun exposure, pressure from clothing).
  • Certain probiotics: "Sometimes probiotics ... can induce a histamine response." (Ben, 09:50)

4. Mast Cell Activation Syndrome (MCAS)

• What Is MCAS?
  • A condition where mast cells become destabilized, releasing histamine excessively, leading to reactions to numerous, often unrelated, triggers.
  • “It’s an internal mast cell issue where the mast cells are destabilized by something that you’re putting in your system.” (Ben, 04:30)

5. Hormonal and Enzymatic Influences

• DAO Enzyme and Estrogen:

  • Diamine oxidase (DAO) breaks down histamine. Women's DAO levels drop as estrogen fluctuates (e.g., during menopause), increasing histamine reactions.
  • "As a woman's estrogen fluctuates, her DAO levels drop and she's going to be more prone towards a histamine response." (Ben, 05:35)

• Topical Remedies and Considerations:

  • Use of topical antihistamines (melatonin, zinc, vitamin C, cannabinoids).
  • Avoid highly stimulating actives (retinoids, AHAs) during flare-ups.

6. Practical Tips for Managing Histamine-Related Skin Issues

• General Recommendations:

  • Address underlying digestive health—“Always, always, always a good idea if you have a skin problem ... to link it to foods and look at the digestive issues.” (Ben, 06:55)
  • Use natural antihistamines: vitamin C, zinc, quercetin, cannabinoids, melatonin, phospholipids.
  • Consider DAO supplements, especially for women in perimenopause/menopause.

• For Estheticians:

  • Be judicious with stimulating treatments if clients are reacting or in a heightened histamine state.
  • "You can also use topical antihistamines, topical melatonin, topical zinc, topical vitamin C ... but it's mainly a blood problem ... work on the digestive system." (Ben, 10:30)
  • Help clients develop personalized food diaries to track and associate symptoms with specific foods, since even “good foods” can trigger responses.

7. Broader Health Implications

• Histamine as a Brain Chemical:
  • Antihistamines can cause drowsiness and, with prolonged use, are linked to higher dementia risk among older adults.
  • “People who use ... antihistamines are more prone towards dementia.” (Ben, 07:10)
  • Some antipsychotic drugs also interact with the histamine system.

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Notable Quotes & Memorable Moments

• On the Skin-Gut Connection:

  • "It's always, always, always a good idea if you have a skin problem or any real, really any health problem to link it to foods and look at the digestive issues." (Ben, 06:55)

• On Food Triggers:

  • "The problem with good foods and bad foods ... is a classic example of why you have to do a food diary and you have to associate your particular problems with specific foods." (Ben, 12:35)

• On Estrogen/Hormone Shifts and Skin:

  • “When your estrogen starts to drop, your DAO levels will decrease as well and you'll be more prone towards histamine reactions.” (Ben, 07:57)

• On MCAS:

  • "It's a mast cell issue more than it is the allergic triggers ... the mast cells are destabilized by something that you're putting in your system." (Ben, 04:25)

• On Allergic Responses as a Circulatory Issue:

  • “You don't want to consider it to be a skin or respiratory problem as much as you want to be considering it a circulatory problem ... getting into the bloodstream, usually through a leaky gut...” (Ben, 08:45)

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Important Timestamps

• 01:18 – Histamine’s role beyond classic allergies; immune modulation and gut connection
• 03:00 – Foods contributing to/exacerbating histamine issues
• 05:15 – Dermographia as a sign of high histamine
• 05:35 – DAO, estrogen fluctuation, and female sensitivity to histamine
• 07:10 – Histamine’s role in the brain and cognitive risks of antihistamines
• 09:20 – Circulatory vs. localized histamine responses
• 09:50 – Probiotics as potential histamine triggers
• 10:30 – Esthetician guidance: balancing topicals and internal strategies
• 11:17 – Mast cell behavior during allergic response; link to foods like bananas, tomatoes
• 12:35 – Food diaries and individual triggers

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Takeaways for Estheticians and Listeners

• Think Systemic: Many skin reactions have roots in gut health and immune load, not just topical or environmental exposures.
• Personalization is Key: “Good” foods can be triggers—encourage clients to keep food/symptom logs.
• Approach Flares Carefully: Limit stimulating skin treatments during allergy/histamine flares.
• Support Internally & Topically: Combine digestive support, nutritional antihistamines, and gentle topical care to help allergic clients.
• Educate on Supplements and Diet: DAO and vitamin C play central roles; awareness can make a big client impact.

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For more information or to connect with Ben Fuchs:
Visit truthtreatments.com or check the episode show notes.

Transcript

[A]

If you're an esthetician, you know how frustrating it is when clients don't return consistently. Stop using software built for salons and start using Spa Sphere. Spa Sphere is built specifically for estheticians with simple tools like treatment plans and skin reports that get clients to come back. It helps you turn one time appointments into loyal regulars so your clients get better results and you make more from every session. ASCP members can try it for $1 for 90 days at Spa Sphere. AI ASCP. Hello and welcome to ASCP and the Rogue Pharmacist with Benjamin Nightfoux. In each episode, we'll explore how internal and external factors can impact the skin. I'm Maggie Stasik, ASCP's program director. And joining me is Ben Fuchs, skincare formulator and pharmacist. Hi, Ben.

[B]

Hello, Maggie. Good to see you.

[A]

Good to see you. With allergy season in full swing, can you walk us through how histamine mast cells and allergic responses aren't just something we feel in the sinuses, but are actually influencing what we see in the skin?

[B]

Oh, yeah. Histamine is a major immune modulator. It is produced by mast cells, as you mentioned. In fact, let me just say this real quick. Mast cells line the intestine and under conditions of dysbiosis, changes in bacteria, leaky gut, et cetera, mast cells can release histamine into the blood and you can be off to the histamine races. Histamine is associated with vasodilation and itchiness and secretions. Basically, histamine is a molecule that makes the immune system more active or makes the immune system stronger. So it's, it tells the immune system to work. That's why you get the opening of the blood vessels so the white blood cells can get to the area. That's why you get secretions, like tear secretions and respiratory secretions. So the body can kind of wash things away. It basically activates the immune system. When people think of histamine, they usually think of seasonal allergies, which is true, those will activate histamine. But people don't realize that histamine is largely in many ways a digestive system and an immune system chemical that is secreted into the blood through the digestive system, through the intestine specifically. So if you have histamine reactions to pollen, for example, it may have less to do with pollen than it has to do with immune load. And this concept of immune load is like the straw that breaks the camel's back. So you can have a certain amount of Immune activators, and the body can handle them. So pollen, for example, you can have a certain amount of pollen. But if your body's being bombarded with histamine internally through the digestive system, and now a little bit more histamine comes into the system through pollen, it may look like it's the pollen that's causing the runny nose and the itchiness and the rashiness and the vasodilation, et cetera, when it's really the accumulation of histamine that's being secreted into the bloodstream through the digestive tract. So if you do have seasonal allergies, for example, you may want to work on digestive histamine. And if you find yourself getting red, rosacea red, or vasodilation or telangiectasia or itchiness or rashes or. Or respiratory secretions, it may have more to do with digestive health than it has to do with anything in the environment. And so working on the digestive system is always the most important thing that you could do. And also keeping in mind that there are foods that are histamine activators, for example, and some of them are good foods. Citrus fruit, citrus, for example, can activate histamine. Fermented foods contain histamine. Leftovers, deli meats, avocados. You know, you think these are good foods, which they are good foods, but they can be histamine activators or they can contain histamine. So really, if you have these kinds of responses, whether they're seasonal allergy responses or just random responses, you know, there are people who have histamine issues who will be allergic to the sun. Have you heard of this? People get rashes from the sun. You say, what the heck? How do you get a rash in the sun? Well, that is a histamine response. There are people who. Women who will get rashes around their bra strap. Histamine response. You know, there's a little party trick you can do. If you have a histamine response or you have high histamine levels. You can sign your name with your fingernail in your skin. And where you signed your name will kind of be. It'll be a rash will occur and you'll see your signature in your skin. That's called dermographia, and that is a histamine response. There are people who get histamine response from showers, from hot showers. So if you find yourself reacting, or sometimes people say, I react to everything, everything I put on my skin makes me break out. That kind of thing. Almost always there's some kind of histamine issue going on. In fact, the cells that make histamine, the cells that store the histamine, are called mast cells. As you mentioned today, there's a condition called mcas. Have you heard of this? It's called mast cell activation syndrome. And this is the, the phenomena where you're allergic to everything. And what it is, it's a mast cell issue more than it is the allergic triggers. It's an internal mast cell issue where the mast cells are destabilized by something that you're putting in your system. Another very interesting aspect about mast cells and histamine is there's a molecule in the body that breaks down histamine. It's called DAO diamine oxidase. And as your estrogen flu or as a woman's estrogen fluctuates, her DAO levels drop and she's going to be more prone towards a histamine response. Which is why sometimes women, when they go through menopause or perimenopause will get very sensitive skin, they'll get rosacea, they'll have vasodilation issues, seemingly allergy issues, which are really histamine issues that are secondary to a decrease in their metabolizing, their histamine metabolizing enzymes. So if this happens to you, you can actually buy DAO on the Internet or in health food stores. Diamine oxidase. And that's usually a good idea. There are also natural antihistamines. You know, cannabinoids have natural antihistamine properties. So not necessarily smoking pot or anything, but. Or you could, I suppose, but you could do CBD or cbn. You know, non psychoactive cannabinoids. Zinc has natural antihistamine properties. Melatonin has natural antihistaminic properties. Quercetin has natural anti histamine properties. Phospholipids can act like natural antihistamines. Zinc, zinc is a natural antihistamine. Vitamin C, of course, is a very, very important antihistamine fact. That's one of the most important. And you can, it's always a good idea to increase your vitamin C. So these are all strategies you can use if you're exhibiting a histamine response using digestive health strategies. So it's always, always, always a good idea if you have a skin problem or any real, really any health problem to link it to foods and look at the digestive issues. And then one more thing. Histamine is a brain chemical. I don't know if You've, you know, I. About a year ago, two years ago, there was a study that came out that talked about people who use, about older people who use antihistamines are more prone towards dementia. Did you ever. Benadryl? Yeah.

[A]

Oh, yeah, I did hear that about Benadryl, yeah.

[B]

Yes. That's because histamine is a brain chemical. In fact, a lot of antipsychotics work with the histamine system and psychosis is associated with histamine. And we know drowsiness or excess stimulation is associated with histamine. And one of the side effects, the common side effects of antihistamines is drowsiness. So much so that antihistamines are actually used as sleeping pills, um, or drugs that affect histamine, we'll say can be used as sleeping pills. Benadryl being, being the classic.

[A]

So I know that there are people who will go most of their life till middle age, no allergies whatsoever.

[B]

Estrogen. There you go. Yeah, yeah, that happens a lot. You go through your life perfectly fine and then when your estrogen starts to drop, your DAO levels will, will decrease as well and you'll be more prone towards histamine reactions. Also, digestive health issues can be cumulative. So you may be able to get away with things when you're younger, but as you age and that connective tissue starts to, and the mucosa starts to break down in the intestine, you may also be more prone towards, towards leaky gut issues which can destabilize mast cells and cause a histamine response.

[A]

Why would you say some people experience like skin flares during allergy season, even if they don't have like classic roll respiratory allergy?

[B]

Why are they getting, why are they having skin symptoms as opposed to respiratory symptoms? For whatever reason, their skin cells are more susceptible, more, more responsive to histamine than cells in their, in their respiratory tract, I would guess. I don't know why one symptom would be more prominent than others, but that, I do know what you're saying, that does happen. Also, I should say that if you do have a histamine response, you want to be really careful about, aside from foods, which you definitely want to be careful of, about certain topical ingredients, super stimulating ingredients like retinoids or alpha hydroxy acids, but really you don't want to consider it to be a skin or respiratory problem as much as you want to be considering it a circulatory problem. Histamine is getting into the bloodstream, usually through a leaky gut or through mast Cell destabilization.

[A]

So you mentioned a little bit about actives, but generally speaking, from an aesthetic perspective, what's actually helpful or even not helpful when somebody's having like this heightened

[B]

histamine state when they're in an. When they're producing lots of histamine or having a histamine response, using a DAO to help break down histamine. B, using anti histamine, not drugs, but nutrients, I would say, like zinc and vitamin C and the cannabinoids, et cetera. And then always, always correcting digestive issues, patching up a leaky gut and staying away from or at least being aware of the foods that are histamine triggers. Either they contain histamine or they can activate a histamine response. Citrus, avocado, leftovers, fermented foods, miso, tempeh, which ordinarily would be good foods. But if you're having a histamine response, you may want to be careful. Also, interestingly, sometimes probiotics. Taking probiotics can induce a histamine response. You got to be a little bit careful with probiotics. Not always, but that may happen. I've heard people taking probiotics and all of a sudden they'll get rashy or they'll get itchy and rashiness, redness, itchiness should always be regarded as a histamine response.

[A]

Interesting. And what about from the aesthetic perspective, the esthetician.

[B]

For the esthetician, you know, as we talked about, stimulating ingredients can aggravate the skin if there's a histamine response. But stimulating ingredients can be effective for the skin as well. So a couple things. First of all, you want to work internally, all the things we just talked about. So you can lower histamine naturally, but you can also use topical antihistamines, topical melatonin, topical zinc, topical vitamin C. These all would be a natural way to topically reduce a histamine response. But it's all. It's mainly a blood problem. So you'll want to work on the blood system, which means you want to work on the digestive system.

[A]

Let's go back to the mast cells for a second.

[B]

Yes.

[A]

During an allergic response, what exactly are the muscles doing? They're.

[B]

They're exploding. You know, I used to, I. And it's not just, it's not just a skin thing. I used to. Or it's not. I should say it's not just on your face or in your body. I used to make a product that I used for a condition called vulvodynia. Have you heard of vulvodynia? Right. It's. It's agonizing. And I used to make a product that was a mast cell stabilizer. It was used for asthma patients. But I would make it. I put it into a cream that women could use topically because vulvodynia is a histaminic response, and it's associated with gluten, and it's associated with what they call lectins, which are defense molecules in plants. So using mast cell stabilizers can have a. Have a beneficial effect, cromolyn being the most famous one. Chrome, sodium. But basically what's happening to the mast cell is it's exploding and it's releasing its chemicals, largely histamine. The list of good foods, bananas, which everybody loves. Who doesn't love bananas? They're so beautiful and so sweet. Those are high histamine foods. Tomatoes, another high histamine food. You know, a lot of people who say they have shellfish allergies are really reacting to histamine because histamine is. Shellfish is high in histamine. So, you know, you gotta go. That's the problem with good foods and bad foods. When people say, I only eat organic or I only eat vegetables, I'm a vegetarian, et cetera, it doesn't work that way. And the histamine content of things like bananas and avocados and citrus fruits and tomatoes are a classic example of why you have to do a food diary and you have to associate your particular problems with specific foods.

[A]

That concludes our show for today, and we thank you for listening. But if you just can't get enough of Ben Fuchs, the ASCP's rogue pharmacist, you can find him@truth treatments.com for more information on this episode or for ways to connect with Ben Fuchs or to learn more about ascp, check out the show notes.