What is the role of allergy in eczema?
There is some controversy with regard to the role of allergy in eczema:
- Some authors believe that allergic responses to aeroallergens are a rare cause of worsening of eczema and that food allergy is generally not a factor.
- Other authors believe that allergy can definitely worsen eczema in some patients and that the data indicate that allergy plays a role in selected patients with eczema.
A worsening of eczema by foods in food allergic patients has been repeatedly reported, with the vast majority of cases seen in young children. The most common concerned allergens are milk, egg, peanut, soy, and cereals. This should be considered in the management of eczema when there is a history of food allergy, or when conventional treatment measures are ineffective.
An appropriate diagnosis of the suspected food allergy should be made and the culprit food should be avoided.
On the other hand, it has to be said that no evidence suggests so far that non-sensitized patients benefit from primary prevention (e.g. a diet during early childhood). Parents must know that even in the rare cases when a food allergy may worsen the eczema of their children, the food allergy is not the cause of eczema.
Some adult patients with eczema experience a worsening of their skin lesions after contact with certain aeroallergens, e.g. house dust mite, pollen or animal dander. An allergy test exists which can help to identify if the worsening of eczema is allergy-driven or not.
How can a worsening of eczema be prevented?
- Eczema trigger factors that have been identified should be avoided where possible (e.g. dietary changes, encasing bedding to reduce exposure to house dust mite allergen, removal of pets from the home, etc.).
- The regular use of emollients can protect against relapsing disease
- The intermittent use of anti-inflammatory topicals (corticosteroids, calcineurin inhibitors) may be a second-line option
This information is not intended to replace the advice of a doctor. HelloSkin disclaims any liability for the decisions you make based on this information.