Prevalence
Eczema and food allergies are common in the developed world.
This photo contains content that some people may find graphic or disturbing.
DermNet /CC BY-NC-ND
Eczema symptoms can wax and wane, often for no apparent reason.
Verywell / Zorica Lakonic
Just because a flare occurs after eating doesn’t mean that food was the cause.
Most infants with severe eczema do not require a food allergy evaluation.
Causes
Why eczema tends to precede a food allergy is still something of a mystery.
DermNet /CC BY-NC-ND
Part of the explanation may be in the way in which each develops.
By contrast, eczema is inflammation of the skin that can occur without any specific external trigger.
This, in turn, triggers an immune response in the form ofinflammation.
Once the flip side, in some patients, food allergies can trigger eczema by causing itching and swelling.
Scratching only makes things worse.
Itch-Scratch Cycle
Eczema flares, or flare-ups, are frequently triggered by the “itch-scratch cycle.”
Eczema symptoms, in turn, lead to more itching, perpetuating the cycle.
Food allergens cause cross-linking of IgE and activation of mast cells and basophils that releasehistaminesand cause allergy symptoms.
Non-IgE-Mediated Food Allergies
Non-IgE-mediated food allergies are those in which IgE is not involved.
These are hypersensitivity reactions that mainly take place in the intestines after certain foods have been eaten.
Among these areceliac disease, food-protein-induced enterocolitis, and allergic proctocolitis (primarily seen in infants).
Food Sensitivities
Many people with eczema will report reactions to food even though there are no actual allergies involved.
These can be aptly described asfood sensitivities or intolerances.
With food sensitivities, there is no IgE involved.
Intestinal inflammation is believed to be the key instigator.
Other examples of food sensitivity includelactose intolerance.
Some doctors are reluctant to test due to the high rate of false-positive results.
A false positive could very well motivate for changes in diet that are simply not needed.
Still, there are times when testing is appropriate.
Keeping afood diarycan also be useful to help identify the possibility of food triggers.
Among the options:
All of these tests have their limitations.
A positive result does not inherently mean that food is the cause of an eczema flare.
In the end, neither eczema nor food allergies can be cured, but they can be treated.
In many cases, both conditions improve with age.
The elimination of foods from your diet should be done under the supervision of a doctor ornutritionist.
Allergy shotsused to treat seasonal allergies or hay fever are not effective for food allergies.
Foods rich in probiotics include yogurt, miso, and kefir.
The effect was not seen in younger children.
Synbiotics containing multiple bacterial strains proved far more effective than single-strain probiotics in relieving symptoms.
Overuse can lead tovitamin D toxicity.
It is presumed that by reducing inflammation in the gut, the risk of eczema may also be alleviated.
In some cases, the benefits may be minimal.
Eczema is a multifaceted disease with many interlinked causes and triggers.
Ensuring long-term remission typically requires a multifaceted approach.
Children with mild to moderate eczema should be introduced to peanut protein starting at 6 months.
The uncomfortable and often unsightly rash can be distressing enough without the added burden of a comorbid allergy.
Fortunately, there are ways to manage both conditions.
Patience and persistence are key to obtaining an informed diagnosis and effective treatment.
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