Eczema and food allergies are something we’ve discussed on the blog before. It’s only in the past few years that we have started to make that connection, which is why there has been no skin testing involved. Now, we’re moving away from that belief. At the 41st Annual Meeting of the Society for Pediatric Dermatology, two doctors evaluated this association.
One doctor made some great suggestions for dermatologists - food allergens are usually most common in infants with moderate to severe eczema. For this particular age group, skin testing is absolutely necessary. In addition, it is interesting to note that out of all the foods that have an impact on eczema, eggs are the most common triggers. This means eliminating eggs from the infant’s diet at a young age. Most parents will focus on removing milk, but you should be aware that that recommendation is often over-prescribed, as only 2% of children with eczema actually have milk allergies.
I had brought up the topic of peanuts in an earlier blog, and I still recommend introducing it into the child’s diet before they are 12 months old, unless their siblings have severe allergies. This has proven to be effective in Israel: when peanuts were introduced during this time period, the incidence of peanut allergy was very low - just 0.04%. We should focus more on key allergens such as egg and peanuts, and less on soy, milk and wheat.
The bottom line is this: if infants have severe eczema, they should definitely undergo allergy tests. For children with mild to moderate eczema, food allergy testing should only be carried out if there is a history of foods triggering acute allergic symptoms such as lip swelling, urticaria, nausea, or wheezing. The focus for them should be repairing their skin barrier and protecting their skin.
So what does this all mean? Could food really play a role in the severity of eczema? It would seem so, and I think it’s better to be safe than sorry. More importantly, continuously educating yourself and keeping up with developments in this field is necessary.