Exploring the link between eczema and food allergies
With so much information contained in the new FDA qualified health claim (QHC), it can be hard for parents to figure out exactly what to do with the new information we’ve been given (if you haven’t read our summary yet, check it out here).
The new QHC includes a caution that if your infant has severe eczema and/or egg allergy, you should check with your infant’s healthcare provider before feeding foods containing ground peanut. One of the most common questions we’ve received in response to our last article was “why?” With all the curiosity surrounding the link between eczema and food allergies, we sat down with Dr. Azza Gadir. Azza has her M.Sc. in Immunology from London School of Hygiene and Tropical Medicine, her Ph.D. in Immunology from University College London, and is a research fellow at Harvard Medical School/Boston Children’s Hospital. She’ll explain what eczema is, the relationship to food allergies, and what you can do as a parent.
Inspired Start: What is eczema?
Azza: Eczema is the name for a group of eight chronic skin conditions that may onset early in life. These conditions cause skin to become red and itchy and can often lead to sleeplessness in young children.
Inspired Start: What are the symptoms of eczema? What makes it worse?
Azza: Itchiness and a red, inflamed, scaly rash that may be prone to skin infection. Because of the irritation, we often find that young children are not sleeping which may lead to behavioral problems. Dry skin, colder weather and itchy clothes can trigger flares and contribute to irritation.
Inspired Start: What is the most common type of early onset eczema?
Azza: The most common type of eczema is atopic dermatitis.
Inspired Start: How common is eczema?
Azza: Pretty common! Nearly 30 million Americans have some form of eczema and 6-10% of children born have been reported to have eczema.
Inspired Start: What’s the biology that underlies eczema?
Azza: The exact cause of eczema is currently unknown, however it is thought to be connected to a robust immune response to irritants. It is that response that causes the symptoms observed with eczema (red, cracked skin). There have also been studies exploring the genetics underlying eczema (atopic dermatitis) which have reported a gene variation in the protective outer layer of the skin. This break in the skin barrier can allow entry of irritants, microbes and potentially food allergens that can lead to even more inflammation.
Inspired Start: How can we understand the connection between eczema and food allergies?
Azza: Of the 6-10% of children reported to have eczema, up to 33% of those go on to develop food allergies. The Allergic March is the term used to describe the sequence of allergic events that happen early in age. These allergic events may include eczema, food allergy, hay fever, and asthma.
Inspired Start: You call it a “march.” What comes first?
Azza: Eczema is the first symptom to appear usually as early as the first months of life, while food allergies start later in life between 1 and 3 years old.
Inspired Start: So eczema and food allergies are related in that they are both part of a sequence of allergic events. What else?
Azza: Multiple groups have reported that food allergens can trigger flares of severe eczema in those that are food allergic and have eczema, but the two phenomena don’t always go hand-in-hand. Severe eczema is most strongly associated with allergies to peanut, egg, and milk. Furthermore, one study showed that peanut applied to the inflamed skin of infants was associated with peanut allergy development later in life.
Inspired Start: Woah! We’ve heard from a lot of parents that they make sure to kiss and hold their babies after eating peanut butter to help expose them. It’s crazy that may be doing more harm than good!
Azza: Agreed, this finding supports the theory that food allergens from the environment can enter through inflamed skin.
Inspired Start: What should parents do if they think their child has a food allergy or eczema?
Azza: They should always talk to their doctor and stop feeding any foods they suspect of causing a reaction.
What else would you like to ask Azza? Leave a comment and we will add it to our list of topics to explore!