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The link between eczema and food allergies

May plays host to both Eczema Awareness Month and Food Allergy Awareness Week, but did you know that eczema and food allergies can be linked, especially in children?

Food allergy occurs in around 5-10% of children and 2-4% of adults in Australia and New Zealand. Eczema affects one in 5 children under 2 years of age. Eczema can also occur in older children and adults but usually improves with age.

In this month’s blog, we take a closer look at eczema and food allergies and the link between them.

What is eczema?

Eczema is a skin condition that causes the skin to become red, dry, itchy and scaly. In severe cases, the affected skin may weep, bleed and crust and may become infected.

The most common type of eczema is atopic dermatitis – a chronic, itchy skin condition that generally affects the elbows, knees, hands and face.

While it is very common in children, it can affect people of any age and often occurs in individuals with an existing predisposition to and/or family history of eczema, asthma or hay fever.

Those with eczema carry large numbers of Staphylococcal bugs on their skin. These can make eczema worse by activating the immune cells that cause inflammation of the skin.

 As eczema often leads to broken skin, sufferers are at greater risk of contracting skin infections when an outbreak does occur. This can make the eczema worse and treatment more difficult.

Eczema can cause great discomfort for sufferers. It can greatly impact on quality of life, causing sleepless nights due to itching, absenteeism from work, school and other activities, or hospitalisation and costly treatments when severe flare ups occur.

Winter can be a prime time for eczema. You can read more about this in our previous blog – How Winter Impacts on Eczema>>

How is it treated?

While eczema cannot be cured, it can be managed.

The first step is consulting your GP or skin specialist for a formal diagnosis. They will then work with you to develop an individualised treatment plan to best manage your eczema. This will often include a three-pronged approach of:

  • reducing your exposure to any triggers, where possible;
  • regularly applying moisturiser to your skin; and
  • intermittent treatment with topical steroids.

Other key recommendations for managing eczema day-to-day include:

  1. Washing your skin with non-soap cleansers, to help reduce the number of Staphylococcal bugs on your skin. Non-soap cleansers can also maintain important oils that can often be stripped through the use of soap based products.
  2. Moisturising your skin every day to help replace the moisture often lost in winter. This also helps to block out germs that can cause infection. The best time to moisturise is generally after showering, when the skin is still slightly damp. It’s important to use a moisturiser that is suited to your skin.
  3. Keeping showers and baths short and using lukewarm water (no more than 30oC), as hot water will cause your skin to dry out further.
  4. Wearing soft, breathable fabrics and loose fitted clothing to prevent further skin irritation.
  5. Avoiding the overuse of heaters, as they can dry the air and exacerbate the problem.

What is a food allergy?

According to Allergy and Anaphylaxis Australia, a food allergy is “an immune system response to a food protein that the body mistakenly believes is harmful. When the individual eats food containing that protein, the immune system releases massive amounts of chemicals, triggering symptoms that can affect a person’s breathing, gastrointestinal tract, skin and/or heart.”

Food allergy symptoms

Most symptoms of food allergy are mild or moderate and occur within 30 minutes of eating the food. These symptoms may include:

  • Swelling of the lips, face or eyes.
  • Skin reactions like redness, hives or eczema.
  • Tingling or itchy mouth.
  • Vomiting, stomach pain and/or diarrhoea.
  • Nasal congestion.

If these symptoms occur, it is best to avoid that food again and to make an appointment with your GP as soon as possible.

A severe allergic reaction, or anaphylaxis, can happen immediately and symptoms include:

  • Difficult or noisy breathing.
  • Swelling of the tongue and throat (e.g. drooling, difficulty swallowing).
  • A change in voice or cry and/or difficulty vocalising.
  • A persistent cough, wheezing or stridor.
  • Collapse or fainting.
  • Paleness and floppiness (in young children).

Anaphylaxis can be life threatening. Please seek urgent medical assistance for any signs of a severe allergic reaction.

Common food allergies

The most common allergy causing foods are:

  1. Eggs
  2. Peanuts
  3. Tree nuts (such as cashews, pistachios, walnuts, pecans and hazelnuts)
  4. Cow’s milk
  5. Wheat
  6. Fish
  7. Shellfish
  8. Sesame
  9. Soy
treenut
soy
sesame
seafood
fish
peanut
milk carton
egg
bread

Food Allergy Prevention

To help reduce the risk of food allergies developing, the Australian Society of Clinical Immunology and Allergy (ASCIA) recommends introducing solid foods to infants between four to six months of age. It also recommends introducing the common food allergens by 12 months of age.

Delaying the introduction of common allergy causing foods does not prevent food allergy. In fact, research shows that giving your baby the common allergy causing foods before they are one year of age can greatly reduce the risk of them developing an allergy to that food.

Breastfeeding mothers are also encouraged to continue to breastfeed their infant while solid foods are first introduced, to help reduce the risk of food allergies developing.

This video from the Telethon Kids Institute provides some useful tips on ways to prevent food allergies developing in children>>

Even if common allergy causing foods are introduced before one year of age, a small number of children will still develop a food allergy. While there is currently no cure for food allergies, the good news is that many children will naturally outgrow them.

One tool being used to help better identify food allergies in infants is SmartStartAllergy. Illawarra Medical Centre’s Principal GP – Dr Alan Leeb – is one of the people behind SmartStartAllergy; a collaboration between SmartVax, the National Allergy Strategy (NAS), with funding from the Australian Government Department of Health and the Perth Children’s Hospital Foundation.

SmartStartAllergy uses automated SMS technology to send a text message to parents when their baby is 6, 9 and 12 months old to find out if they have introduced solid foods (including peanut).

Some parents will only receive a text message at 12 months. Subsequent messages ask if the child has had an allergic reaction to any introduced foods.

Parents also receive a brief questionnaire to find out about any allergic reactions, family history of allergy, or if their child has eczema.

How are food allergies and eczema linked?

People with eczema often have other allergic conditions, including food allergies. Studies have shown that infants with eczema and a family history of allergy are more likely to develop food allergies. Some research has also shown that babies with eczema can develop food allergy if the food comes into contact with their skin.

The foods most commonly found to be linked to worsening eczema are cow’s milk, eggs, wheat and peanuts.

Managing an infant’s eczema, to boost the skin barrier, may reduce the chance of them developing a food allergy.

While food allergy itself does not cause eczema, avoiding certain foods may also result in better eczema control for those with severe eczema. However, it’s important that any food elimination diets are conducted under the supervision of a clinical immunology/allergy specialist alongside a dietician, especially for infants. With an elimination diet, foods are introduced one at a time to see if they cause the eczema to flare. If there is no improvement over two weeks, this generally means that food is unlikely to be a trigger for the eczema.

Worried about food allergies or eczema?

Then book an appointment with your GP to discuss your concerns. At Illawarra Medical Centre, we offer dermatology checks with Dr Dhruva Ramachandran every Tuesday morning for those with any skin concerns.

To make a booking with Dr Ramachandran or any one of our GPs to discuss your skin and allergy concerns and the best treatment options available for you, go to our online bookings page or contact us on (08) 9208 6400.

To find out more about our dermatology services, visit the Dermatology page of our website>>

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