Table of ContentsView AllTable of ContentsPrevalenceSymptomsCausesDiagnosisTreatmentCopingPreventionA Word From Verywell
Table of ContentsView All
View All
Table of Contents
Prevalence
Symptoms
Causes
Diagnosis
Treatment
Coping
Prevention
A Word From Verywell
Eczema and food allergies are common in the developed world. Research suggests that eczema affects roughly 20% of children and up to 5% of adults.By comparison, around 7% of children and 6% of adults report symptoms of at least one food allergy.
While a connection between allergic or atopic diseases has long been recognized, a2017 review published inThe Lancetreported that a large percentage of people with eczema report some form of food allergy. According to the researchers, eczema appeared to precede the development of the allergy, suggesting that the former somehow triggered the latter.
Food allergies are today recognized as a comorbidity (related health condition) of eczema along withallergic rhinitis(hay fever) and asthma.
Food allergies are more likely to cause eczema flares in infants with severe eczema.Symptoms develop soon after eating an offending food or up to a couple hours later, and may include:
A severe food allergy can present with shortness of breath or anaphylaxis, which is a severe, life-threatening reaction.
This photo contains content that some people may find graphic or disturbing.See PhotoDermNet /CC BY-NC-ND
This photo contains content that some people may find graphic or disturbing.See Photo
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. 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. A thorough history and physical exam will help direct an allergist to determine if any testing is necessary, and if so, what type.
Why eczema tends to precede a food allergy is still something of a mystery. Part of the explanation may be in the way in which each develops.
It is believed that this hypersensitizes theimmune systemto the various allergens it encounters on the skin, causing an exaggerated response when those allergens are later eaten or inhaled.
This may explain why kitchen workers with eczema are more likely to develop food allergies than people with eczema who have different jobs.The increased exposure to food allergens appears to amplify the risk, suggesting that the environment plays as strong a role in the development of allergy as physiology.
Itch-Scratch Cycle
Risk in Children
Food allergies are also more common in people who develop eczema early in life compared to those who experience later onset of disease. Moreover, those who develop eczema as infants or in early childhood are more likely to experience severe food allergy symptoms.
A2019 study published inScience Translational Medicinereported that children with both eczema and food allergies had significant differences in their skin at the molecular level when compared to children with eczema only. Their skin was more prone to moisture loss, and they were at a far greater risk ofStaphylococcus aureusskin infections.
This suggests that eczema associated with food allergies may, in fact, be an entirely unique subtype of atopic dermatitis.
Common Food Triggers
IgE-Mediated Food Allergies
The foods that are most likely to trigger an IgE response in people with eczema are also among the most common food allergens in the United States, namely:
IgE-associated food allergies can be difficult to avoid because many of the offending foods are used as ingredients in other food and non-food products.
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).
Non-IgE food allergies can manifest with gastrointestinal symptoms, such as vomiting, diarrhea, gas, stomach pain, and a flare of eczema symptoms. Non-IgE food allergies are different from IgE food allergies in that the symptoms tend to be delayed until food passes into the intestines, making them harder to diagnose.
The most common non-IgE mediated food allergens associated with eczema include:
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.
How Gluten and Eczema Are Linked
Current guidelines suggest that limited food allergy testing should be considered if a child under 5 years old experiences persistent atopic dermatitis despite topical therapy and other forms of management, has a reliable history of an immediate allergic reaction after ingestion of the food, or both.
Some doctors are reluctant to test due to the high rate offalse-positiveresults. A false positive could very well motivate for changes in diet that are simply not needed.
Still, there are times when testing is appropriate. Food allergy testing is typically recommended when:
The American Academy of Dermatology recommends food allergy testing for children younger than 5 whose eczema is not being controlled with treatment.
Keeping afood diarycan also be useful to help identify the possibility of food triggers.
Labs and Procedures
A doctor, such as an allergist, can determine if food allergy testing is necessary and what forms of testing are appropriate.
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. Clinical expertise is needed to interpret the results and, even so, there can be a high level of uncertainty.
The treatment of eczema and food allergies is multifaceted, involving avoiding certain foods and treating eczema or allergy symptoms when they occur. 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. Avoiding certain foods or food groups (likedairyor wheat) can have serious consequences, depriving you of the nutrients and fiber you need to remain healthy.
Allergy shotsused to treat seasonal allergies or hay fever are not effective for food allergies.
Probiotics
According to a review of studies published inJAMA Pediatrics,the use of synbiotics for at least eight weeks improved eczema symptoms in children 1 year of age and older. The effect was not seen in younger children.
Synbiotics containing multiple bacterial strains proved far more effective than single-strain probiotics in relieving symptoms.
Vitamin D
People with lactose intolerance or a milk allergy can increase their intake of vitamin D with a daily supplement if needed. Overuse can lead tovitamin D toxicity.
Anti-Inflammatory Diet
Ananti-inflammatory dietinvolves the exclusion of foods known to promote inflammation (such assaturated fats) and the increased intake of foods with anti-inflammatory effects (such as those rich inomega-3-fatty acids).
With that said, the anti-inflammatory effects of omega-3s (found in fatty fish such as salmon, mackerel, sardines, and herring) are known to be beneficial to the heart and circulatory system.
What to Eat When You Have Eczema
If you or your child has been diagnosed with a food allergy, avoiding food allergens may help improve eczema symptoms but may not be the “magic bullet” you had hoped for. Even if an allergen is found, the impact that it has on eczema can vary from one person to the next. 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.
Among some of the self-care tips that can help are:
Alcohol and Eczema: Does Drinking Trigger Flares?
While there is no real way to prevent eczema, there is increasing evidence that the appropriate introduction of food to infants and children may reduce the risk of certain food allergies. In fact, most research today suggests that gradually exposing a child to common food allergens can help reduce the risk of allergies compared to the avoidance of allergens.
Children with mild to moderate eczema should be introduced to peanut protein starting at 6 months.
Other studies have looked into the early introduction of cow’s milk and eggs, but there is not enough research yet to conclude if the same strategy might prevent milk or egg allergies.
Eczema is a serious skin condition that can diminish the quality of life of individuals as well as their families. The uncomfortable and often unsightly rash can be distressing enough without the added burden of a comorbid allergy.
How Eczema Is Treated
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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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