Why Does Eczema Increase the Risk of Food Allergies?

Eczema is a condition that causes the skin to become itchy or inflamed and creates a rash-like appearance. It is not contagious and while the exact cause is unknown, researchers believe it’s caused by a combination of environmental triggers and genetics. According to the National Eczema Association (NEA), over 31 million Americans have some form of eczema.

Eczema impacts 20% of children, and young children with eczema are 6 times more likely to develop a food allergy than their peers without eczema.

So what’s the connection? How does eczema increase the risk of food allergies?

According to the Dual-Allergen Exposure Hypothesis , when exposure to a food occurs through the skin, it can lead to sensitization and potentially the development of a food allergy, whereas exposure to a food through the gut (oral consumption), leads to tolerance.

Eczema causes small breaks in the skin, which increases the likelihood of exposure to potential food allergens (such as peanut protein) through the skin barrier, therefore increasing the likelihood of developing a food allergy.

One way we see that play out, according to pediatric allergist and Mission MightyMe Co-founder Dr. Gideon Lack, is that typically the most common food allergies in a given country also tend to be the most common foods in that culture. “In Scandinavia we see elevated rates of fish allergies, whereas in the U.S. there are more peanut allergies,” says Dr. Lack. “This happens because families are eating and cooking with these foods, so they are in the household environment, but babies aren’t eating them, so their primary exposure comes through the skin.”

“Eczema tends to develop earlier in life than food allergies,” says Atlanta Dermatologist Dr. Amy Kim, “So there is a crucial window for intervention starting as early as 4-6 months when it is critical to both aggressively control eczema and establish oral tolerance to prevent a food allergy from developing.”

3 Simple Tips to Prevent Eczema and Food Allergies

If your child has eczema, you might be asking, “What can I do?” Here are some simple things you can do to decrease your child’s chances of developing food allergies.

1. Manage and treat your child’s eczema. 
   • The NEA encourages a daily bathing and moisturizing routine to keep the skin clean and to prevent dryness. Apply over-the-counter or prescription medication as directed. Avoid skin products that cause further itching or irritation. As always, consult your child’s doctor before beginning a new treatment plan.
2. Limit allergen exposure through the skin. 
   • The LEAP (Learning Early About Peanut Allergy) Study by Dr. Gideon Lack showed the importance of establishing oral tolerance to peanut protein before these proteins penetrate the skin barrier. After handling peanuts or other potential allergens, wash your hands thoroughly before touching your child. Avoid putting peanut butter or any creams or oils that contain peanut oil on your child’s skin.
3. Introduce early, oral, peanut exposure. 
   • Based on Dr. Lack’s landmark clinical trial, the LEAP Study, leading medical organizations including The American Academy of Pediatrics  and The National Institute of Allergy and Infectious Diseases  now recommend that children, especially those with eczema, regularly consume peanut foods, starting as early as 4-6 months, to help prevent peanut allergy. The recommendations for how and when to introduce peanut foods depends on your child’s risk factor which correlates to the severity of their eczema.

AAP / NIAID Peanut Allergy Prevention Guidance Based on Risk Factors

• High Risk (If your infant has severe eczema, egg allergy, or both): 
  • Talk to your doctor before giving any peanut foods to your baby. Your doctor may recommend allergy testing or introducing peanut foods under medical supervision. Once cleared, high risk infants should start peanut foods as early as 4-6 months and consume 6 grams (3 teaspoons) per week to help prevent peanut allergy.
• Moderate Risk (If your infant has mild to moderate eczema):
  • Introduce peanut foods around 6 months of age to reduce the risk of developing a peanut allergy. Depending on your preference, you can introduce peanut foods at home or in your doctor’s office under supervision. Low Risk (No eczema or food allergy):  Freely introduce peanut foods into your child’s diet at home in an age-appropriate manner together with other solid foods.
• Low Risk (No eczema or food allergy): 
  • Freely introduce peanut foods into your child’s diet at home in an age-appropriate manner together with other solid foods.

The good news is that the new research and guidelines have given parents the tools to potentially prevent food allergies from developing by being proactive.

“Solid food introduction between 4-6 months of age allows the parents to have a strategic and purposeful way of introducing solids and creating that oral tolerance.” - Moms on Call Co-Founder and LPN Laura Hunter.

When can you start? Is it a date on the calendar?  Hunter says the best way to determine when to start solids (after speaking with your pediatrician) is to look for some of these signs:

• Good head control
• Sitting with minimal support
• Beginning to show interest in what others are eating

Mission MightyMe's Proactive Peanut Puffs were developed by the global expert in food allergy prevention to make it deliciously simple to include peanuts in infant diets, as pediatric feeding guidelines recommend. Use code MOMSONCALL20 for 20% OFF your order for early peanut introduction!

For more information see our blog post Introducing Solids, Including Peanuts and Other Potential Allergens with Moms on Call.