Eczema and Food Allergy Concerns – A Guide for Parents

Key Messages

Your child’s eczema is most likely not driven by food allergies. Restricting certain foods can carry potential risks, such as nutrient deficiencies and an increased risk of developing allergies.
There is evidence to suggest that good eczema control can reduce the risk of developing food allergies. Hence, active daily management of eczema is a key strategy. This is especially important in infants
Food allergies (known as IgE-mediated allergies) often cause a rash or hives that typically appear within an hour after eating the triggering food and usually clear up with antihistamine use.
Early weaning, as recommended by the British Society of Allergy, may be beneficial for babies who develop eczema in the first 1-2 months of life.

What Your GP May Do

History Review: Your GP may examine the details surrounding the rash, including when it started, whether a specific food seems to trigger it, what it looks like, and how it responds to treatment. They’re looking for clues that might point to an IgE-mediated food allergy, which often manifests as hives that appear within an hour after eating and disappear completely with antihistamine use.
Eczema Management: Your GP may advise you on the best practices to manage your child’s eczema. This includes regular moderate-temperature baths, applying moisturizers, using mild to moderate topical corticosteroids during flare-ups, and using protective clothing at night to prevent scratching.
Dietary Management: If a food trigger is suspected, your GP may suggest keeping a food diary and conducting a careful food exclusion and reintroduction process. They’ll emphasize the importance of reintroducing foods because there are no reliable tests for diagnosing food-triggered eczema.

Your GP will avoid conducting specific immune response tests or skin prick tests for children with eczema who don’t show symptoms of IgE-mediated allergies. These tests can lead to confusion and unnecessary dietary restrictions due to a high likelihood of false positives.

If your child’s eczema proves challenging to manage, your GP may refer you to a specialist dermatology service for advanced treatment.
If symptoms point towards an IgE-mediated food allergy, your GP may refer your child to an allergy clinic with detailed notes about the symptoms.
If your child is excluding significant food groups like milk or wheat from their diet, your GP may refer you to a dietetic service to ensure they are meeting their nutritional needs.

Restricting certain foods from your child’s diet has potential risks, including nutrient deficiencies and increased chances of developing allergies. It’s important to discuss the balance between food exclusion and these potential risks with your GP. The reintroduction of foods is a key part of managing eczema that may be triggered by certain foods.