Food and Eczema Flares in Children

Could diet be to blame for your child’s eczema?

It's possible.

Up to 1 in 3 kids with eczema has a food allergy that could make symptoms worse. If you remove some choices, it could make a big difference.

But since finding food triggers is tricky -- and eczema can have lots of other causes -- don't jump to conclusions. Work closely with an allergist.

Which Foods May Trigger Eczema?

When you have a food allergy, your body reacts to a harmless treat as if it's a dangerous germ and attacks. Symptoms -- like swelling -- are side effects of your body's defenses.

Eczema doesn't seem to be an allergic condition, but reactions from food can make it worse in some kids. It’s more likely in babies and young children.

Some foods are more likely to bring symptoms. The common offenders are:

  • Milk
  • Eggs
  • Peanuts
  • Tree nuts
  • Wheat
  • Fish
  • Shellfish
  • Soy

While trigger foods can make eczema worse, experts don't think they’re really the original cause. Instead, it seems to result from "leakiness" in the outer layer of skin that lets in irritants, germs, and allergens.

How to Find a Food Trigger

Some are obvious. If your child eats lobster for the first time and breaks out in hives 15 minutes later, it’s probably not hard to figure out.

But with eczema, it's often tougher. Symptoms may not show up for days after you eat something. If you do find a trigger food and get rid of it, that may help. Still, it may not make the eczema go away. Remember, 2 out of 3 kids with eczema don't have a food allergy at all.

That's why working with a doctor is so important. He can guide you toward the real cause through tests like:

Elimination diets. If your doctor thinks a food may be harmful, he may ask you not to give it to your kid for 10 to 14 days. Watch to see if it makes a difference.

Food challenges. After you've taken a food out of your child's diet, your pediatrician might want you to add a small amount back in to see if it causes symptoms. He may want to do this in the office, just in case your child has a reaction.

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Skin testing. A doctor can take an extract of the food and use it to scratch the skin lightly. If the area swells up, that could be an allergic reaction. However, it's not always accurate.

Blood tests. RAST -- a radioallergosorbent test -- can check for special cells in the blood that signal specific food allergies. Again, it's not always accurate. Other lab tests can check for cells that trigger swelling.

Tracking down a food trigger can take patience and detective work.

Be methodical. Only eliminate one food at a time. If you ban dairy and gluten at the same time and symptoms get better, you won’t know which one made the difference. Use a food diary to keep track of what you get rid of, and the changes that brings.

Move slowly. A positive skin test isn't reason enough to cut out a food. Lots of kids test positive for foods that don't really cause symptoms. Plus, if you get rid of too many foods, you could cut out nutrients your child needs to grow and develop. So for his sake and yours, be sure before you take a food from your child's diet permanently. Work with your doctor.

Keep using other treatments. Even if you find a trigger food, getting rid of it may not make the rash disappear. Stick with the other things your doctor recommends -- like skin ointments, lotions, and medicines. Continue to steer clear other allergens like dust mites, pollen, or pet dander, too.

WebMD Medical Reference Reviewed by Dan Brennan, MD on 4/, 017

Sources

SOURCES:

American Academy of Allergy, Asthma, and Immunology: "Skin Allergy Overview."

American College of Allergy, Asthma, & Immunology: "Eczema in Children."

Asthma and Allergy Foundation of America: "Atopic Dermatitis (Eczema)," "Food Allergies."

Demehri, S. PLOS Biology, May 19, 2009.

Zheng, T. Allergy, Asthma, & Immunology Research, February 2011.

Van Bever, H. WAO Journal, April 15, 2008. 

University of Iowa Children’s Hospital: "Common Additional Questions."

UpToDate: "Epidemiology, clinical manifestations, and diagnosis of atopic dermatitis (eczema)," "Patient information: Atopic dermatitis (eczema) (Beyond the Basics)," "Role of allergy in atopic dermatitis (eczema)."

World Allergy Organization: “Food Allergy."

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