Studies have indicated an increased rate of sensitization to food and environmental allergens in patients with eczema. Infants and young children less than 5 years of age are more likely to be sensitized to foods while older children and adults are more likely to be sensitized to aeroallergens, especially dust mites.
How to sort it out?
Allergic triggers for eczema may be identified through skin testing or blood testing for specific IgE antibodies. In allergic patients, the immune system makes IgE antibodies to foods or aeroallergens that lead to an allergic response. Testing can be done for both foods and environmental allergens. A careful history should guide allergen selection for testing. In small children, the most common food triggers are milk, egg, wheat, peanut and soy. Once the positive sensitizations are known, working with your Allergy Partners allergist is instrumental in determining whether a food should be eliminated from the diet or if a supervised food challenge is warranted. As a positive skin or blood test in and of itself does not indicate a food allergy, your allergist may suggest a food challenge to determine if a true food allergy exists. Subsequent follow up is also needed to determine if and when a food allergy resolves. Aeroallergens can also trigger eczema flares. Dust mite allergy is common and certain measures in controlling dust mite exposure, such as allergen proof bedding encasements, have improved patients’ eczema. Pollen and animal dander have also been implicated as eczema triggers.
What is the treatment?
A more recent indication for immunotherapy (allergy shots) is eczema. Dust mite immunotherapy in adults with chronic eczema improved both eczema severity scores as well as reduced the use of topical steroid creams. Unlike medications, allergy shots work to modify the course of disease rather than simply treating symptoms.
Patients with eczema also have higher rates of contact dermatitis. Contact dermatitis is a delayed type of allergic reaction to substances touching the skin, for example poison ivy. Common contact allergy triggers include metals, fragrances, preservative and neomycin. A different type of allergy testing called Patch Testing can be performed to determine if patients are allergic to these common products. If so, avoidance can lead to significant improvement of eczema.
Allergy Partners physicians are specially trained physicians who are experts in identifying allergic triggers to eczema and other allergic diseases. They offer skin testing, both to foods and aeroallergens, and patch testing and are experts in interpreting the results of all allergy tests. They perform food challenges and can provide patients and families with expert advice as to how best treat and manage eczema.
By Dr. Patrice Kirchoff
Allergy Partners of the Blue Ridge