Ask the Doctor

Examining the link between eczema and food allergy

Q: Is my baby at higher risk of food allergies due to her eczema?

A: Eczema Society of Canada contacted Vancouver based paediatrician and eczema expert Dr. Joseph Lam, MD, FRCPC to learn more about the connection between atopic dermatitis (the most common form of eczema) and food allergies.

“With atopic dermatitis (eczema), one of the features is sensitive skin.  This doesn’t just lead to the skin being more likely to get irritated.  It can also allow food proteins to enter the skin and trigger the immune system to recognize these food proteins as something it needs to attack.  The next time the infant eats the food, the body may decide to attack the food protein, leading to the symptoms of a food allergy.”, says Dr. Lam.

“Fortunately, it seems that early introduction of foods can help reduce this risk. A recent landmark study demonstrated that early introduction of peanuts to “high-risk” infants (such as infants with severe eczema) reduced the odds of developing an allergy by 70-80 per cent. Its findings were a breakthrough in how we understand the link between food allergy and eczema.”

Dr. Lam offered guidance to better understand this new research: “To help navigate this emerging research, the Canadian Paediatric Society issued guidance in early 2019 on introducing allergenic foods to infants at high risk of developing food allergies. For example, they recommend introducing common allergenic foods to babies who were at risk of developing food allergies at around six months of age, but not before four months. High risk was defined as having a history of eczema or having a first-degree relative – such as a parent or sibling – with allergies. To read the full guidelines visit cps.ca/en/documents/position/allergenic-solids and consult with your child’s health care provider.”

Dr. Lam reminds us to consult with our own health care providers: “It is important to also remember that while there is a link between food allergies and eczema, there is no current evidence to support that that certain foods cause eczema. This means it is not recommended to use elimination diets or avoid certain foods as a method to manage eczema. If you think a certain food is linked with your eczema flares, consult with your healthcare provider.”

Working with your own health care provider is very important, and Dr. Lam reminds us again, “If your infant has severe eczema you should consult your allergist, dermatologist, or healthcare provider before introducing any allergenic foods into their diet (such as peanuts).”

Dr. Joseph Lam is a paediatrician from Vancouver, British Columbia.