Managing eczema and allergies together: insights from Dr. Kun Tian
People with eczema are also more likely to suffer with allergies. Eczema Society of Canada (ESC) recently spoke with Dr. Kun Tian, allergy division lead and internist at Scarborough Health Network and assistant professor of medicine at the University of Saskatchewan, to shed light on allergists’ valuable role in eczema treatment plans and to help patients navigate life with both eczema and allergies.
What is the role of an allergist?
Dr. Tian: “An allergist is a doctor specializing in the immune system. They diagnose, manage and treat allergic conditions within the atopic triad (eczema, asthma and allergies) and immune system disorders. The allergist’s role includes a range of responsibilities from allergy assessment to developing personalized treatment plans to helping educate patients to manage and minimize allergic reactions effectively.”
How can an allergist help manage eczema?
Dr. Tian: “When it comes to eczema, an allergist treats eczema with the first line of defence –good skin care practices, including increasing the skin barrier with moisturizing and avoiding products with potential allergens such as fragrance. Allergists can prescribe medical treatments to control inflammation and manage flares. Allergists also play a role in identifying eczema triggers and work with patients to identify environment, lifestyle or dietary factors causing flares. Additionally, an allergist often helps to manage eczema comorbidities such as asthma and allergic rhinitis.”
Is food allergy testing recommended if someone has eczema?
Dr. Tian: “No. Food does not cause eczema; therefore, generally, allergy testing doesn’t change the basics of eczema management. The relationship between eczema and food allergies varies from person to person, and testing is only useful in certain cases. Patients with eczema are likely to have a higher risk of food allergy development, but not always, and the associated food allergies are not what’s causing the eczema. Eczema is caused in part by an impaired skin barrier and a dysregulated immune system. Food testing may lead to the unnecessary removal of foods from the diet. If you have eczema and are sensitized to a food by avoiding it, there is a higher chance of developing a food allergy because of the loss of tolerance.”
Do allergies cause eczema?
Dr. Tian: “Food or environmental allergies can trigger a worsening of eczema or a flare, but they do not cause eczema. Avoiding triggers won’t cure eczema, but avoiding triggers can help to prevent flares. Trigger avoidance can be difficult, as it can be either allergic or non-allergic. For example, excessive sweating is a common non-allergic trigger, which often occurs during sports or in the summer. At the same time, certain product or environmental factors can be hidden allergens that take a long time to identify.”
What about eczema and seasonal allergies?
Seasonal allergies do not cause eczema, but there is an association that eczema patients have a higher chance of co-existing seasonal allergies. It is an association rather than a causal effect. Eczema patients suffering from environmental and seasonal allergies can work with an allergist to help manage their symptoms. Dr. Tian says, “Once allergies are diagnosed, an allergist can work with patients to create a management plan tailored to the needs of each patient. This could include discussing appropriate treatments even before peak allergy season, such as allergy shots and ways to enhance a patient’s quality of life during the pollen season.”
If you suspect that you are suffering with allergies as well as eczema, Dr. Tian advises speaking to a qualified health care professional to explore potential solutions tailored to your unique situation.
The Eczema Society of Canada thanks Dr. Kun Tian, MD, FRCPC, for his volunteer contribution to this educational content.
Disclaimer: Information provided in this resource does not constitute medical advice and is not intended to be used as a diagnostic tool. The information is up-to-date at time of publication. All medications, interventions, and treatment plans have risks and benefits, and it is important that individuals discuss their or their child’s specific health care needs with a qualified health care professional.
February 2024
