The Link Between Atopic Dermatitis and Food Allergies

Could certain foods worsen your eczema rash?

A doctor does a skin test on man with atopic dermatitis (eczema) rashes—is a food allergy making it worse?

Atopic dermatitis, also referred to as AD or eczema, is a chronic skin condition characterized by red, irritated and itchy patches of skin. While there is a known correlation between atopic dermatitis and food allergies, it is still a controversial subject as to whether food allergies worsen atopic dermatitis symptoms. Several decades of studies have shown that food allergies may exacerbate AD symptoms in some patients, though it does not appear to be common. It most often affects young children with moderate to severe AD, and is rare in older children and adults. 

The atopic dermatitis and food allergy link 

Researchers affiliated with Oregon Health and Science University in Portland spent five years studying infants and toddlers with atopic dermatitis and found that participants with more severe atopic dermatitis seemed to be at a higher risk for developing food allergies than those with milder symptoms. 

Understanding the connection 

Scientists speculate that there are several possibilities as to why this connection exists. Atopic dermatitis usually occurs in people who have a weakness in their skin's outer layer, thereby making the skin very vulnerable to irritants and allergens, including food, that can easily penetrate the skin barrier and cause inflammation, itching and other symptoms. 

It's also speculated that many of these food sensitivities can cause positive skin or blood allergy test results, though this kind of food sensitivity may not be indicative of a full-blown allergy. Nonetheless, because of a positive allergy test result, the person will avoid the food completely and in the avoidance process, may not develop a normal tolerance for the food; in other words, too much avoidance may be causing more allergies. 

If your child has atopic dermatitis 

The National Institute of Allergy and Infectious Diseases recommends food allergy testing for all children under the age of 5 who are diagnosed with moderate to severe atopic dermatitis and have not had success in managing the condition, and those who have had symptoms of food allergies. Common signs of an allergic reaction to food include skin reactions, inflammation, breathing difficulty or gastrointestinal upset that occurs after eating. 

If you suspect your child has a food allergy, speak with your child’s healthcare provider. Diagnosis of a food allergy typically involves a physical examination, medical history and a number of tests that can help identify specific allergens. These tests may include skin prick tests, where the healthcare provider uses a special needle to introduce potential allergens to the surface of the skin and observes for a reaction, and blood tests that look for allergen-specific antibodies in the blood. 

Skin prick tests and blood tests can identify sensitization to certain foods, but a diagnosis of a food allergy usually requires an oral challenge test as well. During an oral challenge test, the patient consumes small amounts of a potential food allergen, and observes for allergic reactions. These tests need to be performed in a carefully controlled environment due to the risk of anaphylaxis, a life-threatening allergic reaction. 

While there is no cure for atopic dermatitis, there are treatment options available that can help control symptoms, and knowing what substances trigger or exacerbate flare-ups—which for some people, may include food allergens—can help you manage the condition.

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