There is some controversy with regard to the role of allergies in eczema. There is no conclusive data on whether allergens do have a worsening effect on eczema or not, but in this overview we'll take a look at some of the key allergens that are thought to play a role, and what you can do to minimise their risk.
A worsening of eczema by foods in food allergic patients has been reported on numerous occasions, with the vast majority of cases seen in young children. The most commonly cited allergens are milk, egg, peanut, soy, and cereals. This should be considered in the management of eczema when there is a history of food allergy, or when conventional treatment measures are ineffective.
An appropriate diagnosis of the suspected food allergy should be made and the culprit food should be avoided.
That said, there is no evidence to suggest that people who don't have a food allergy benefit from primary prevention (e.g. a restricted diet during early childhood). Even in the rare cases when a food allergy may worsen child eczema, the food allergy itself is not the underlying cause of the eczema, but merely a contributing factor.
Some adult patients with eczema experience a worsening of their skin lesions after contact with certain aeroallergens (airborne allergens), e.g. house dust mite, pollen or animal dander. If you're concerned about airborne allergens, there is a specific allergy test which can help to identify if the worsening of eczema is allergy-driven or not, which you might consider taking.
How can a worsening of eczema be prevented?
Eczema trigger factors should be avoided where possible (e.g. dietary changes, using hypoallergenic bedding to reduce exposure to house dust mites, limiting exposure to cats and dogs, etc.).
The regular use of emollients can also protect against relapsing disease
The intermittent use of anti-inflammatory topicals (corticosteroids, calcineurin inhibitors) may be a second-line option to support emollient use.
This information is not intended to replace the advice of a doctor. If you are concerned about the role allergies might be playing in your eczema, be sure to seek advice from your healthcare professional.