What is eczema?
The word eczema simply means dermatitis, which is an inflammation of the skin. There are different types of dermatitis or eczema. The most common type of eczema in children is atopic eczema. The terms "atopic eczema" and "atopic dermatitis" mean the same thing. The child with eczema has sensitive skin, which is irritated very easily. Their sensitive skin often is itchy (the medical term is pruritus), and the eczematous rash results from the scratching or rubbing of the extremely itchy skin from which these children suffer. While it is apparent from observing a child with atopic eczema that the rash is very itchy, it may be more accurate to say that atopic dermatitis is "the itch that rashes."
Why does my child have eczema?
Atopic eczema is believed to be a genetic disorder resulting in sensitive skin. It tends to be associated with the predisposition to become allergic to foods and substances in the air such as pollens, molds, animal danders, and dust mites. Some children with eczema develop severe allergic reactions to foods and many develop asthma and hay fever symptoms as they get older. Often there is someone else in the family with eczema, asthma or hayfever (allergic rhinitis), but this is not always the case. There are many external factors which may influence eczema on a day to day basis; some are irritants and some may be from allergy.
Will my child "grow out" of eczema?
The tendency for sensitive skin may remain even into teenage years or beyond. However, in most cases your child's eczema will gradually improve as they get older. The age at which eczema ceases to be a problem varies. Many are better by the age of 3 years, and most will have only occasional trouble by the time they are teenagers. It is estimated that about 2/3 of children "outgrow" their eczema, although they may always have a tendency for dry skin. Only a few continue to have troublesome eczema in adult life.
Is eczema due to an allergy?
No, atopic eczema is not caused by any specific allergy. But atopic eczema may be worsened in some children from allergy to foods. Since this is the case only for some children, restricting diets as a general treatment of atopic eczema is not useful. However, when allergic antibody is demonstrated to a specific food by skin testing or a special blood test (which is often called a RAST for radioallergosorbent test although that test has been largely replaced by an ELISA for enzyme-linked immunosorbant assay), the possibility that the food can worsen atopic eczema should be investigated by a food challenge under medical observation. This is done by first withdrawing the food from the diet for two weeks and then giving the child that food while under medical observation. The most frequent observation that demonstrates the possibility that the food is worsening the eczema is the presence of redness and itching, particularly at the site of the eczema, within an hour (and usually sooner) after ingestion of the food. Of course, a food challenge of this sort is only done if the food has not previously been observed to cause a severe allergic reaction. When there are multiple foods to which allergic antibody is demonstrated, the most important ones to consider are those that are frequently in the diet. There is no need for concern about foods to which tests for allergic antibody are negative.Will allergy tests help my child's eczema?
Allergy tests identify the type of antibody that can cause allergic reactions. Children with atopic eczema are prone to make allergic antibody to many things that they eat, contact, and inhale. Some, but certainly not all of the allergic antibodies developed in a child may cause clinical problems. Allergy tests provide information that may or may not help the child's eczema, depending on what is found from the tests, a careful medical history, and in some cases observations during exposure to a suspected food to which a positive allergy test is found. Allergy tests can also provide information about the risk of severe anaphylactic reactions (generalized hives with or without difficulty breathing), allergic rhinitis (runny or stuffy nose, sneezing), allergic conjunctivitis (itchy red eyes), or asthma.