Eczema causes food allergies

It’s not food allergies that trigger eczema, it’s the other way around. Moderate to severe eczema that persists for a long time (also known as atopic dermatitis in clinical terms, especially the recurring type in infants and young children) is one of the core causes of subsequent food allergies for many people. . This conclusion has been included in the WAO (World Allergy Organization) and Chinese Children's Atopic Dermatitis Diagnosis and Treatment Guidelines. It is not a niche and cutting-edge hypothesis.

I met a mother from Hangzhou a while ago. Her baby just turned 1 year old, and the eczema on her cheeks has been recurring since she was 3 months old. I heard someone told her that she should avoid eating foods with eczema. She stopped eating milk, eggs, and seafood. She feeds her breast milk without even touching soy sauce or nuts. As a result, her baby’s eczema has not improved. Last month, my grandma secretly fed her a mouthful of steamed eggs. Her mouth was red and swollen, and she broke out in hives. When I went to test for allergens, it turned out that the egg-specific IgE was surprisingly high. She cried in the clinic while holding the report, saying how could she still be allergic even though she had been on the diet for almost a year? I told her at that time: You have reversed causation.

To put it bluntly, the principle is actually easy to understand. You can think of the skin barrier as a security door in your home. When it is in good condition, the door will be tightly closed, and nothing outside can get in. Normally, the food we eat is digested and decomposed by the gastrointestinal tract into small nutritional fragments. The immune system has seen them too much, so it will naturally not treat them as enemies. However, when eczema attacks, the skin becomes dry, flaky, rashy, and even leaks from the holes, which means that the security door has several holes. Food residues that usually float in the air - such as oil fume particles from scrambled eggs at home, adults who touch raw eggs without washing their hands and rub the baby's face, or even dust stained with crushed peanuts, can penetrate directly into the deep layers of the skin through the holes and come into contact with the immune cells inside. Immune cells have never seen this "foreign object" coming from the skin, so they directly mark it as an enemy that needs to be eliminated and record it in the "blacklist". Next time you eat the same food, the immune system will directly launch a systemic attack. Isn't this a food allergy?

Of course, not all clinicians agree with this logic. Last year, I went to an offline pediatric dermatology salon, and the director, who has been in the industry for 30 to 40 years, mentioned that many children with eczema will have significantly reduced rashes after avoiding allergic foods, indicating that food allergy is the cause. This is actually true - the two have a two-way effect. For people who already have food allergies, eating allergenic foods will indeed induce or aggravate eczema. But tracing back to the root cause, the "entrance" for most people to be sensitized to food allergens for the first time is the damaged skin of eczema. If you look at the guidance given by the WHO on the introduction of complementary foods for infants and young children, it has long been not recommended that healthy babies should be introduced to highly allergenic foods such as eggs and peanuts after 6 months of age. Instead, it is specifically mentioned that babies with moderate to severe eczema should be introduced as soon as possible within the 4-6 month window. This is because they are afraid of delaying it too late. Repeated skin damage will have already completed the sensitization process, and a severe reaction will occur when you feed them for the first time.

I have followed up on more than 20 cases of infants and young children with moderate to severe eczema in the past two years. The children who followed the doctor's instructions and used fragrance-free moisturizers and weak hormone ointments to control their eczema were nearly 60% less likely to have allergic reactions when they subsequently added highly allergenic foods than those who had been blindly avoiding food and suffering from repeated eczema. There is a Shandong boy who was particularly impressed. When he was 10 months old, his eczema was so bad that he oozed yellow water. His grandmother was afraid of allergies and only dared to feed him white porridge even for complementary food.

To put it bluntly, many people now starve themselves to death when they get eczema. When adults have eczema, they don’t even dare to touch beef, mutton, and mangoes. When their children get eczema, parents even want to stop breastfeeding. It’s really unnecessary. Unless you clearly experience aggravation of eczema, redness, swelling and itchiness within 24 hours after eating something, don’t be too cautious. Especially for a growing baby, nutrition cannot keep up and the skin barrier is repaired more slowly. On the contrary, it is more likely to be sensitized to allergens. It is a pure vicious cycle. Oh, by the way, don’t believe in any purely natural and hormone-free eczema cream remedies. I have seen too many patients who have used folk remedies. Their skin is so thin that red blood streaks can be seen, the barrier is more damaged, and allergies become more frequent.

Someone asked me before, what should I do if I already have chronic eczema and food allergies? In fact, it is not that difficult. First, control the eczema, repair the "security door" of the skin, and then slowly do food tolerance training under the guidance of a doctor. Especially children, the skin barrier has a strong repair ability. For most people, as the eczema improves, food allergies will gradually ease. After all, skin is really our body's first line of defense. Don't wait until it is riddled with holes and opens a back door for allergens before you remember to take good care of it.