I ran into an old friend yesterday and enjoyed hearing stories about her two young children, Mallory and Mikey. Once upon a time, she babysat for my young children; now she has babies of her own. She talked about their struggles trying to get Mikey’s eczema under control. I thought it would make an interesting topic for a blog post, and she agreed.

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Eczema, in case you don’t know, means allergies in the skin. Medicine has different names for allergies, depending on where they pop up. Allergies in the lungs is asthma, in the sinuses is allergic rhinitis, in the eyes is allergic conjunctivitis, and so on. I, myself, have wondered whether anxiety isn’t a manifestation of allergies in the brain. What I know for sure is that if you have allergies in one place you’re a lot more likely to have them elsewhere.  And, conversely, the better controlled your allergies overall, the fewer allergy-related problems you’re likely to have anywhere.

Ordinarily, an allergy starts when the immune system mistakes a normally harmless substance for a foreign invader. The immune system produces antibodies to attack the invader. The body releases histamine, a protein that causes swelling, itching, irritation, and other common allergic symptoms. When the histamine is released in your skin, it gets itchy. When it’s released in your sinuses, they get drippy. This is why “antihistamines” are used to treat allergy symptoms.

In medical school we learn that eczema is “the itch that rashes.” I always found that kind of interesting. You would, of course, think that it’s the reverse. To me, this means that if you can figure out how to stop the itching you can probably make the eczema better.

Since eczema is likely to be allergy-mediated, my next goal is to identify its cause. What might it be? Well, the most common offenders are pets, mold, or food. Food is the reason for my interest here on the blog.

A doctor with specialty training in allergies and immunology can do tests to help identify the cause. That’s a good place to start. But testing is not always definitive, and so the doctor may recommend an “exclusion diet.” The idea behind an exclusion diet is, as it states, to exclude (to the best of one’s ability) one food category at a time from the diet for about three weeks. Following that, at the end of the three weeks some people may try to induce symptoms by eating a generous portion of the excluded food. Other people already know. Three weeks should hopefully be sufficient time to see improvement in one’s symptoms unless, that is, the allergy symptoms are being caused by more than one allergen. Keep in mind that there may be more than one cause.

The eight most common food allergens (proteins that cause allergies) are milk, eggs, peanuts, tree nuts, fish, shellfish, soy, and wheat. These eight food categories account for approximately 90 percent of allergic reactions, so they are a great place to start. And, with luck, you’ll figure out what the problem is long before you reach the end of the list. 

When I was little almost no one at school suffered from food allergies. Now they are epidemic, some life-threatening. Immune-mediated diseases have been rising steadily, and no one has yet provided an adequate reason. Is it the glut of pro-inflammatory omega-6 fatty acids in most processed “foods”? Is it an additive, such as carrageenan, for example? Or maybe it’s the triclosan, aspartame, saccharin, sodium lauryl sulfate, or blue dye no. 2 in toothpaste? Is it our comparatively sterile environments, or maybe the high rates of cesarean section, that have significantly decreased our exposure to a wide variety of “healthy” microorganisms? Or is it all of these? I cannot say.

While my friend attempts to identify the allergen(s) bothering Mikey, I recommend that they apply baby oil gel to his skin immediately after his bath, before drying off. That should help to hydrate the skin better and decrease the irritation. But I’m going to put my money on a food allergy, especially after I learn that the eczema is especially bad around his mouth.