In eczema, or atopic dermatitis, the skin is dry, irritable, sensitive and prone to inflammation and infection. The natural course of eczema is to see periodic flares in symptoms – whether there is an identifiable trigger or not. Because of this, it can be very tricky to determine if a food is causing the eczema flares. Most of the time, the food does not cause the eczema, despite someone having a strong suspicion. People with eczema are at risk for food allergies, but when the food is ingested, there will typically be an immediate allergic reaction (with hives or wheezing, for example), rather than an eczema flare. Finally, it is not common for foods that were previously eaten without problems to become the allergic trigger. If you cannot get your eczema under control and have concerns about a food trigger, it’s important to discuss with your allergist. In the meantime, here are some tips:

1. Don’t assume the rash is result of a food allergy. Eczema is due to a barrier dysfunction and inflammation in the skin. A good skin care regimen or eczema care plan can help minimize flares and keep skin under control. The most important part of a skin care regimen is moisturizing (especially after bathing) and avoiding known triggers (chemicals, certain fabrics, etc).

2. If you see typical food allergy symptoms (such as hives, wheezing, vomiting) in addition to the eczema flare, it makes it much more likely that a food could be a trigger. Treat any reactions, take note of food ingredients, and talk to your allergist.

3. Do not remove foods from the diet on your own when a relationship is not clear. Removing foods can cause social and nutritional problems, and potentially cause more issues down the road.

4. Come to your allergist appointment ready to give details. Keep a good history about the foods eaten, how symptoms started and timing of symptoms. The history is the best “test” to determine if there is a food allergy, and way more informative than any blood or skin tests. Random testing for several foods can be inaccurate and misleading, but a good “history”, or details of what happened, is the most accurate test.

Managing food allergy and eczema is complicated. If you continue to have problems controlling your eczema, make an appointment with your allergist to discuss.