Do food allergies cause eczema? If a baby has eczema, are they more likely to develop a food allergy? Vhi consultant paediatrician, Dr Aisling Stafford, explains the important eczema facts, how it’s linked to food allergies, and what parents need to know about treatments and care.

What is eczema?

Eczema is a skin condition that causes inflamed, dry, itchy and cracked skin. It impacts the skin’s ability to act as a barrier to things in our environment. People sometimes think eczema is an allergy, but this isn’t the case. A Food allergy does not cause eczema, but there is an association between the two, which I’ll delve into further on. The exact causes of eczema aren’t fully understood, but research shows it could be a mix of genetic and environmental factors. Eczema causes the skin to be more penetrable and prone to damage from allergens in our environment. On light skin, eczema can appear reddish in colour, and dark brown, purple or greyish on darker skin tones. It can develop at any age, sometimes within the first few months of life. The main symptom of eczema is itching, and for some people, it can be severe and disruptive to their day-to-day when they have a flare-up. It’s commonly found on the face, creases of the neck, elbows and backs of the knees, but really, it can affect any part of your child’s skin.

Your healthcare provider will be able to diagnose your baby with eczema by examining their skin, and this won’t usually require blood or skin tests. They’ll also prescribe treatment for your baby, (there is no cure for eczema, but plenty of treatments to help with the symptoms), such as lotions, ointments, steroid creams, or antihistamines. Your healthcare provider will also recommend that you moisturise your baby’s skin a couple of times a day.

The link between eczema and food allergies

There are two types of food allergies, knowns as immediate food allergies and delayed food allergies. As the name suggests, an immediate food allergy will cause symptoms within minutes or up to two hours after your baby eats the allergen (the food that causes your baby’s reaction). A delayed food reaction takes place between two and 24 hours after eating an allergen.

As mentioned above, a food allergy doesn’t cause eczema. However, children that have eczema are at a higher risk of developing food allergies. In fact, if a baby has eczema within the first few weeks of their life, they are more likely to develop a food allergy[1]. Our skin acts as a barrier to water loss, allergens and infections; but skin with eczema has a disrupted or broken-down barrier, due to inflammation and cracks in the skin. This means small amounts of foods or allergens can pass through the cracks in your baby’s skin from their environment. These allergens are then noticed by their immune system, which reacts to the food as a foreign substance that’s attacking the body, and it produces antibodies against that food. When this happens, your baby is now sensitised to the allergen. So, your baby has never eaten the food, but they met it through their skin; maybe you cooked the allergen for dinner, and it was in the air, or your baby came into contact with food on someone else’s plate. When this happened, their body made antibodies against it. Then, when they do eat the allergen for the first time when weaning, they can have an allergic reaction. For this reason, if your baby has eczema and you delay getting allergens into their diet and their gut, there’s a chance they could sensitise to it through their skin. 

It’s advised that babies with eczema start eating allergens (foods like eggs, milk and nuts) at an early age of four to six months old, as long as they are developmentally ready. Babies are developmentally ready when:

• They can sit up and hold their head up.
• They can pick up food and put it in their mouth.
• They can fully swallow food without their tongues pushing any back out of their mouth.

Weaning when your baby has eczema
Weaning is what we call the process of introducing a baby to solid food. In the past, it was thought by some that avoiding the foods that people were commonly allergic to was the best way for your baby to steer clear of allergies. We now know the opposite is true; it’s important to introduce all the common food allergies to your baby’s diet as soon as they begin weaning. This reduces their risk of developing an allergy to the foods. This is backed by studies such as the 2015 LEAP study and its follow-up 2024 study, which found that babies at high risk for peanut allergy (babies with severe eczema, egg allergy or both), reduced their risk of peanut allergy by more than 80% when they were eating peanut foods early and regularly (compared to avoiding peanuts completely).

If your baby has eczema, it’s even more important not to delay the introduction of allergens (such as dairy, egg and peanut) to their diet when you begin weaning. When introducing your baby to allergens when they have eczema, I recommend putting an ointment like Vaseline around the skin at their mouth. This acts like a barrier for the skin and helps keep the allergen off your baby’s sensitive skin. It’s not advised to remove any foods from your baby’s diet to see if it helps with their eczema before consulting with your healthcare provider first.

If you’re ever unsure about when and how to introduce allergens when weaning, speak to your healthcare provider for guidance. 

Here’s a rundown of some of the main takeaways about eczema and food allergies:

• Eczema is a genetic skin condition caused by a defect in the skin barrier. It’s not an allergy. 
• There’s no cure for eczema, but lots of possible treatments are available to help with flare-ups. 
• If your baby has eczema, and is developmentally ready, it’s very important you don’t delay the introduction of allergens to their diet when weaning.
• It’s not recommended to remove food from your baby’s diet to try and help their eczema without talking to your healthcare provider first.

For more information and tips on weaning, take a look at my blog, ‘Is your baby ready for weaning? Signs and considerations.’
 

This content is for information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment. Always seek advice from your GP or an appropriate medical professional if you have concerns about your health, or before commencing a new healthcare regime. If you believe that you are experiencing a medical emergency call 999 / 112 or seek emergency assistance immediately. 

[1] The Irish Skin Foundation, https://irishskin.ie/eczema

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