Atopic eczema is a common chronic inflammatory skin disorder, the cause of which is complex and not fully understood. Both genetic and environmental factors are likely to contribute, with defects in epithelial barrier function arising from abnormalities in structural proteins such as filaggrin making the skin both excessively permeable and more prone to damage from environmental irritants and allergens.
About 20% of infants under 2 years of age with moderate to severe eczema will have food allergy.
In infants under 2, food allergy can exacerbate existing eczema but there is no justification for manipulating diet or removing food until skin care has been fully optimised.
Dietary manipulation must be short term and under experienced supervision from an allergy team that includes a Dietitian.
Children over 2 years with eczema should not have dietary manipulation without expert medical assessment.
Irish Skin Foundation guidelines for diagnosing and managing childhood eczema
Irish Skin Foundation and IFAN “20 Questions about food allergy and eczema”
Royal College of Paediatrics and Child Health Allergy Care Pathway for Eczema
Scottish National Clinical Guideline Managing Atopic Eczema in Primary Care