Does an eczema flare-up necessarily mean eating too much seafood or beef? Could it be a food allergy? Many parents or teenagers, upon learning that they have eczema or that their eczema has recurred, immediately stop eating seafood, beef, milk, and other foods without a second thought. What impact would a "one-size-fits-all" dietary restriction have on teenagers going through puberty? Dr. Chan Yick-chun, a paediatric specialist, points out that research has shown that children and adolescents with food allergies do indeed have a higher chance of developing eczema.1but the causes of eczema also include genetics, exposure to allergens such as dust mites, animal dander, etc.2,3Therefore, whether to abstain from food or not depends on the individual. If you suspect food allergies are causing recurrent eczema, what should you do? You can consider taking skin prick or IgE allergy blood tests to identify the allergen, then abstain from that food accordingly!
The two most common allergens: environmental and food. Allergic reactions are divided into acute and chronic.
There are many causes of eczema. In addition to genetic factors, allergens and emotional changes can also trigger or aggravate eczema symptoms. Dr. Chan explains that allergens are mainly divided into two major categories. First, environmental allergens. In Hong Kong, most environmental allergens come from dust mites or the fur of pets like cats and dogs, which can cause allergies. Second, food allergens. Once a person is sensitive to a certain type of food, their reaction after consumption can be very rapid, with itchy lips, tongue, and throat within minutes to 2 hours, or even hives (commonly known as urticaria). Severe cases may result in swollen eyes, itching, wheezing, and even shock in some individuals.4.
Aside from the aforementioned acute food allergies, some individuals may experience delayed reactions hours after consuming allergenic foods, such as eczema flare-ups, gastrointestinal discomfort, vomiting, and diarrhoea. Using common childhood and adolescent eczema patients in Hong Kong as an example, children of different age groups have varying food allergies. For instance, infants and toddlers might be allergic to milk and eggs; children aged 2 to 3 may react to nuts and peanuts; for adolescents, allergies commonly occur towards beef, fish, seafood, shellfish, and crustaceans, depending on family history or personal sensitivities.
Eczema and food allergies do not necessarily have a connected relationship
However, Dr. Chan stressed that even if adolescents suffer from both eczema and food sensitivities, the two are not necessarily interconnected. Therefore, do not arbitrarily restrict your diet. It is recommended to consult a specialist doctor first for further examination to identify the allergens and causes that trigger eczema.
Dr. Chan stated that the reasons behind adolescent dietary restrictions could be due to puberty, where dieting for weight loss is not uncommon, and there are higher demands on appearance. Another situation involves avoiding certain foods due to concerns about eczema or skin problems. However, adolescents have a fast metabolism, and their bodies require proper nutrition to grow. Randomly cutting out certain food groups can potentially affect height and body shape, leading to unintended consequences.
If red meat such as beef and pork is avoided for a long time, it can lead to iron deficiency anaemia, causing symptoms such as dizziness and inability to concentrate in class.
Dr. Chan stressed that food sensitivities are a serious issue to be addressed, but one should not restrict their diet without proper grounds! "Young people need to maintain a balanced diet, get adequate rest, and exercise moderately, which is of great help to their physical and mental development."
Teenagers' ways to deal with eczema
- Diet and gut health:A balanced diet should be maintained. Dr. Chan pointed out that many studies have confirmed a close link between improved gut health and a reduced chance of eczema triggered by allergens, and probiotics can be taken if necessary.5.
- Managing stress properlyExcessive stress can also trigger eczema. Teenagers may suffer from insufficient rest due to issues such as exams, social life, and further education. If stress is not properly managed, the immune system can be affected and trigger eczema. It is recommended that patients participate in more extracurricular activities, manage their time effectively, and alleviate stress appropriately.
Allergy testing to find allergens, do not arbitrarily restrict food intake
Besides food allergies, there are also patients with nasal allergies, tracheal sensitivity, etc. Apart from medication, it is more important to find the root cause of the problem. Dr. Chan pointed out that if you suspect an allergy or want to identify the allergen, you can consider the following two testing methods:
Skin prick test6-7(Skin Prick Test)This is a clinical skin test, generally carried out on-site at a clinic. The doctor will use a small needle to place a drop of a potential allergen on the patient's skin, usually on the arm. After approximately 15 minutes, the allergen can be identified based on immediate skin reactions such as redness, swelling, or itching. Up to 20 allergens can be tested at once.
IgE allergy blood test6IgE Blood TestA more accurate blood test requires a small blood sample (1-2ml) from the patient to be sent to the laboratory for testing, with results taking approximately 1 to 2 weeks. IgE tests developed in recent years can detect over a hundred allergens each time. If the sensitivity is mild, it is not necessary to completely avoid the food; one only needs to reduce the frequency of consumption or control the portion size.
Severe eczema patients should seek prompt and appropriate treatment, with many medication options available.
Dr. Chan reminded that eczema in adolescents, causing skin inflammation, itching, redness, and swelling, is often due to continuous scratching, leading to complications such as bacterial infections that result in skin discharge and scabbing, severely affecting the patient's daily life.
"If eczema has reached a moderate to severe stage, it will mostly affect the patient's sleep quality and emotional well-being, subsequently leading to a decline in abilities such as learning and socialising." He emphasised that moderate to severe eczema patients may not be triggered by a single factor. Therefore, it is recommended to treat the symptoms accordingly. Under a doctor's prescription, it is important to select suitable emollient creams and steroid medications, and also to use some newer medications, such as PDE4 inhibitors, depending on the condition.8and even biological agents9Or desensitisation therapy10Wait, to alleviate eczema symptoms, rather than just stopping eating!
References
1. Caruso DM, et al. J Allergy Clin Immunol. 2008; 121(2):S236
2. Senra MS & Wollenberg A. Br J Dermatol. 2014; 170 (Suppl 1):38-43
3. Hostetler SG, et al. J Clin Aesthetic Dermatol. 2010; 3:22-31
4. Mayo Clinic. (2019, 2 November). Food allergy. Retrieved 5 October 2021
5. Fang Z, et al. Front. Immunol. 2021; 12:720393
6. Ansotegui IJ, et al. World Allergy Organ J. 2020; 13:100080
7. Mayo Clinic. (2020, April 4). Allergy skin tests. Retrieved 11 October 2021
8. Yang H, et al. JAMA Dermatol. 2019;155:585-93
9. Worm M, et al. J Dtsch Dermatol Ges. 2020; 18:1085-92
10. Leung TNH & Hon KL. Hong Kong Med J. 2015; 21:251-60
