Eczema may be associated, caused or aggravated by an underlying food allergy. This is especially true in infants and children. In adult eczema, food allergens are less relevant, instead environmental allergens such as dust mites or exposure to pet dander may be more relevant.

Identification and managing these allergies is integral part of managing eczema. This needs considerable expertise as random or inappropriate elimination of foods is not recommended, and in fact may be harmful.

Your allergist will arrange for appropriate diagnostic tests to help identify any associated food allergies. This is sometimes done in association with a dietitian who has specialised knowledge of food allergies.

Eczema is often a chronic and complicated disease and can be very disruptive for the affected patient and other family members. 

The patient/family individualized treatment plan depends on several factors such as age of the patient, the severity of eczema, complications such as secondary infection, and clinically relevant food or environmental allergies.

In cases of moderate or severe eczema, your allergist may recommend prescription medication, including topical steroids and/or nonsteroidal immune modifying medications. Milder cases may be treated with emollients and moisturizers. Those should be applied daily, even when the skin appears clear, to help prevent dryness.

People with eczema should avoid harsh cleansers, drink water often, and avoid wearing materials such as wool, which could irritate the skin. 

Flare-ups of eczema need to be managed with potent topical steroids; sometimes antibiotics are also needed for secondary infection.

If you have an infant with eczema, your allergist may recommend daily baths followed by immediate application of moisturizer to “seal” in moisture. This technique is called “soak and smear” and can provide relief from the itching. Some infants and children with chronically infected eczema, may need “diluted bleach baths” especially with secondary infection is making eczema resistance to 1st line treatments.

Managing the itch is important, as scratching of the skin besides causing damage also introduces secondary infection. Cold compresses and wet wraps may help reduce itch. Antihistamines may also be helpful.

Finally, managing stress is important as it may worsen eczema, even though eczema is not a psychological disease.

In select cases allergen immunotherapy has proven to be effective treatment, greatly reducing symptoms and reliance on topical medications, especially in older children and adults.

New treatment options that are currently pending approval include a topical treatment called crisaborole for children 2 years of age and older and adults with mild to moderate eczema. The drug, dupilumab, is a twice-monthly injection under the skin that patients can do at home. The drug was made for those whose eczema which is not controlled well by topical therapies such as ointments or creams.

Contact dermatitis is a red, itchy rash caused by direct contact with a substance or an allergic reaction to it. It is not contagious and can occur at any age. Signs and symptoms of contact dermatitis include:

These symptoms may develop hours or even days after exposure to the trigger and can range from mild to quite severe.

If you have contact dermatitis, it’s important to see an allergy specialist or allergist. Your allergist may prescribe you medicated creams or oral medications in severe cases.

If you’re looking for advice on diagnosing or treating either condition, contact (07) 3348 7921 today. Our expert team are experienced with dermatitis and would love to work with you to develop a treatment plan.