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Eczema Flare-ups and Food
Q: When my daughter was 10 months old, she was diagnosed with eczema and was prescribed an ointment and a liquid antihistamine. Now she is 18 months old, and it seems like certain foods, such as dairy and acidic foods, make her skin worse. How can I be sure what foods are causing her skin to flare up more?
A: Certain foods can cause a flare-up of eczema (atopic dermatitis), a condition that causes a red rash on the skin that is dry and irritated. If a child is sensitive to certain foods (more common in infants and toddlers), an eczema flare-up can occur when these foods are eaten. Similarly, a child with environmental allergies (such as allergies to dust, molds, and pets) is more likely to suffer from eczema and it can worsen when she is exposed to them. Although avoiding certain triggers is not a cure for eczema, it can certainly relieve some of your daughter's discomfort.
Certain foods have been known to make eczema worse, such as eggs, milk, wheat products, and soy. Tomatoes, nuts, fish, citrus, and tropical fruits are other foods that have been associated with worsening symptoms. There is no one food or set of foods that makes every child's eczema worse; each child is different. Even though you may notice that one particular food makes your daughter's eczema worse, it is important to speak with your doctor before removing any foods which are necessary for growth and development from your child's diet. It may be difficult to pinpoint the exact food because many prepared foods contain a variety of ingredients.
To determine what is worsening your daughter's eczema, observe what she is eating, wearing, and doing during the flare-up. Keep a diary and review it for some consistent pattern. Finding food sensitivities is very difficult and often never determined, so do not get discouraged. In the meantime, here are some tips to help relieve your daughter's discomfort and prevent other flare-ups: Bathe your child with warm -- not hot water -- and avoid excessive scrubbing and toweling. Be sure to apply a moisturizer immediately after her bath. However, make sure that the moisturizer you use does not contain alcohol, which can dry her skin. If your home is dry, particularly in the winter when the heat is on, consider using a humidifier in the house to moisten the air. Also, try to dress her in mostly cotton clothing since it is less irritating to her skin. To avoid skin infections, cut her nails short so that she does not break the skin while scratching. Mittens or gloves may also prove helpful. If her skin becomes infected, your physician should treat it promptly. The cortisone cream and liquid antihistamine your physician prescribed should also help decrease her skin inflammation and itching within a few hours.
The good news is that your daughter's eczema will probably improve as she gets older. In the meantime, by avoiding triggers and following regular treatment as recommended by your pediatrician, her eczema can be controlled.
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Henry Bernstein, M.D., is currently the associate chief of the Division of General Pediatrics and director of Primary Care at Children's Hospital, Boston. He also has an academic appointment at Harvard Medical School.