Parents often ask us if their child with eczema is allergic to something in the belief that removing the allergic “cause” would clear the eczema.

Unfortunately, it is not that simple. It is very rare for childhood eczema to clear after removing or reducing a possible allergen. However, allergies are more common in children with atopic eczema than in other children, so it is helpful for you to think about whether your child might be reacting to something.

Allergies in children with eczema may be:

• Foods – most commonly egg and milk in the first year of life or peanuts in older children
• Things in the air (airborne allergens) eg. grass, animal hair
• Things in contact with the skin (contact allergens) eg plasters, preservatives found in some creams .

Things that make eczema worse (“flare”) are called “triggers”. Eczema often flares in response to several triggers happening at the same time rather than one at a time.

Triggers may be allergic in nature, but more often than not, they are non-allergic and include irritants, soaps, stress, heat, tiredness, sweating, changes in weather and having a cough or cold. Therefore it is only sometimes that allergy tests help to get better control of your child’s eczema.

In the case of eczema affecting the hands, the most common reason for worsening eczema are the irritant effects from contact with water, soap, sand, play materials, saliva, foods and cold wind. These effects are not allergic ones.

The best way to find out if there is something which causes your child’s eczema is to take notice of the reactions your child has. For example, if your child gets itchy patches and swellings on their skin after stroking a cat they do not see often, along with sneezing and a runny nose, then these are fairly reliable signs that your child is allergic to that particular cat.

Food allergies are sometimes harder to spot. If your child gets immediate ‘hives’ or a nettle rash on the skin or tingling in the mouth when eating a particular food, it is very likely they are allergic to that food. Blood or skin prick tests can be done to confirm this. (See details of these tests below.)

Remember that atopic eczema is a condition that comes and goes quite quickly and that the best time to look for allergies is when your child’s eczema is in a good and stable state.

Allergy Blood Tests

This blood test tells us if your child has antibodies in the blood which could react to common substances that spark off allergies. Blood tests are helpful to confirm a suspicion of an immediate food or airborne allergy. They can be helpful in babies less than 1 year old to look for allergy to milk and egg. Blood tests are helpful if they are negative to the suspected food as a negative test is pretty good at ruling out allergy. The blood test is also helpful if it is strongly positive when there is a history of possible allergy. More often than not, especially in older children, the tests come back as low positive which does not mean very much as lots of people without eczema are the same. In other words, what happens in the blood may have little to do with what happens in the skin. Sometimes, especially if your child also has asthma or hay fever, what happens in the blood is more related to those conditions.

Just to summarise then: a strong positive test can be helpful to confirm a suspected allergen. A negative blood test is sometimes helpful in telling us that your child is not allergic to something. A low positive or multiple low positive tests don’t help us a lot. For more information follow this link: https://www.allergyuk.org/diagnosis–testing-of-allergy/blood-tests

Allergy Skin Prick Tests

These are tests that involve pricking a tiny amount of liquid into your child’s forearm to see which ones react. Test liquids are made up out of things that may cause allergies. Drops of these liquids in very dilute form are put on to the arm and the skin is pricked with a tiny needle. If your child is allergic to a particular substance, then they will get a red swelling on their skin after a few minutes. To see a video of this process follow this link: http://www.allergyuk.org/diagnosis–testing-of-allergy/skin-testing

Like the blood test, skin prick tests are only really helpful if they are strongly positive or negative. Skin prick tests cannot be done on skin that is affected by eczema at that time. Anti-histamines must be stopped several days before skin prick tests.

Allergy Patch Tests

These are used to look for another kind of eczema called allergic contact eczema. Sticky patches containing various substances are placed on your child’s back. Contact eczema is very uncommon in babies with atopic eczema, but can occasionally occur in older children. It is much more common in adults. For example, someone may have hand eczema due to wearing rubber gloves as they have an allergy to rubber. The rubber substance will show up as a reaction on their back 2-4 days after placing the patches on. Unlike the positive tests for food and airborne allergens, identifying an allergic contact factor such as rubber, glue, perfume or nickel in jewellery offers a good chance of clearing the problem if that factor is avoided.

Allergy tests on the High Street

We would not recommend you having high street or internet allergy tests because there is no evidence of their value in the management of atopic eczema.

Final thoughts

If you have any questions about these tests or the information you have
read here, please talk to us at Elan Medical Skin Clinic.

Just remember that allergy tests are only part of the story when assessing your child for possible allergies.

In our last blog, Sue Ibrahim, a nurse consultant dermatologist and medical director of Elan Medical Skin Clinic in Essex, stressed the importance of only believing scientifically proven advice. This time she takes a look at general skin care tips including using moisturisers and detoxing.

Read More…

Allergy testing has become increasingly popular over the years, in fact we see a lot of people at Elan Medical Skin Clinic who claim that they  have been diagnosed with certain food intolerances. But how reliable are these tests?

The medicines regulator (MHRA) has said there is no scientific basis for tests widely available in health food shops and pharmacies that claim to show food intolerances. In fact the MHRA found that there was “no scientifically valid test to diagnose food intolerance”. Many of the tests confirm the presence of IgG antibodies, which show only that a food has been eaten at some stage, not that someone is intolerant of it!

The MHRA said that attempting to self-diagnose a food intolerance or allergy using a test kit alone could potentially result in a delay in identifying or treating other medical conditions. It added that there was a clear distinction between food intolerance and food allergies, which can be potentially life-threatening.

So what should I do if I think my child has a food allergy?

Pregnancy is normally a time when you are radiating with excitement, yes? But when your pregnancy complexion doesn’t always reflect that inner joy it can dampen your spirits.

Worry not, for most you will find that these skin issues resolve themselves following the birth of your baby.  Here are some of the most common skin problems women encounter during pregnancy—and what you can do about them.

Skin Sensitivity

Go easier on your skin now that you’re pregnant. You might get red more easily if you use a facial scrub, your normal facial might verge on painful, and the perfumed lotion you wear might irritate your skin (and make you nauseated, but that’s a different story). That’s why many mums-to-be switch to unscented products and start choosing products that do not contain harsh chemicals, preservatives and fragrances. “You certainly don’t want anything causing micro-tears on your skin,” says Sue Ibrahim, our dermatology nurse consultant.  “The more cuts and wounds on your skin, the easier it is for chemicals to be absorbed into your bloodstream. Ingredients to stay away from in soaps and body washes include sodium laureth sulphate, parabens and fragrance.” These ingredients aren’t just potential irritants—some say they could pose health risks to baby. We say believe it, because (not surprisingly) a lot of products aren’t tested directly on pregnant women. If you are using prescription topicals on your face you need to tell your doctor that you are pregnant as most prescription creams are not licensed for use during pregnancy either. At Elan Medical Skin Clinic we advise our patients to use our Elan Medical DermaCalm range during pregnancy, because they are free from fragrances and preservatives. They also contain mild anti-inflammatory ingredients that can soothe irritated skin.

Acne breakouts during pregnancy

During pregnancy your hormones are all over the place, and that might mean pimples like you had when you were a teenager. The cruel joke, of course, is that many of the treatments that are prescribed for acne cannot be used during pregnancy. Prescription medications like Tetracyclines, Isotretinoin (Roacutane(R)) and the anti-androgen hormone therapies are definite no-nos. And the jury’s out on over-the-counter creams, since they haven’t been tested specifically on pregnant women (yup, you find that a lot with products). Ingredients like benzoyl peroxide and salicylic acid can be absorbed into the bloodstream, so they’re not worth the risk either. “You can safely use lactic acid and biosulfur to treat acne,” Sue Ibrahim says. Don’t touch, pick or squeeze pimples— just wash with a mild cleanser twice a day. “A lot of women find Acne Phototherapy beneficial during pregnancy and it is perfectly safe for both you and the baby.

Sun Sensitivity

Sorry, mums-to-be, but “pregnancy glow” does not refer to a bronzed, sun-kissed complexion. You should actually try to stay out of the sun as much as you can while you’re pregnant. That’s because your surging hormones make you susceptible to dark patches on your skin—known as melasma, or the ‘mask of pregnancy’, which is triggered by sun exposure. So pull out the big floppy hat, find a beach umbrella and be diligent about wearing sunscreen with an SPF of at least 30 every day. If you are unlucky and do get Melasma during pregnancy it may resolve on its own following the birth of your baby, if not then you will need the help of a dermatologist I’m afraid.

Stretch marks

Now you’ve got another big skin concern: stretch marks. Anytime someone’s body grows quickly, they’re at risk for stretch marks, so the fact that baby is growing exponentially in there puts you right in the high-risk zone. Of course, not every mum-to-be gets stretch marks. “For most people, whether or not they get stretch marks has to do with genetic predisposition,” says Sue Ibrahim. But you can do your best to head them off by gently exfoliating and thoroughly moisturising your belly, boobs, stomach, hips and thighs as much as you can. As for what moisturizer to use, it’s hard to make a recommendation. “A lot of products make claims,” Sue Ibrahim says. “Some may help but aren’t really proven to prevent stretch marks.” If you are left with troublesome stretch marks following the birth of you baby, it is worth looking into the skin tightening treatments we offer at Elan Medical Skin Clinic.

Skin rashes during pregnancy

If you’ve got red, itchy skin, it’s important not to ignore it. Itchy feet and hands could be a sign of cholestasis of pregnancy, a scary complication that can cause liver problems for baby. Your doctor can do a simple blood test to make sure that’s not causing your rash. Another common pregnancy rash is PUPPP (pruritic urticarial papules and plaques of pregnancy), which often starts in the abdomen and spreads from there. PUPPP is actually harmless to baby, but it will be completely aggravating for you. Book in for a Dermatology Consultation if you are concerned.

Eczema, also known as ‘atopic eczema’ or ‘atopic dermatitis’, is a skin allergy/condition causing inflammation and intense irritation. When it occurs in young babies and children it can be really upsetting for whole family.

Eczema symptoms tend to be caused by dry skin. Skin that is affected by eczema gets sore and broken when it is scratched. It can look wet and may bleed. Scratching is hard to avoid since the main distressing symptom of eczema is unbearable itching, but once the skin gets broken and cracked, infections can set in, causing even more discomfort.

What Does Atopy/Atopic Mean?

There are many types of eczema and dermatitis:

• Atopic Eczema / Atopic Dermatitis
• Discoid Eczema
• Contact Dermatitis

Atopy, or being atopic, means having a genetic tendency for your immune system to make increased levels of IgE antibodies to certain allergens. An atopic individual is likely to have more than one allergic condition during their lifetime, such as eczema, asthma, hay fever or food allergy.

Can Food Allergies Cause Eczema?

Children are born with the tendency to have eczema, and many things can make their eczema worse. These are known as eczema ‘triggers’. Eczema in children can have various triggers, of which food can be one, especially in babies. However, foods are not the primary cause of eczema.

How can we help at Elan Medical Skin Clinic?

We all understand the pressures that GPs are under. One of the biggest problems is the pressure of TIME. At Elan Medical Skin Clinic in Essex our Dermatology Nurse Consultant, Sue Ibrahim, has over 30 years experience in helping children and their families cope with the day to day struggles of coping with eczema. She can help you identify the trigger factors in your child and thoroughly discuss the treatment options open to you. No, she cannot cure eczema but she can work with your GP to ensure that a management programme is in place and that exacerbations of eczema are dealt with quickly and effectively.

How to help us diagnose an allergy

The first step in managing an allergy is identifying the cause(s) of the problem. Diagnosing allergy can be difficult since the symptoms may be similar to other conditions. If you think your child may be allergic to something and do not know what it is, you should start to keep a record of the symptoms. In particular, the following information may help us make a diagnosis

• Do the flare ups occur at any particular time of the day?
• Does your child only get symptoms at certain times of the year?
• Does your child suffer more at night time or during the day?
• Do the flare ups occur when your child is in the house as well as outside?
• Does exposure to animals bring on the symptoms?
• Do you think that any food or drink brings on the symptoms?
• Do the symptoms occur every time your child comes into contact with the allergen?
• Do the symptoms improve when you are on holiday?

If you are at the end of your tether, and would like a consultation to discus your child’s eczema, our friendly team are here to help. Contact us today!