Eczema is a common problem in children and is food allergy until
proven otherwise. The problem often appears on the face as patches
of reddish, scaling skin. As eczema worsens, the skin becomes more
itchy, red, thickened, and grooved, and may blister, weep, and crack.
The typical distribution of eczema is on the face, behind the ears,
on the fronts of the elbows, the backs of the knees, the hands, neck,
and trunk. Elbow and knee flexures, wrists and ankles and neck are
commonly involved. The neck may show increased pigmentation (dirty
neck). Hands may be dry and thickened. The face is less frequently
affected. The eczematous lesions tend to become more thickened
with age. There is a tendency for the eczema to improve or
disappear as children get older.
Toddlers and older children will often have food-allergic disease and
may also have airborne allergy. Chronic nose and throat congestion is
common. Sore throats and chinch coughs are also common. Coughing may
progress to asthma attacks. Some children develop the whole complex of
delayed pattern food allergy symptoms including behavior and learning
disturbances. Children with typical atopy will also tend to develop
immediate type allergic disease with seasonal pollen allergy and they
may react to house dust mites, fabrics, cigarette smoke and fungi.
We noticed that there was a sub group of children with moderate
to severe eczema who are otherwise happy, healthy children - they do not
have the other problems suggestive of food allergy and we are inclined
to look more closely food non-food environmental causes of their skin
eruptions; nevertheless, some of these "healthy" eczematous children
also respond well to diet revision.
Villaveces and Heiner reported remission of symptoms in six patients
with severe atopic dermatitis by replacing food with an elemental
nutrient formula for at least a week and then reintroducing foods to
determine reactivity. Ratner et al reported similar success in 16
children and 14 adults with moderate to severe eczema. Sixty percent
achieved significant remission after 3-12 days on an elemental nutrient
formula. They noted that half the food challenge reactions were
immediate and the other half delayed.
Although eczema is included in the atopic group, its mechanism
clearly goes beyond type 1 hypersensitivity. Chronic inflammatory
changes in the skin, eosinophilic recruitment, circulating IgA, IgG, IgE
immune complexes, and demonstrations of associate increased gut
permeability implicate all four hypersensitivity mechanisms in the
pathogenesis of this common skin disorder. IgG complement-fixing immune
complexes have been demonstrated in children with eczema. Complete diet
revision is the best way to treat this disorder rather than selective
elimination of foods either by history or skin test.
An Italian study of 5500 newborn infants with a family history of
allergy found 4677 with elevated IgE levels in cord blood. The parents
of these infants were encouraged to take preventive action to prevent
atopic disease; breast feeding with reduction in the maternal diet of
cow's milk, egg, tomato, fish was recommended for six months. Soya
formula was used beyond six months -13.3% of infants on the prescribed
regime developed atopic disease; 54.7% of the non-compliant group
developed AD. 73.3% of the afflicted infants had skin involvement.
Zeigler et al demonstrated a lower incidence of atopy at 12 month in
infants whose diet and mothers diet excluded cow's milk, wheat, corn,
soya, and citrus.
A prospective, randomized control study of 120 infants showed that
avoidance of allergenic foods and smoke prevents allergy. Lactating
mothers avoided milk, egg, fish, nuts and excluded these foods as well
as soy, wheat, and orange in the infant's diet for the first 12 months.
The restricted group had significantly less eczema and asthma.
James et al performed double-blind food challenges in a group of 320
children with atopic dermatitis and confirmed food allergy in 64% of
children who had skin disease.
The Decision to do Diet Revision The decision to modify the
child's diet is made when the eczema is moderate to severe, especially
when there are other problems suggesting food allergy. Allergy skin
tests are not always helpful in identifying the trigger allergens. With
milder eczema and strongly positive skin tests to specific foods, single
food elimination may be successful in controlling the eczema.
Dermatologists often deny food allergy leaving parents on their own to
solve the problem. Allergy who rely only on skin tests are also not
With more severe, prolonged or complicated eczema, skin tests
are never adequate to determine a new diet for the child and complete
diet revision must be carried out. Follow Alpha Nutrition. Often, a
retreat to phase 1 foods is adequate to improve the skin condition,
although 2 to 3 weeks is required for healing to occur.
We have encountered children with extreme food sensitivity who do
well only on a few foods and have used Alpha ENF to replace some of the
missing foods and to supplement nutrient intake for several weeks to
several months. Parents need to be very patient and determined to solve
a severe eczema problem. The afflicted child suffers a great deal and
may be irritable, hyperactive at times and emotionally unstable.
Eczema sometimes marks the child with food allergy who will go on to
have learning problems at school because of hyperactivity and attention
deficits. We see this as a packaged deal and treat the child
compassionately with careful food and environmental control.