Sunday, April 19, 2009

Eczema and Allergy connection

This past weekend found me in Chicago, attending the FAAN conference. I came a way with a few tidbits of information that were especially relevant in our allergy life, and I thought I would share. Of course, the following information is what I understood as it was said. As with any other information, you may want to double check it for accuracy, and you should certainly discuss it with your allergist or physician before making any changes to your lifestyle.

First, the relationship between allergies and eczema changes as your child ages. In infancy and toddlerhood (through about 3) food and eczema are directly linked. Consuming allergenic foods causes eczema flare ups. If your little one was diagnosed as a baby, you already knew about this link. What I did not know is that as your child ages, food is no longer the primary trigger. In fact, it becomes less and less so. Environmental allergies begin to trigger eczema outbreaks around the age of three, taking the place of food allergy triggers. So for us moms trying to figure out what we fed our kiddo, stop doubting yourself. Yes, check the food. Also check the environment though, as your munchkin may be getting seasonal or environmental allergies.

As we move into puberty those crazy changing hormones play a part in the eczema. And as young adults the allergies and eczema are more loosely associated. The relationship eventually breaks down far enough that one does not lead to the other.

Eczema is closely tied to allergies, but it is it's own disease as well. This means that while allergies exacerbate eczema, no allergic exposure is needed to cause a flare up. It can be caused by being hot and sweaty in the summer or overly dry in the winter. It will go through cycles with no prompting. An eczema flare up is not a guarantee of allergic exposure. But we parents know that it's a pretty good clue for our little ones. For now.

Another source of interest for me was that topical exposure to food allergens does not result in a fatal allergic response. The medical adviser stopped short of saying it never happens or it is impossible, but he stressed repeatedly that life threatening reactions occur when the allergen is ingested. Ingestion to me means that the allergen is introduced into your body orally or through contact with a mucous membrane. (Rubbing your eyes and getting the allergen into your eye, or that dreadful -but rare- instance of childhood nose spelunking.) So, when daddy kisses your forehead and you get a rash, it may be uncomfortable, but it won't kill you.

Speaking of kissing....if you have teens, and thank goodness I don't yet, it's something for them to think about. Your date should refrain from foods you are allergic to. If they do not, think twice about kissing. (Insert graphic mental image of big teenage grins- complete with braces- immediately following any given meal. 'Nuff said.) Again the stressing that life threatening reactions occur upon ingestion. No braces? Super! That does not mean, though, that your date won't leave a telltale rash that you would prefer not to explain to your parents.

Another fun fact: Legumes are not a close knit family. The medical adviser present explained that the legume family is unusual in that you can react to one, such as soy or peanut, and not react to another, like garbanzo beans and peas. They all react individually, not as a family. So, if you are allergic to one legume do not assume that you are allergic to them all. Can you be? Of course. Will you be? Try them with sensible caution to find out.

If you use your epi-pen, go to the ER. Period. Expect to stay four hours for observation if it was a food induced reaction, longer if it was a reaction to medicine. (Food is processed through your system faster than medicines are, so you can leave sooner.) The reason for mandatory ER visits? Biphasic reactions can happen. In other words, your reaction can be controlled with the epi-pen, then come back full force later. We all know this, I think, but when faced with the decision of whether to spend the night in the ER or your own beds, your resolve can waiver. An unexpected word of caution: you may know as much or more than your ER doctor. Really. You live with an allergy every day, and have spent a lot of time educating yourself about how to handle it. This is not their area of specialty, and their training on the subject was not as extensive. Be ready to advocate (politely) for your child if faced with under-education. Wow. Not what I expected to hear from a medical professional.

Finally, allergies are taking longer to "outgrow". In the past the standard expectation was that many allergies would be outgrown by school age. Now they are lasting into early adolescence. Right up through high school. So, we drag out the light of hope into a longer beam. While the medical adviser would not stomp on hope that every allergy can eventually be outgrown, he did hint that the more severe the allergy the less likely it will be outgrown. It CAN still be outgrown, always that teasing flickering light of hope.

That sums up my take aways. Hope at least one of them is interesting to you too. If not, why on earth did you read this far?

1 comment:

  1. Great info from the meeting. I wish there was one on the West Coast!


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