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Home > Portable Practical Pediatrics > Is Eczema in Infancy the Spark that Ignites a Child’s Allergies? (Pedcast)
Podcast: Portable Practical Pediatrics
Episode:

Is Eczema in Infancy the Spark that Ignites a Child’s Allergies? (Pedcast)
Category: Kids & family
Duration: 00:11:59
Publish Date: 2020-02-16 19:50:56
Description: Photo from Pixabay Images You are just not paying attention if you haven't noticed that more children today have eczema and allergies than in past generations. Allergy is one of the most common chronic health problems children today have. Interestingly, most children with allergies have eczema before their allergies develop. A coincidence or does this tell us something fundamental about what triggers allergy?  Stay tuned and my outstanding intern Sonya Williams and I are about to tell you the answer to this interesting and practical question. Musical Intro What is the Allergic March? For a long time, pediatricians have recognized that children who develop rough itchy skin, a condition called eczema, frequently turn out to suffer from food allergies, seasonal hay fever, and asthma. This sequence is so common that is has been coined with the name, the allergic march because as the child gets older, these maladies typically appear in a predictable order- eczema first, then food allergies, then hay fever, and finally asthma. The child literally marches from one condition to another. Fortunately, not every child who develops eczema in infancy gets all the rest of these problems but pediatricians have also noticed that the more intense the eczema, the more likely these other conditions develop. They must all be related in some way, right?   All of these problems are signs of a child's immune system acting up, overreacting to substances that should not provoke reactions but somehow do. Substances like milk, peanuts, grass pollen, or cat dander. Until recently, it was thought that allergies are mostly a manifestation of a child's genes that drives the child's immune system to overreact but recent evidence points to an additional mechanism which we are about to talk about.  And, if you think about it, the child's immune system overreaction happens where the child's body interacts with the outside world- their skin that touches various surfaces, the inside of their intestines where various foods pass through, and the inside of their noses and bronchioles where dusts and other airborne substances settle; all places where stuff from the outside world touches the child. So, you can see that the outside has something to do with provoking allergies and when it happens, it happens in a very predictable way, usually in the baby's skin first. It turns out that the baby's rough skin may be the initiating event to the entire process as you are about to see.     What is Eczema and why does the Allergic March Start in the Skin?   So why does the allergic march start with eczema? It may seem like eczema is just a skin-deep issue, right? Well let’s delve into the issue of eczema a little further. The word eczema comes the Greek meaning “bubbling up” and for a long time, there has been a debate among doctors as to whether eczema starts under the skin surface and bubbles up, hence the name, or whether eczema is actually a surface barrier problem where the skin 's outer barrier is failing and therefore letting allergens get through and provoking allergic reactions. This is known as the barrier hypothesis. Recent evidence confirms that the basic problem in eczema is a  ‘barrier problem’ and here is why it mostly affects young babies.  A baby's skin is much thinner than an older child's skin and is more prone to drying and cracking allowing allergens to touch the deeper part of the skin. This actually makes sense when you think about it. Just close your eyes and run your hand gently over the skin of a child with eczema and you can tell that the surface barrier, the epidermis of their skin, has a lot of cracks compared to a child without eczema. Could those cracks actually be letting allergens touch the baby's deeper skin and start the allergies ...and... could prevention of cracking by frequent application of moisturizers prevent the entire allergic march? The answer is a resounding YES!
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