Came across this 2015 research study on Environment Tobacco Smoke Exposure Affect Childhood Atopic Dermatitis Modified By TNF-α and TLR4 Polymorphisms in which the researchers studied:
- 3,639 children aged 7 and 8 years old
- Survey format – 2-year follow-up
- Participants were followed up 2 years later with blood test
Results were that children with the gene variant (that encode immune proteins TNF-alpha and TLR-4) associated with inflammatory conditions such as asthma and Crohn’s disease were more likely to develop eczema if they had been exposed to smoke in the womb. Since we wouldn’t know whether there’s gene variant in a fetus, it’s best to quit smoking and have everyone around to quit if you’re planning to have a baby. More studies on Pubmed linking second-hand smoke and eczema:
Cigarette smoking on allergic conditions – Maternal smoking in the first year of the child’s life resulted in the children having an increased chance of wheezing, exercise-induced wheezing and asthma.
Foetal exposure to maternal passive smoking is associated with childhood asthma, allergic rhinitis, and eczema – Foetal exposure to maternal passive smoking was significantly associated with wheezing, allergic rhinitis and eczema.
Improvement of Atopic Dermatitis Severity after Reducing Indoor Air Pollutants – After the completion of the program that reduced the air pollutants in kindergarten, the prevalence of atopic dermatitis and the mean eczema area and severity index (EASI) were decreased, and the changes were both statistically significant.
Pre- and postnatal exposure to parental smoking and allergic disease through adolescence – Exposure to second hand smoke during infancy was associated with an overall elevated risk of asthma, rhinitis and eczema up to 16 years.
Updated in October 2015, new study on:
Parental smoking and development of allergic sensitization from birth to adolescence -Second hand tobacco smoke exposure in infancy appears to increase the risk of sensitization to food allergens up to age 16 years as well as eczema in combination with sensitization.
It is likely that not only tobacco smoke but also outdoor air pollutants like traffic exhaust can stimulate immune cells to respond. What is your experience? I was living in a scaffolded apartment for the first two trimesters – till today, I still wonder what the effect had been on my baby…
Many parents are concerned with whether (and W-H-E-N) their child will outgrow eczema – the stress, the sleep deprivation, the constant itch and scratching that comes with eczema can indeed be very challenging for both parents and the child. Are there any factors that give us hope that our child will have a higher chance of outgrowing eczema? Is there anything that we can do to increase the likelihood of ‘outgrowing’?
1st things 1st – What’s Outgrowing?
There is no definition for having ‘grown out’ of eczema – how would you as a parent deemed your child to be free from eczema? No rash within a certain time period? A reasonable amount of sleep, dry skin without rashes that requires daily moisturizing? The majority of babies (40% -70%) with eczema will have it in remission by the grade school or teen years (study here, and here). Dry skin with occasional flare-ups would be considered as having outgrown eczema.
Key Predictive Factors
1. Severity of Atopic Dermatitis – The more severe the eczema/ AD, the less likelihood the chance of outgrowing. There is also a study that the more severe the AD in a child, the less likelihood the child can outgrow milk and egg allergy. The interplay between eczema and allergy is not fully understood – does one lead to another? There is this study that showed food allergy being associated with an earlier onset of age for eczema in children. Conversely could a defective skin barrier render the immune system more vulnerable to an onslaught of allergens? Or both can co-exist independently? Similarly the mechanism for outgrowing isn’t clear. Is untreated eczema reducing the chance of outgrowing?
2. Gender – Various studies had highlighted a difference between teenage males vs females, for instance in this study, eczema is more likely to develop for teen girls while teen boys are more likely to outgrow it.
3. Presence of other allergic conditions – Having other allergic conditions like asthma and allergic rhinitis associated with a lower likelihood of outgrowing eczema.
There are many factors involved in eczema, but specifically on outgrowing, it seems that the above 3 are the most predictive. The BIG question is what can parents do and I’d say that treating the eczema is of utmost importance. The longer it goes untreated (aka the longer you try alternative/unvalidated treatment while the skin is constantly inflamed and child is scratching), the higher chance of infection, the thicker the skin gets from scratching (thus even more difficult to treat) and the likelihood of more allergens/irritants penetrating via the defective skin barrier.
What’s your take on this? Do share in the comment!