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News & Research

Eczema News #Christmas Special – Top 10 Allergy Suspects

It’s end of the year, it’s Christmas time and there are actually quite a few things about Christmas that can really spoil the season fun. Apart from visiting others’ homes (pet, mold, dust mites), eating foods that you don’t normally eat (or never eaten before), there’s the Christmas tree that can cause quite a few allergic symptoms.

This Christmas special looks at some of these ‘Christmas Allergy Suspects‘:

10 Top Christmas Allergy Suspects
Don’t let these 10 Top Christmas Allergy Suspects spoil your season fun!

Christmas allergy suspect #1: Christmas tree

Allergic contact dermatitis – reaction to colophony, also known as rosin, is the sap or sticky substance that comes from pine and spruce trees.

Allergic rhinitis – reaction to alternaria mould

Main trees are scotch pine (allergic conditions likely due to mold Penicillium spinulosum), followed by spruce tree (due to mold Epicoccum and Alternaria). Hose down the tree outdoors and handle with gloves to reduce the mold spores.

Even artificial christmas trees can cause a reaction as they have been stored and accumulated dust mites and molds in the basement.

Christmas allergy suspect #2: Poinsettia

Cross-reactivity with latex allergy observed in a case study

Christmas allergy suspect #3: Christmas cactus

Contact urticaria and rhinoconjunctivitis (of workers at a cactus nursery)

Christmas allergy suspect #4: Christmas candy

Asthma (of a candy maker) after exposure to pectin, a compound in Christmas candy

Christmas allergy suspect #5: Food, Cocktails

Common allergens are milk, eggs, soy, fish, shellfish, peanuts, tree nuts and wheat. Ask before you eat or inform the host. If you’re hosting, take care to avoid these allergens or avoid them in some of the dishes and not re-use the utensils without washing.

Allergens in cocktails include sulfites in wine, maraschino cherries, and tree nuts in beer.

Christmas allergy suspect #6: Pets

If you’re allergic to pet dander, it’d be best to check out if the home you’re visiting has pets. The concentration of pet dander allergens are usually higher during Christmas, due to more time spent indoors.

Christmas allergy suspect #7: Dust mite

Though dust mites are present all year round, it is worse during the holidays as we spent more time in our bed with the cold weather.

Christmas suspect #8: Artificial snow or Frosting

Asthma can be triggered when spraying artificial snow or any chemical spray (say on frosted window) can irritate the eyes, nose, lungs and skin.

Christmas suspect #9: Stress

Stress is a known trigger for eczema and asthma – go easy on shopping and visiting schedules.

Christmas suspect #10: Candles, air fresheners, potpourri

It may add an extra touch to your home for the holiday season but these give off compounds that irritate the nose and throat.

Enjoy Christmas, and remember it is the time for celebrating Christ’s birth and his love for us.

 For unto you is born this day in the city of David a Savior, who is Christ the Lord.

Luke 2:11

References:
  1. The sweet christmas rash
  2. No poinsettia this christmas
  3. Immediate allergic and nonallergic reactions to Christmas and Easter cacti.
  4. Christmas Tree Allergy: Mould and Pollen Studies

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News & Research

Eczema News – Second-hand Smoke and Eczema

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:

Second hand smoke increases risk of eczema in fetus baby up to adolescents

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…


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News & Research

Eczema News – Food Sensitization from Eczema?

Eczema Allergic Sensitization

This is a very interesting topic because it represents a major paradigm shift to how we view allergy – it’s not just what we eat (oral path) but also what’s on our skin. It is now accepted  that what is on our skin can lead to sensitization and allergy. For instance, dermatologist Cheryl Lee MD said in this post:

When allergens come in contact with the skin, then the allergic type of inflammation is turned on.  On the other hand, it has been shown that if you can avoid letting allergens (including foods!) from coming in contact with the skin long enough, then your child’s immune system will build up tolerance to the food when it is presented to the immune system of the gut. What this tells us is that, in susceptible populations, the skin barrier needs a little help as it is maturing.

Let’s take a closer look at this article published in Aug 2014 in Journal of Allergy and Clinical Immunology by Japanese researchers.

Article title: Eczematous sensitization, a novel pathway for allergic sensitization, can occur in an early stage of eczema

This is an article that looks at the studies being conducted, and it’s not exactly recent but I like it because it reinforces the understanding of outside-in hypothesis.

Link between Food Allergy and Eczema – From the Skin

Researchers started to look at the link between our skin and food sensitization because studies (quoting this article) demonstrated that exposure to environmental peanut protein–containing household dust and use of hydrolyzed wheat protein–containing soap significantly increased the risk of allergic sensitization to peanut and wheat, respectively. In addition, filaggrin loss-of-function mutations were a significant risk factor for peanut allergy. Those findings strongly suggest that epicutaneous exposure to proteins induces allergic sensitization…

presence of eczema is a robust risk factor for allergic sensitization to food antigens and development of food allergy

It is compiled in the article that increase in skin pH, scratching and impaired filaggrin are factors that lead to food sensitization. We have talked about the importance of skin pH for the whole of December last year and in summary, skin that is too alkaline is linked to reduced ceramides, skin lipids (good for our skin) and increase in staph bacteria (bad for our skin). Foods that come into contact on our skin can certainly trigger eczema flare-ups too!

My take: Strengthen the skin barrier – moisturize, use right products of optimal skin pH and without common irritants, treat skin promptly to reduce scratching. Keeping eczema under control or moisturizing to prevent eczema onset can have a real chance of preventing allergy.

What’s your take? Do share your take in the comment so we all can hear from each other!

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News & Research

Eczema News – Abdominal Pain and Allergy, Sensitization in Kids?

We’ve been looking at eczema research news for the past 2 weeks and this week, I came across an interesting study looking into the correlation between abdominal pain and allergy-related disease. My child sometimes complain of tummy ache and now I’m wondering if it got anything to do with her eczema. Let’s check out this study!

Study title: Allergy-related diseases and recurrent abdominal pain during childhood – a birth cohort study

Study objective: Examine the association between allergy-related diseases or sensitisation during childhood and abdominal pain at age 12 years.

Study method:  2610 children in Sweden, using questionnaires. Parents answered questions regarding asthma, allergic rhinitis, eczema and food hypersensitivity and children answered questions on abdominal pain at 12 year old. IgE blood tests were taken at ages 4 and 8. Celiac disease and inflammatory bowel disease excluded.

Why focus on Abdominal Pain?

Recurrent abdominal pain affects 8% of children in western countries and often leads to school absence and lower quality of life. Multiple factors contribute to it, including irritable bowel syndrome (IBS). It’s also related to low-grade gut inflammation and the link to asthma, eczema and rhinitis had also been studied (with no conclusive result).

Abdominal Pain Allergy Disease

What’s the Possible Link between Abdominal Pain and Allergy?

As written in the study,

Children with multiple allergy-related diseases may have a low-grade inflammation in the gut, resulting in barrier defects in the gastrointestinal tract, thus increasing the risk for disturbed motility and pain sensitivity. IBS patients with an allergic background have demonstrated increased IBS symptom scores, colonic permeability, mast cell counts and tryptase release or increased gut permeability compared to IBS patients without an allergic background.

Conclusion: Among 2610 children with complete follow-up, 9% reported abdominal pain at 12 years. All allergy-related diseases were associated with concurrent abdominal pain at 12 years and the risk increased with increasing number of allergy-related diseases. Asthma at 1 and 2 years and food hypersensitivity at 8 years were significantly associated with abdominal pain at 12 years. There was an increased risk of abdominal pain at 12 years in children sensitized to food allergens at 4 or 8 years, but in stratified analyses, this was confined to children whose parents had not reported food hypersensitivity at time of sensitisation.

My take: It’s not causal and admittedly, associations are not accurate. As pointed out in the study, it could be allergy kids already go to clinics more often or have increased anxiety and stress that lead to the recurrent tummy aches. But I do believe in benefits of a healthy gut – an area where increasingly gut influences more than just gut! Eat a low oxidation diet, fruits, vegetables and probiotics.

What’s your healthy gut diet? Do you monitor the foods for your child with allergy, asthma, eczema or rhinitis? Do share in the comment so that everyone can hear from each other!

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Eczema Tips

Children Food Sensitivities – Confusing Gluten

There’s so much about gluten-free these days – it’s an industry in itself and marketing ‘Gluten-Free’ is seen in menus and food packaging. We hear of sports celebrities performing better after cutting gluten and we hear of celebrity moms choosing gluten-free diets for their children. But what is gluten and what happens when you eat it? As the 4th part of this series, today’s post explores the different types of gluten sensitivities.

TOP 5 Facts You Need to Know to Differentiate Your “Gluten Sensitivity Type”!

Gluten refers to the proteins found in wheat, barley, rye and triticale (a cross between wheat and rye). Gluten gives elasticity/stickiness to the dough.

GLUTEN SENSITIVITY

GLUTEN SENSITIVITY TYPE #1 – CELIAC DISEASE (CD)

CD Fact #1: Involves immune system, BUT not IgE-mediated reaction to the gluten.

CD Fact #2: Immune system attacks the villi in the esophagus when exposed to gluten protein gliadin, found in wheat, barley, rye, and sometimes oats. This lead to intestinal inflammation, flattening of the villi and long-term damage to the small intestine. Associated with high intestinal permeability whereby bacteria, antigens and undigested food ‘leaked’ through the gastrointestinal barrier.

CD Fact #3: Symptoms include diarrhea, abdominal bloating/pain/cramps, bone/joint pain, bruises, constipation, depression, failure to thrive for children, mouth sores, infertility/miscarriage, malnutrition, weight loss, chronic fatigue, anemia, blood or fats in stool, nausea, joint pain, tingling on hands/feet, Dermatitis Herpetiformis or no symptom. Related to malabsorption of nutrients due to the intestinal villi being compromised.

CD Fact #4: Diagnosis is straightforward with tests to detect AGA (Antigliadin) and EmA (Andomysium Antibodies). Cutting gluten before testing will affect results. Small intestinal biopsy is an accurate test for celiac disease.

CD Fact #5: Treatment is strict avoidance of gluten in order for the villi to heal. Note that oats can be tainted with gluten and some common medications, vitamin supplements and cosmetic products also contain gluten. Untreated gluten has been linked to intestinal cancer, liver disease, small bowel ulcers and other inflammation-related diseases of the digestive tract, heart, joint and even brain.

GLUTEN SENSITIVITY TYPE #2 – NON-CELIAC GLUTEN SENSITIVITY (NCGS) or GLUTEN INTOLERANCE

NCGS Fact #1: Does not involve immune system and is not celiac disease. However, patients clearly experience discomfort and symptoms after ingesting gluten.

NCGS Fact #2: No intestinal inflammation and not associated with high intestinal permeability, unlike celiac disease.

NCGS Fact #3: Symptoms are gastrointestinal symptoms like abdominal bloating, diarrhea, gas, cramps, headaches and fatigue.

NCGS Fact #4: Diagnosis is not straightforward with no proven medical test. It is typically diagnosed after elimination of other similar conditions (for instance, wheat allergy, Irritable Bowel Syndrome) and after observation and further consultations.

NCGS Fact #5: Treatment is avoidance of gluten ONLY after confirmation of this course of action by doctors. Doctors will eliminate the possibility of celiac disease, wheat allergy or other diseases before advising on treatment for NCGS.

GLUTEN SENSITIVITY TYPE #3 – WHEAT ALLERGY (WA)

WA Fact #1 : Involves an immune Ig-E mediated reaction to the wheat protein

WA Fact #2: The increase in IgE antibodies trigger chemical release that lead to allergic reactions, that can either be manifested via the skin, respiratory or gastrointestinal systems and other behavioral issues.

WA Fact #3: Wheat is one of the common food allergens in children and symptoms include eczema, rhinitis, asthma, urticaria, conjunctivitis, abdominal pain, diarrhea and angiodema. These symptoms could be immediate (swelling or hives) or be delayed, including low weight gain in children. There’s also exercise-induced anaphylaxis to wheat.

WA Fact #4 Diagnosis is via allergy testing.

WA Fact #5: Treatment is avoidance of wheat. There is no need to avoid barley and rye which contains gluten but not wheat.

There is recently studied that people with non-celia gluten sensitivity may actually not be sensitive to gluten, but instead to FODMAPs. FODMAPs stand for fermentable oligo-, di-, and mono-saccharides and polyols, which are sugars, carbohydrates that tend to be poorly digested, e.g. frutose. It could be that gluten-containing grains are high in FODMAPs and thus avoiding gluten makes one who is sensitive to FODMAPs feel better. (see this study conducted as double-blind cross-over trial).

Update on 17 October 2016 – A new study showed the possible group of proteins found in wheat – amylase-trypsin inhibitors (ATIs) – to trigger an immune response in the gut that can spread to other tissues in the body. From MedicalNewsToday

ATIs only make up a small amount of wheat proteins – around 4 percent – yet the immune response they induce significantly affects the lymph nodes, kidneys, spleen, and brain in some people, causing inflammation. ATIs have also been suggested to exacerbate rheumatoid arthritis, multiple sclerosis (MS), asthma, lupus, and nonalcoholic fatty liver disease, as well as inflammatory bowel disease.

Hope this 4-part series clarify! it did for me and I have a clearer picture and better appreciation of the complexities involved in understanding and diagnosing one’s gluten-related (or suspected!) condition.

For other posts in this series, do check out

Allergic, Intolerant or Hyper?

Top 10 Kids’ Food Sensitivities Myths

Outgrowing Food Allergy

Sources:

MedicineNetFODMAP studyMayo ClinicWebMd

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Eczema Tips

Children Food Sensitivities – Outgrowing Food Allergy

This blog has always been focused on eczema, rather than allergy. However, I came across a very good book by Dr Wayne Shreffler and Dr Qian Yuan on ‘Understanding your food allergies and intolerances‘ and found that it clarified many food allergy concepts. Thus, this 4-part series is to share that knowledge with you!

For the past 2 weeks, we’ve covered

This week, I’m doing something totally unscientific – I’m compiling all statistics I find online on outgrowing allergies to lay out in a graphical representation of  WHAT AGE will a CHILD (likely!) OUTGROW FOOD ALLERGY! It’s definitely not scientific because each study/report has a different focus but just to save time for you (paranoid moms and dads who would try to do the same), I figure I might as well make an attempt!

Age your Child will Outgrow Food Allergies

While reading up on outgrowing food allergies, I’ve found some interesting food allergy facts!

Fact #1 Shellfish allergy onset later in life (6 years and older) and usually lifelong. Same for fish allergy.

Fact #2 Shellfish allergy IS NOT THE SAME as fish allergy.

Fact #3: Shrimp, lobsters and crabs are more allergic than mollusks such as scallops, oysters, clams and mussels.

Fact #4: Allergy to one type of (fin)fish does not mean allergic to another BUT study in 2004’s Journal of Allergy and Clinical Immunology found that 30% of children and approximately 66% of adults reacted to multiple types of fin fish.

Fact #5: More women than men are allergic to fish (0.6% vs. 0.2%).

Fact #6: Egg allergy is most closely associated with eczema, among the other food allergens. (Does not mean that egg allergy is most likely the trigger for your child’s eczema, as house dust mite is the more likely suspect for older children)

Fact #7: You can be allergic to either egg white or yolk or both but avoid the whole egg as it’s not possible to ensure clean separation.

Fact #8: Eggs and Milk cooked under intense heat (say baking cakes) seem to be more well-tolerated but don’t experiment without doctor’s advice (study here).

Fact #9: Soy allergy tend to be mild

Fact #10: Highly refined soybean oil (not cold pressed, expeller pressed, or extruded oil) and soy lecithin is usually tolerated by people with soy allergy.

Fact #11: Food allergies developed from young (except peanuts, tree nuts, shellfish and fish) are more likely to be outgrown versus food allergies developed as a teenager or adult, which tend to be lifelong.

Fact #12: 26.6% of children outgrew their allergies by age 5.4.

Fact #13: The more severe the allergic reaction, the less likely to be outgrown.

Fact #14: Mean age of tolerance for egg allergy was age of 7.2; Milk 6 years; Tree Nut 9.6; Shellfish 11.6; Soy 7; Fin fish 9.3; Peanuts 8.4

Fact #15: Boys are more likely to outgrow allergies than girls.

When researching for this post, I actually found quite a number of websites carrying misinformation or unclear information where it’s either proven wrong in later studies (for instance, to delay introduction of foods) or information relating to intolerance being grouped as food allergy information (such as only larger amounts of food trigger a reaction).

Another ‘sad’ news is that there is a study that children can develop a second (different) reaction to foods that they have outgrown. This is a study on Eosinophilic Esophagitis or EoE where it was found that 17 out of 1,025 patients in the study had initially outgrown IgE-mediated reaction to the foods but now suffer from EoE reaction (see AllergicLiving.com for their interview with the researchers of the study). EoE is an inflammation at the esophagus due to increase of eosinophil cells, leading to narrowing of the esophagus.

Hope whatever age your child is, your family is managing the food allergies well. Share your outgrowing age below!

Sources:

  1. ACAAI
  2. RaiseHealthyEaters (post by Dr Joneja)
  3. FARE
  4. Mayo Clinic
  5. Medscape
  6. Studies (egg) here and here
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Eczema Tips

Children Food Sensitivities – Top 10 Kid’s Food Sensitivity Myths

Top 10 ids food sensitivity mythsThis blog has always been focused on eczema, rather than allergy. However, I came across a very good book by Dr Wayne Shreffler and Dr Qian Yuan on ‘Understanding your food allergies and intolerances‘ and found that it clarified many food allergy concepts. Thus, this 4-part series is to share that knowledge with you!

Last week, we clarified Food Allergy vs Food Intolerance which gave an overview of the differences between the two. Today we can put this to test by tackling these Kids’ Food Sensitivity Myths!

Myth #1: This Food Doesn’t Agree with Me, I’m Allergic to It!

This actually reminds me of my hubby (lol), most times we don’t agree (that is when we actually talk!) but no, I’m not allergic to him (hopefully he thinks the same!). As explained in last week’s post, food sensitivity can be either in the form of allergy or intolerance. Some doctors also allow for a 3rd category of food sensitivity, when they can’t classify it as either an allergic reaction or find the chemical the body is intolerant to.

However, these days, there’s almost a ‘cool’ factor to say you’re allergic to something. So while it is possible that more people think or say they have an allergy than they really have, food intolerance/sensitivity may also be underestimated as they are hard to diagnose. Do note too that adults can also have an onset of allergy at an older age, esp for certain allergy like shellfish.

Myth #2: Food intolerances can be tested using IgG antibodies test

There are many IgG tests available online and generally the medical community is against this test for identifying food sensitivity. The main reason is that elevated IgE implies an exposure to the food rather than an allergy to the food. Also while 80% of the foods are the common suspects in allergy, IgG test may test hundreds of foods and with false positives, lead to harmful elimination diet.

Myth #3: You are either Allergic or Intolerant

For some individuals the same foods can trigger both food allergy and intolerance. For instance, there can be an allergy to the milk protein while also lacking lactase digestive enzyme to break down lactose. This is why it is important to consult a specialist as it is not easy to figure it out on your own.

Myth #4: You can eat JUST A LITTLE of the sensitive food

This falls back to last week’s explanation of food allergy and intolerance. For severe food allergy, smelling the food can trigger a reaction, and it can be fatal one like anaphylactic reaction (that’s why there is so much debate about peanuts on plane!). However, for food intolerance, some people can eat certain amounts or in certain forms, e.g. food cooked with milk (I tried this fish recipe before, tasted horrible!) may give a different reaction to drinking milk.

Myth #5: I feel Bloated, I’m Allergic!

Bloating is more closely related to food intolerance but eating gassy foods cause bloating too. Pregnant women suffer more from bloating and constipation due to pregnancy hormones leading to relaxation of gastrointestinal wall muscles, thus foods stay in the tract longer.

Myth #6: I didn’t eat the food, how can I be allergic to it?

Food sensitization is when the body first comes into contact with the food protein and the body then ‘tag’ it as an enemy. The next time even small amounts of the food (in some cases, touched or smelled) can trigger an allergic reaction. So smelling peanuts on plane, touching or shaking hands with another child with peanut butter trace on hands can lead to an allergic reaction.

Myth #7: Delaying food introduction to a child can prevent the food allergy

Based on updated studies, the recommendation to delay introduction of common food allergens (usually peanuts, tree nuts, shellfish) is now revoked. The studies were contradictory – some showed late introduction helped as the child’s immune system is stronger while others showed early introduction helped as the child builds an immunity to it earlier. Thus the current recommendation is Just Eat (Whatever) a Balanced Diet. An update on a study on early introduction of eggs done in August 2015 showed that the elevated immune responses to egg were established prior to egg ingestion at 4 months and were not affected by whether eggs were introduced early.

Myth #8: Allergy testing is 100% accurate

Allergy testing (skin prick and IgE) is fairly accurate but not 100%. The only gold standard in food allergy testing is the oral food challenge. However due to the difficulty of conducting the oral food challenge (involves hospital stay), doctors form a diagnosis based on corroborated ‘evidence’, for instance the test results, parents’ observations and doctor’s knowledge of food allergens, family history.

Myth #9: Organic Foods are Safer

Organic foods (only the properly certified ones) may be safer in terms of free from pesticides but not safer in terms of allergic reaction to the food protein. Organic or not, the food protein is still present. For some people, peeling the fruit’s skin or cooking in a different way may help.

Myth #10: Allergy test can tell how Allergic you are

Allergy testing only tells you if you have an allergy, but it cannot predict the severity of the reaction. For instance, (see this previous post), the size of the wheal from skin prick test does not correlate with the reaction you will have.                                                                                                   

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Eczema Tips

Children Food Sensitivities – Allergic, Intolerant or Hyper?

This blog has always been focused on eczema, rather than allergy. However, I came across a very good book by Dr Wayne Shreffler and Dr Qian Yuan on ‘Understanding your food allergies and intolerances‘ and found that it clarified many food allergy concepts. Thus, this 4-part series is to share that knowledge with you!

Each week is a different concept de-mystified, so let’s get started!

Kids Food Sensitivities – What is Sensitivity?

What does it mean to be sensitive to a food? In layman’s term, it could mean a range of symptoms from headaches to tummy upset, but medically, it covers two main terms:

Food Allergy and Food Intolerance – both have similar symptoms but the cause and treatment is different, which is why it is important to differentiate the two.

Food Allergy Food Intolerance
Direct immune system’s response to food protein Not a direct immune response but different causes (not all known), e.g. lack of specific enzymes to digest the food (not necessarily a protein)
Cause is the reaction to food protein, can be tested with fair accuracy with allergy tests Cause is not always known and not easy to test a food intolerance
Symptoms can be immediate (few hours) or delayed, and include

Itch, hives, breathing difficulty (including anaphylaxis), eczema, runny nose, coughing, vomiting, diarrhea, abdominal pain, swallowing difficulty, chronic chest pain, heart burn, constipation, weight loss, swelling of facial features

Symptoms can affect the skin, intestines, respiratory tract and cause behavior change

Symptoms may take place gradually – nausea, stomach pain, gas (bloating)/cramps/bleeding, vomiting, diarrhea, heartburn, headache or migraine

 

Symptoms typically affect intestines.

Happens every time May not happen for the tolerated amount or in certain forms; the more you take, the more severe the symptoms and symptoms may differ in each incident
Small amount triggers Certain amounts may be tolerated (trial and error process to figure out)
Common food allergens: Milk, soy, egg, wheat, peanuts, tree nuts, fish and shellfish Common food intolerances: Frutose, Sucrose, Lactose, MSG (monosodium glutamate), sulfite, tyramine, histamine
Except for peanuts, tree nuts, fish/shellfish that are harder to outgrow, other food allergens tend to be outgrown at older age May actually onset at older age
Genetics play a role Genetics play a role

As seen above, there are distinct differences between food allergy and food intolerance although the symptoms of both are similar. However, to be concerned that there is indeed a food sensitivity issue, there has to be a reproducible reaction with the food – i.e. not referring to a one-time stomach upset after eating prawns in the past year (that might be food poisoning!).

The diagnosis of food intolerance is generally difficult, except for lack of digestive enzymes lactase, frutase and sucrase. The lack of the digestive enzymes result in lactose, fructose and sucrose not being broken down and result in pain, bloating, spasm and diarrhea.  Even stress or anxiety associated with a certain food can cause an intolerance.On the other hand, symptoms such as swelling are closely associated with allergic reaction.

The diagnosis of immediate food allergy is more straight forward than delayed food allergy, with allergy testing and blood test to detect elevated levels if immunoglobulin E (IgE). The common food allergens differ in different country (taken from allergyuk.org)

  • Worldwide – milk, egg
  • USA, UK, Australia – peanut and tree nuts
  • France – mustard seed
  • Italy, Spain – peach, apple, shellfish
  • Israel – sesame
  • Spain, Japan – fish
  • Japan – buckwheat
  • Singapore – birds’ nest, shellfish

For those in Singapore, it is interesting that fish isn’t on our list of common food allergens possibly due to it being so much part of our diet. Birds’ nest on the other hand is given as ‘tonic’ to children early and may actually trigger an allergy!

Treatment wise – for both food allergy and food intolerance, avoidance is key. For food allergy, children can undergo another allergy test to see if they have ‘outgrown’ it. For food intolerance which usually does not result in fatal reaction, small amounts of food can be re-introduced in different forms to see which form/amount can be tolerated. There is no cure for allergy or intolerance; however, for certain food intolerance, enzyme supplements can be taken beforehand to digest the food to be ingested e.g. lactose.

Here’s a graphic for recap!

Is it Food Allergy or Food Intolerance? Graphical representation
Is it Food Allergy or Food Intolerance?

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Eczema Devotional

(ScratchMeNot) Mom E-votional : No longer Allergic!

Devotional for Moms by Andrea ScratchMeNot

When we realized she was no longer allergic, I realized the extent of our journey.

Summer of 2014 marks a new adventure for us! My daughter is no longer allergic to dairy, tomatoes, or corn!

Ever since she was 2 months old, we as a family, have been battling her eczema. There were long days & long nights of scratching, searching and wanting to understand why eczema was making our world crazy! We wanted her to be comfortable and NOT SCRATCH! I didn’t take a lot of pictures of her during her flare-ups, because it hurt to see her in such pain. Remembering those times is still challenging. Through testing, we learned that she was sensitive to many foods, while only being allergic (anaphylactic) to nuts. As a nursing mom, both of us had to stop eating her list of “no foods”. I had come to the resolve that I wanted her to understand that we are grateful for what we can have, even though we want some thing we can’t have. We must remember, everyone’s load is different; we must persevere with joy.

Our family did our best to show her foods she could eat, instead of focusing on what she couldn’t eat. I knew she was curious, yet she ate her food with pride. Sure there were moments, she wanted to be like other kids and eat ice cream & spaghetti and be ok. Those moments challenged me and made us stronger. I had to answer some hard questions, like “Why can’t I eat it, but she can?” On the flip side, I’m also VERY positive that she snuck a few cheese crackers on a few occasions and giggled about it afterwards. Then IT happened. After eating some cheese crackers at church (a story for another day), she told me about it and was not scratching. No redness, no eczema.

I gave her a few cheese crackers after this, with success. As a family, we decided to do a test of our own. Knowing she wasn’t anaphylactic to dairy, we took her out for her first taste of ice cream. I could feel the excitement as we raced to a local creamery. Between birthday parties and fun days at school, ice cream is THE thing to eat for a kid her age.

As we drove to the land of dairy, I thought of the countless times we enjoyed sorbet as an alternative. Now it was her chance to have her own ice cream. As she began to eat it, I was holding my breath, praying she didn’t break out or flare up. And she didn’t!! Although her face began to frown because she didn’t like it at all! Thankfully, not one reaction was seen that day or even days later.

I was curious if she’d outgrown other foods. Weeks later, we slowly incorporated other foods back into her diet, tomatoes, and citrus, there were NO REACTIONS! Relief, excitement, joy and a different peace settled in.

Our journey continues, as she’s still very allergic to nuts and sensitive to a few other foods. We’re hopeful that she’ll outgrow them all, but if not, we’re blessed.
Our journey continues, as she’s still very allergic to nuts and sensitive to a few other foods. No matter the outcome, I know we were blessed whether her condition got better or worse. Blessings are peace, hope & joy. Even during our hardest bouts with allergies & eczema, we’ve had to focus on what true blessings are.

1 Corinthians 13:7 “Love bears all things, believes all things, hopes all things, endures all things.”

Andrea, founder of ScratchMeNot, had shared about how she managed childcare in 2013 Someone Managed Eczema series here.

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Living with Eczema

SOMEONE Manages Eczema Baby and Nut Allergic Child

Gail shares on managing eczema and allergy for her baby son and daughter, and oh, they look so lovely!
Gail shares on managing eczema and allergy for her baby and teenage daughter, and oh, they look so lovely!

This is a series focused on a personal journey with eczema while managing a certain aspect of life. Today, we have Gail, who shares about managing eczema for her baby and nut allergy for her older daughter. Gail has spent much time looking for products to help families with eczema, and has it all under one roof at her store, Everything for Eczema.

Marcie Mom: Hi Gail, it’s good to have you share in this series! Let’s start with you sharing a little of your older daughter’s nut allergy and the extent of care that is required.

Gail: Hi Mei.  My older daughter, Charlie, was diagnosed with a nut and seed allergy when she was 3 and she’s now 14.  The biggest challenges now that she is a teenager are that she hates carrying her epi-pens around with her as she feels they make her seem different to everyone else.  She will frequently take them out of her bag before she goes to school or out with friends.   Now that she eats out more without me, it’s also a worry as she is very self-conscious about asking whether there are nuts or seeds in a meal.

Marcie Mom: What about care for the younger baby? When did the eczema start and was the scratching intensive?

Gail: My younger daughter’s eczema started when she was just 6 weeks old.  Within a couple of months the whole of her body was covered in eczema and she often needed to have her legs and arms bandaged.  Tallulah was incredibly itchy and would scratch until she bled if left alone for more than a few seconds.  Bath times and nappy changing times were incredibly stressful as this was when she could get at her skin and scratch uncontrollably.

Marcie Mom: How did you manage bedtime for all of your children? What was the most difficult part?

Gail: Bedtime was one of the worst times of the day.  Tiredness would always make Tallulah extra itchy and she would need lots of attention.  This would have a knock on effect on Charlie who would start to feel left out.  It probably didn’t help that I was very sleep deprived too!

Marcie Mom: One final question – was there a turning point during this period which made it easier for your family to manage eczema and allergies for your children?

Gail: Establishing a good bedtime routine really helped.  When my little one was tucked up in bed I would then spend some quiet time with my older daughter so that she felt special too. Finally getting some sleep was a turning point for us all.  Suddenly you start to feel human again!

Marcie Mom: Thank you Gail for your sharing, it is truly not easy to manage all of it and we keep our fingers crossed that night time will get better for all families with eczema kids!

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Living with Eczema

SOMEONE Manages Children with Eczema and Allergy

Janice manages Children with Eczema and Allergy
Janice manages Children with Eczema and Allergy

This is a series focused on personal journey with eczema while managing a certain aspect of life. Today, we have Janice, whose son has allergies and daughter has eczema, and shares how she juggles her time managing both children’s allergic conditions and work. Janice is a working mom, read more about her here.

Marcie Mom: Hi Janice, it’s good to have you share in this series! Let’s start with you sharing a little of your children’s condition, what are both of their triggers?

Janice: Hi Mei, thanks for having me on your series. My daughter has had eczema since she was a baby and was prescribed hydrocortisone ointment at 6 months old. Her eczema usually occurs in the crooks of her arms and flares up with stress or other environmental conditions (chlorine from swimming pools, dry weather). I suspected she may have had food allergies as well. An Allergist confirmed when she was 2.5 years old that she was allergic to fish, ingestion and contact. She avoids fish and fish products. Our dry climate and long winters also cause itchy skin. So we try to keep hers and our own skin hydrated via drinking more water and slathering on lots of moisturizing cream. We still use hydrocortisone on her skin if the eczema episode is too itchy and causing discomfort.

My son has multiple food allergies and we suspected this when he started eating solid foods at 6 months old. He would have redness and small hives around his mouth after he ate his baby cereals and diaper rashes. Our Allergist confirmed he was allergic to dairy, egg, peanut, and tree nuts. Ingesting a small amount of any of these allergens causes hives, itching, swelling, and vomiting.  Without immediate attention he will experience difficulty breathing and anaphylaxis. He is also contact sensitive, meaning if any of his allergens come in contact with his skin hives, itching and swelling occurs. Since diagnosis of his multiple food allergies everywhere my son goes, he or one of his parents will carry epinephrine auto injectors (Epi-pen or Allerject) and liquid antihistamine (Benadryl or Reactine) for immediate treatment. We try our best to ensure my son’s food do not contain any of his allergens to avoid any reactions.

Marcie Mom: Was it hard juggling both children’s conditions or did one get better and offer some time for you to take care of the next?

Janice: My daughter’s eczema is much easier to manage than my son’s multiple food allergies. Eczema flare ups are not life threatening for my daughter. Normally her eczema clears ups and we manage and monitor until the next episode. As for her fish allergies, she doesn’t eat it and we ensure no fish or fish products are in her food.

There is a 2.5 year gap between my children. My daughter was becoming more independent and self-sufficient to allow us time to learn how to manage our son’s food allergies when our Allergist confirmed which allergens. We were also lucky to have other family members and friends to help us with their own personal experiences on managing food allergies. My best friend’s daughter was allergic to the same food allergens as my son. We had immediate help and support with navigating grocery shopping and answers to questions. It was overwhelming at first, but small steps and changes to how we shopped and what we ate helped keep my son safe. If we didn’t have the immediate support, I did find other food allergy information and resources available online and at our public library. I also talked to your Allergist and other health professionals for additional support.

Managing our son’s food allergies, to be honest is stressful and time consuming. Every meal has to be planned. Every grocery shopping trip requires due diligence. Dining out is a hassle. Vacation planning starts with research into dining options and where the nearest hospital or medical facility is located in the event he has an allergic reaction. Until my son is old enough to help manage his food allergies, his parents are his first line of defense to keeping him safe.

Marcie Mom: What measures do you have to take now – for the allergy mainly?

Janice: My husband and I are constantly monitoring my son’s food and surroundings to keep him safe. We try to avoid his food allergens with different measures to reduce the risk of an allergic reaction or incident. Yet we are realistic and we cannot shelter and protect our son from all life experiences and environments.

We spend a lot of time researching and educating ourselves on food ingredients and products. We buy local and organic foods where possible. We eat whole food meals at home and we do like to dine out. To dine out, we contact restaurants to confirm allergen free and safe meals are available for my son. We have taught our son to manage his food allergies, to the best of his abilities and age. He knows not to accept food from others and even confirms with us if the food he will eat is safe.

We provide family members, friends, our son’s teachers and schools food allergy information to raise awareness and educate them of our son’s allergens to help all of us keep him safe. If our son is not at preschool, we have a sitter take care of him at our home. This measure keeps our son safe, as we felt sending him to a daycare even if it was nut free facility the possibility of a dairy or egg allergy incident was still high. Though there is also a possibility an allergic reaction may occur at home, the probability is reduced with his one-on-one care versus being at a daycare or day-home. With all of these measures, we try to keep our son safe and reduce the risk of exposure to his food allergens.

Marcie Mom: One final question – what advice would you give to a mom who has 2 children with allergic conditions?

Janice: Firstly they are not alone and there is a “food allergy army” available either in their community or online who can help and provide support. Secondly I would recommend they build a tool-kit, to help them navigate and manage their children’s food allergies. My tool-kit is filled with

  • reference materials from online and print resources on food safety, product ingredients, recipes, and other parents experiences with managing food allergies
  • contact numbers of friends, family and medical professionals who I can call on when I need help and support
  • my kids’ medication and action plan
  • safe food and snacks

Marcie Mom: Thank you Janice for your sharing especially your precious tip on the tool-kit! Many moms can identify with having more than one child with eczema/allergy.

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News & Research

Eczema Research Focus Month – Food Allergy

Eczema affects food allergy, does it cause it?
Eczema affects food allergy, does it cause it?

Last week, we looked at Probiotics. For today, we’re looking at the relationship between eczema and food allergy. In this study, it was indicated that a breakdown in skin barrier and skin inflammation in eczema could lead to increased food sensitization -> food allergy. This had been covered in the outside-in hypothesis post. Main points of this study:

1. Infants with an impaired skin barrier/ eczema, are more likely than to be sensitised to a variety of foods such as egg white, cow’s milk and peanut.

2. The more severe the eczema, the stronger the correlation to food sensitivity.

3. Repair of skin barrier therefore may reduce food allergy.

My family is already moisturizing lots for our daughter, what about yours? Do you think moisturizing from young had reduced food sensitivity? Share in the comment!

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Living with Eczema

SOMEONE Manages Severe Peanut Allergy for Eczema Child

Louise shares on managing her son's peanut allergy and eczema
Louise shares on managing her son’s peanut allergy and eczema

This is a series focused on personal journey with eczema while managing a certain aspect of life. Today, we have Louise Jones, whose son has a severe peanut allergy and shares how she manages his allergies and eczema. Louise is passionate about learning and sharing on parenting severe nut allergy child at Nutmums.

Marcie Mom: Hi Louise, thanks for taking time to share with us about managing your son’s eczema and severe nut allergy. Let’s start with you sharing a little of your family allergy history, and about your son’s eczema.

Louise: Hi Mei, Thank you very much for asking me to share our journey. There is, in fact, very little in the way of family allergy history. I have mild asthma (but, touch wood, haven’t had to use an inhaler in years) and can get wheezy around cats. His dad sometimes has hay fever symptoms and his paternal grandmother had eczema as a child. Otherwise, there are no known allergies in either side of the family.

My son has had eczema since he was a baby. I’m not sure when exactly it started, but we were regularly using Oilatum and hydrocortisone cream by the time he was 6 months old. I remember one night him scratching his head so much in his sleep that the next day there was what looked like a graze covering half of his forehead. If I put him in scratch mitts, he would still rub and rub at his skin with the gloves until it bled. At 14 months, he had eczema herpeticum and we spent the day on the children’s ward. However, a short while after that, his eczema seemed to improve and, fortunately, at the moment, it is fairly mild.

Marcie Mom: When did you realize your son has severe nut/peanut allergy? Was there any particular incident of severe allergic reaction?

Louise: When my son was 20 months old, he ate a peanut butter cookie and had a severe anaphylactic reaction. That was our baptism of fire into the world of food allergies. We knew next to nothing about allergies before that point and, so far as we know, he hadn’t had any previous mild reactions to food.

He used to love chocolate chip and hazelnut cookies and had occasionally had a bite of cakes containing nuts. We didn’t avoid foods labelled “may contain nuts” and we had peanut butter in the house. However, that first reaction was the first occasion he had knowingly eaten peanut.

The reaction was extremely severe. Immediately after biting into the cookie, his lips swelled, one eye swelled closed and his breathing became loud and wheezy. Fortunately, his grandmother is a retired nurse and recognized it as anaphylaxis and called an ambulance. As this was his first allergic reaction, we hadn’t been prescribed an adrenaline auto-injector at that point. Although the paramedics arrived incredibly quickly, there was still a 10-15 minute time lag between the symptoms starting and him getting the adrenaline injection. He was taken to hospital and, as the doctors were concerned about the swelling in his throat, they decided they needed to put a breathing tube down. He spent the next 3 days in intensive care. However, within a week, he was back at home and to look at him, you would not have guessed what he had been through.

After that, his skin prick tests confirmed the peanut allergy but were negative for tree nuts (almonds, hazelnuts, walnuts etc). For now, we’ve decided to avoid all nuts, to reduce both the risk of confusion (it’s easier to tell his nursery, relatives etc “no nuts”) and cross-contamination.

Marcie Mom: Did avoidance of allergens for your child also result in improved skin?

Louise: I’m not sure, as at the time he was diagnosed with peanut allergy, his eczema was already improving. However, as well as having eczema, he had been quite a sicky baby. When he was little, this was put down to reflux. When he was around 12 months old, he had a series of chest infections, so the sickness at that stage was put down to catarrh. Following his anaphylactic reaction, the doctors got his asthma under control. It may be coincidence, but he then had far fewer chest infections and the sickness improved too.

Marcie Mom: One final question – what would be one reminder or key advice you have for parents of children with severe allergies?

Louise: Well, I would say please don’t hesitate to administer the EpiPen. We’ve used it twice since that initial reaction. The first time we used it turned out to be a false alarm (he had croup which had triggered his asthma), but the second time it stopped the anaphylactic reaction in its tracks. On both occasions, the hospital doctors told us we had done the right thing.

I would also warn parents to be aware of the increased peanut allergy risk if your child (or someone in your child’s immediate family) has eczema (or another atopic illness). I actually think this is something that doctors should spell out when they are diagnosing eczema and prescribing emollients and steroid creams for babies. If your baby has eczema, please talk to your doctor before introducing peanut into their diet – don’t be caught unawares like we were!

Marcie Mom: Thank you Louise for your sharing, and indeed many parents share about their worry that an ‘allergy accident’ will happen to their child and can certainly identify with your journey. For more on eczema herpeticum, refer here.

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Living with Eczema

SOMEONE Manages her Eczema, Allergies and Food Intolerances

WhatAllergy on Eczema BluesThis is a series focused on personal journey with eczema while managing a certain aspect of life. Today, we have Ruth who is sharing about her eczema, allergies, food intolerances and allergic march. Ruth is a copy writer and marketing communications specialist (Ruth Holroyd) and also has an allergy blog WhatAllergy.

Marcie Mom: Hi Ruth, thanks for sharing about your multiple allergic conditions. Let’s start with you sharing a little of your atopic history.

Ruth: Well I was born with eczema, I don’t ever remember NOT having it. Then a peanut allergy, hay fever, asthma and then allergic to dog and cat dander and I was on the allergic march.

I was also allergic to egg as a baby but I can eat eggs now when well cooked though I have to be careful not to overdo it or they can start to make me fell unwell. This now just an intolerant reaction which is easy to manage and I save eggs as something to eat when I eat out.

The eczema has been with me as long as I can remember but does seem to go in cycles. It does clear up sometimes for a few years then comes back to bite me.  I have it pretty well under control but I know that certain foods cause awful itchy eczema to flare up.  Dairy is the worst for this as well as tomato, celery and fresh coriander.  It gets me the day or even two days after eating and my skin will be boiling with pain, red, raw and like a think crusty hard scaly mask of pain. This mainly gets my face and neck but can be all over and even tiny traces can do this.

I have allergies now to all nuts, soya, dairy, kidney beans, celery, tomatoes and pretty much everything processed and any kind of lactic acid. Beetroot and cucumber are suspected foods but this seems to be a bit random.  And the thing is it’s a different reaction with each food. Often delayed and causing eczema so often doesn’t show up in allergy testing. But if I exercise WHAM – if I’ve eaten the above allergens, especially dairy or celery I’ll get anaphylaxis which is just terrifying.

Soya milk causes me immediate and severe asthma. Soya protein, flour and other types cause less dangerous asthma but I’m better avoiding any soya.  It has meant I have reduced my asthma medication drastically since discovering this was a trigger.

I also have a wheat intolerance which I often just don’t mention as it’s not life threatening but it’s really painful, causes extreme constipation and bloating and very very bad wind!  I know if I’ve eaten any.  Not great for anyone who is near when I eat any gluten or wheat.

Marcie Mom: How have so many allergic (and hypersensitivity) conditions affect your lifestyle and quality of life?

Ruth: I try not to let them affect my life but it’s impossible to completely achieve this.  You have to be really well prepared. So I try to have lots of fresh food in the house. I tend to just avoid the allergens and not use many freefrom branded goods because they often contain one of more of my allergens.   Home cooking from scratch is the norm but there are some amazing healthy freefrom ready meals coming out like ilumi which make life just a little more fun.  I tend to cook extra and freeze portions for days when I can’t face cooking.

Eating out is a huge challenge.  I do try to do this as you really miss out when you just never go out but I try to go for entertainment options where food is not involved like walks with a picnic, drinks instead of a meal, shopping, cinema etc. The options are endless. But eating out should be a treat and I have managed to have some lovely meals out but not without military planning, endless checking and just a little worry.

Going on holiday is a challenge too because you NEVER get a holiday from allergies.  We go self catering or camping and this works well.  Expensive hotels tend to be better too as they are less dusty and have better catering but small B&Bs can be wonderful if you can find one you trust which isn’t going to trigger any of your allergies. I find dust is one of my hardest as even in a busy pub I’ll be wheezing if it’s got carpet and curtains.

I know it’s tough on my husband and family too who have to cater to my every whim (Now wouldn’t that be nice?) and often change plans so I’m safe, take extra care in the kitchen etc.  Family and friends have been amazing at helping me stay safe, always have an eye out for mistakes I might make and often surprise me with their kindness and understanding.

Especially with the eczema. What I feel like is a raging, red, angry, miserable horrible person. What they is just me and often they say my skin looks fine. Just a little pink and maybe like sunburn. Not something to worry about but I imagine everyone is horrified.  Learning not to care what your face looks like and what people think is a hard lesson when you can feel it itching and burning but if you take your mind of your eczema and go out you scratch a little less so it’s well worth it.

Marcie Mom: Does your career choice have anything to do with your eczema and allergies?

Ruth: Probably not really but I did want to be a policewoman which was an instant no go when they discover I anaphylaxis AND multiple triggers caused by exercise. Not good really.  Working from home has made my life so much easier. I can take a morning off if I’ve had a really bad allergic reaction and I can catch up when I’m feeling better.  Noone can see me on really bad eczema days and this does take off the pressure.  If I was working full time I would have had a terrible work record over the last few years as the allergies have been so much worse. I’m getting them under control now though and working out ways to stay safe – I have been a bit lax and made lots of mistakes but we live and learn.

Marcie Mom: One final question – what advice would you give to a lady who wants to build confidence and meet more people, despite visible eczema?

Ruth: It really needed not be a life sentence although it often does feel like one.  My advice is always to try to accept it, so you have allergies. Big deal. You can live with this if you’re careful and on the plus side I am really healthy, don’t put on weight, have learnt to cook amazing tasty food, love cooking and baking now, have met some amazing inspiration people through blogging, judging on the freefrom food awards and public speaking.  I also organise an Allergy Support Group. This is a great way to meet like minded people and have a good moan in a friendly place where people really get you.  Get involved in local groups like this, join forums and learn as much as you can and make sure you get the support you need from your doctor and allergy specialists – not always easy but vital as these things change and can get worse without warning.

Keeping eczema and asthma under control can have huge impacts on allergic reactions. If skin is not moisturised well and breaks down allergens can and will penetrate your skin too. If you asthma is not well managed you could get far worse allergic reactions. By keeping these areas well managed you can greatly help your allergy health.

Exercise too for me is key. The fitter I am the less allergic I am. Not sure why but maybe you sweat out the allergens quicker or maybe the body is just better able to process allergens. Who knows, but it’s another way of enjoying a better life too. Eat well and exercise.

Also everyone should read my blog – it was voted in the top 5 UK allergy blogs last year and is jam packed with useful tips, product reviews and advice for living life to the full with life threatening allergies, eczema and asthma.  Life is for living and there is always someone worse off than you.  Life with allergies and eczema can have its positives too and lots of them so keep smiling and moisturise!

Marcie Mom: Thank you so much for sharing your eczema and multiple allergies. Many can identify with it and I do hope ladies reading your sharing will be encouraged.

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Living with Eczema

SOMEONE Manages her Eczema, Allergies and Chronic Pain

Jen shares on managing eczema, allergies and chronic pain
Jen shares on managing eczema, allergies and chronic pain

This is a series focused on personal journey with eczema while managing a certain aspect of life. Today, we have Camper Jen who is sharing about her eczema, allergies and how she manages it all along with her chronic pain. Camper Jen founded PainCamp and holds a license in her field of clinical social work with specialties in the areas of Mental Health, Medical and Chemical Dependency.

Marcie Mom: Hi Camper Jen, thanks for participating in this eczema sharing series. I know you have confirmed food and environmental allergies, can you share with us when you first got allergy tested and what prompted you to do so?

Camper Jen: As a baby, the doctor told my mother that I was allergic to dairy. Between the ages of 12-14, I was tested again with blood and skin tests. I also had testing done for sensitivities as well as allergies. All of the allergies and sensitivities were confirmed back then but I basically ignored the results (except for the 3 years of allergy shots). Two years ago I was diagnosed with Chronic Pain Syndrome (along with many other diagnoses). That brought me back to addressing my allergies, sensitivities and food intolerances as causes or contributors for some of my symptoms. This time around I am addressing them with direction from a naturopath.

Marcie Mom: What about your eczema – when did it start, and how is your skin now?

Camper Jen: I was diagnosed with eczema as a young teenager. I just had an appointment with the dermatologist a couple of weeks ago and she said I’m getting hives along with the eczema now. This is due to higher histamine levels as I’m probably reacting to something I’m eating (oops – corn) as well as my environmental allergies (it is summer time here). The areas that are most affected are my legs, backs of my knees and the inside of my elbows.

Marcie Mom: I read from your site that you also have Chronic Pain Syndrome and a lot of other health conditions. Did any of these conditions make it harder for you to manage your eczema, or even trigger eczema flare-ups?

Camper Jen: Early on in my diagnoses of Chronic Pain, I was using warm water pool therapy as a part of my pain management approach. Due to my Multiple Chemical Sensitivity (along with not having my food allergies/sensitivities under control), my eczema was not managed well during this time. After every visit to the pool (5x a week) I had uncontrollable eczema symptoms. I am not able to manage my eczema with conventional prescription lotions, creams and soaps that my Dermatologist has prescribed because I am sensitive to the chemicals that are in them. I’m trying to find a great organic and non-toxic lotion or cream to sample. If anyone knows of any that works for them, let me know!

Marcie Mom: One final question – what advice would you give to someone who is managing eczema and other chronic health conditions?

Camper Jen: I have experienced frustration with having eczema on top of other chronic health conditions. I have found some relief by addressing my allergies and sensitivities under the direction of a naturopath. My dermatologist is not familiar with holistic and organic approaches to treatment so I’ve started to look elsewhere for help. I would encourage people to look more closely at possible causes and triggers for their eczema (allergies and also sensitivities/intolerances) and seek consultation from a holistic practitioner. There are also other mind/body approaches I have found that helps take my mind off the itching sensation (tai chi chih and listening to music). If one approach doesn’t work, keep trying and don’t give up!

Marcie Mom: Thank you so much for sharing about your eczema, allergies and your journey in healing your body. Truly appreciate the positive vibes and good work you’re doing to help others!

Camper Jen: Thank you for this opportunity to share how eczema has affected my life. We can all learn from each other!

Categories
Living with Eczema

SOMEONE Manages Allergy Testing for Child

Kristin on Allergy Testing on Eczema Blues
Kristin shares on managing allergy tests for child with multiple severe allergies

This is a series focused on personal journey with eczema while managing a certain aspect of life. Today, we have Kristin Beltaos, whose son has severe food allergies and shares how she manages his allergies via allergy testing. Kristin is a member of the Anaphylaxis & Food Allergy Association of Minnesota’s Speakers’ Bureau and a consultant/licensed trainer and owner of A Gift of Miles.

Marcie Mom: Hi Kristin, thanks for taking time to share with us about allergy testing. Let’s start with you sharing your son’s allergy history – when did he have them and did it show up as rashes on the skin?

Kristin: Hi Marcie, thanks for asking me to participate. My son’s allergies exhibited themselves prior to us leaving the hospital from his birth. He vomited and scream-cried after breastfeeding multiple times a day; physicians and nurses attributed the vomiting to a baby’s underdeveloped digestive tract. At six weeks, his pediatrician decided to have an Upper GI Series to rule out pyloric stenosis, a narrowing of the pylorus, the opening from the stomach into the small intestine that causes severe projectile non-bilious vomiting in the first few months of life. This test came back negative. It was decided that he had severe acid reflux and prescribed Zantac and later Prevacid in order to control his condition.

For the next seven months his vomiting continued, he also had eczema, unexplained hives, did not transition to baby food or table food and was labeled borderline failure to thrive for 18-months.

Two particular instances made us think something more was happening than acid reflux. The first was that I tried to wean a breastfeeding and provided him with a milk-based formula. He literally had one drop on his lips; his head looked like a red, cherry tomato and he scream-cried for over an hour. At first I thought, ok, ok, you’re a breast man and you don’t want a bottle. Then connecting the dots had us questioning…is this a clue for something else?

The second was the straw for my husband and I. I’d describe my son as a happy, but fussy baby. I know that sounds contrary, but he really was happy. One morning, he was fussy and I picked him up and kissed him all over his head to make him laugh. For every kiss that I gave him he had a nickel size hive, there were eight hives for eight kisses. I had cereal that morning, and while my lips weren’t wet with milk, there was residue. Later we found he was allergic to milk by touch and ingestion, along with other allergens.

Lastly, because of missing the window between four and nine months when oral motor skills are developed, he served 18-months in the Children’s Hospitals and Clinics Feeding Clinic to learn how to orally manipulate his food, i.e., chew, transition food from side-to-side, learn how much to chew prior to attempt swallowing and work on food texture issues. Even after he was diagnosed with his food allergies at 11-months, his food challenges haunted him until he was just shy of his fourth birthday.

I have to say all the while this was going on, I always knew something was wrong. I knew the doctors were missing something. So I tell parents, especially mothers, know that you aren’t going crazy and to seek opinions until you find an answer.

Marcie Mom: When was your child’s first allergy test and how did the physician help you to interpret his test results? 

Kristin: At 11 months, my son had a Radioallergosorbent Test, commonly known as RAST Test, which is a blood test used to determine to what substances a person is allergic. Our pediatrician broke the news to us that he was allergic to Cow’s Milk (including by touch due to the cereal and kiss episode), Eggs, Peanuts and Tree Nuts. In the summer of 2011 we added Sesame to his list.

After his diagnosis, we moved to a board certified allergist for care.

Marcie Mom: How often is a repeat allergy test required? And did it benefit your family to learn of new/ outgrown allergies?

Kristin: Obviously allergy testing is recommended whenever you have a new and/or unexplained reaction of course. For management of already diagnosed food allergies, the recommendation may vary from allergist to allergist and based upon each patient’s individual allergies and needs. Personally, I have my son’s allergies reviewed on an annual basis.

Coincidentally, we just had his allergen review within the past week. We received good and bad news. His Cow’s Milk numbers have been on the rise in the past two years, very disappointing as you can imagine. In this last test, his numbers more than doubled, placing him in the next Class level, Class 4 that is labeled as a Strong Positive. Our allergist continues to encourage us to stay hopeful, that the big reveal would be closer to when he enters high school as to whether this may be a lifelong allergy. He’s only seven, soon to be eight, so we have some time yet.

His Egg numbers have stayed the same; however, we are able to do a Baked Egg Challenge to see if he might be able to consume Egg in a baked good, i.e., muffins, cupcakes, cake, bread, etc. This is a test done in a supervised medical environment, clinic or hospital, with your board certified allergist or other medical representative present. I should add that this type of Challenge is not something done at home in your own experimentation.

We’re also investigating, via another blood test, whether he might be a candidate for a Baked Milk Challenge. The results remain to be seen on this front.

Peanut is no longer tested for because his numbers are too high. It is believed that peanuts will be a lifelong allergy.

Interestingly enough, his Tree Nut results have come back negative, pointing to outgrowing this allergy. We will investigate with a skin test to confirm and of course orally test him by having him consume Tree Nut(s) that are processed on dedicated lines with no risk of cross contamination with peanuts.

Lastly, his Sesame results came back very low, which may point to him outgrowing this allergy as well. We will pursue a skin test, should he pass, a Sesame Oral Food Challenge would be in the cards for him.

As you can see, testing regularly not only allows you to know the status of a person’s allergies. Moreover, if a child outgrows an allergy or allergens, it permits the reintroduction of food items permitting an expansion in diet. An expanding diet is ALWAYS a good thing. : )

Marcie Mom: One final question – for a mom who has difficultly with figuring out false positives in test results, what would you recommend to do?

Kristin: I honestly do not have any recommendations regarding false positives. What I do recommend is finding and partnering with a board certified allergist that you truly trust. In doing so, you’ll feel confident in the recommendations provided and can go about living life to the fullest with food allergies.

Marcie Mom: Thank you so much for sharing your journey on managing allergies and allergy testing – many eczema families are also ‘figuring’ this out and your sharing will be useful for them!

About Kristin Beltaos, M.A. – Kristin is the owner of A Gift of Miles, offers food allergy one-on-one consulting, national and local trainings, school consulting, and parent/school advocacy; and serves the markets of stress, with subspecialties, and reproductive challenges. She is a Licensed Trainer with the Minnesota Center for Professional Development, teaching food allergy continuing education to early childhood and school age providers and educators, a member of the Anaphylaxis and Food Allergy Association of Minnesota’s (AFAA) Speaker’s Bureau and a former board member. Kristin wrote and drove the implementation of the first food allergy 504 Plan in her child’s school, was influential in creating a new school food policy which eliminated food celebrations (both in classroom and school wide) – a policy that other schools are interested in emulating. Kristin was named a Top 25 Food Allergy Mom, 2012 by Circle of Moms. Stay happy and informed by following Kristin on her Facebook, Twitter and Pinterest.

Categories
Living with Eczema

SOMEONE Manages Baby with Severe Eczema

Lauren Son Eczema Blues
Lauren shares about managing severe eczema for her son in his first year

This is a series focused on personal journey with eczema while managing a certain aspect of life. Today, we have Lauren, whose 3 year old son has severe eczema in his first year, and shares how she manages eczema for a newborn. Lauren plays and teaches bassoon in Traverse City, Michigan.

Marcie Mom: Hi Lauren, it’s good to have you share in this series! Let’s start with you sharing a little of your son’s eczema – when did it start and how was his skin at his worst then?

Lauren: Hi, Mei. Rhys developed cradle cap (a yellow, scaly crust on his scalp) around two months of age and developed body-wide severe eczema at three months of age.  I first noticed a problem when one day he started to repeatedly rub his eyes and face with his hands.  He was not yet coordinated enough to truly scratch.  The red skin and rashes followed, at first on his face, and later nearly everywhere else.  At its worst, his skin was inflamed, crusty, and oozing and the plasma would soak through his clothes and bed sheets.  It was quite similar to a very bad reaction to poison ivy.

Marcie Mom: Allergy testing isn’t accurate in the first few months of a newborn’s life  – did you have difficulty finding out his triggers in the first year?

Lauren: My husband and I had tremendous difficulty and often had disagreements stemming from the mystery of it all.  That first year we took Rhys to three different doctors and also to non-traditional (in the American sense) healers.  I stopped consuming dairy for about a month because I was breastfeeding, we eliminated all detergents from our home – even shampoos and toothpastes containing detergents, and we kept Rhys away from our cats.  No lifestyle change seemed to make an obvious improvement.

Marcie Mom: How and when did the eczema improve?

Lauren: During the first year, it was a combination of two events.  First, Rhys’s pediatrician realized he couldn’t fully help and referred us to a dermatologist.  The dermatologist prescribed Triamcinolone, a strong topical steroid, and frequent moisturizing.  I believe he gave us samples of CeraVe. Second, around the same time, I spoke with a friend whose son has food allergies.  She told me dairy consumption was often a trigger for eczema breakouts and other allergic reactions and convinced me to again eliminate dairy from my diet.  She also told me about a friend of hers whose child had severe eczema.  The pediatric dermatologist in that case had advised to (1) give the child three lukewarm baths a day, using cleanser only on soiled areas, (2) use topical steroid as needed on “hot spots” after the bath, and (3) moisturize on still-damp skin.  The triamcinolone broke the cycle of inflammation and the frequent bathing and moisturizing helped his skin’s resiliency.  Moisturizing red and oozing skin never worked; it was really only effective at maintaining healthy skin.

As you mentioned, Rhys is now three.  We no longer give him baths three times a day, but we do moisturize after baths and as needed throughout the day and we use the steroid Fluticasone Propionate Cream for break-outs.  We still avoid detergents and products with synthetic scents.  Rhys underwent allergy testing late last summer and due to the results and personal experience, we now avoid peanuts, tree nuts, legumes, dairy, and eggs.  If Rhys begins to scratch uncontrollably, the dermatologist gave us permission to give him children’s strength antihistamine.  We have so many more pieces of the puzzle figured out now, not all, but many.  Most of Rhys’s skin is now smooth and healthy.

Marcie Mom: One final question – what advice would you give to a mom who has a family history of eczema/allergy and preparing for the newborn?

Lauren: Eat the healthiest possible foods while pregnant.  Some might even advise you to eat as much chemical-free and organic food as possible while pregnant.  If your baby develops the symptoms I mentioned, do your best to keep the baby from scratching and seek help.  If your child’s healthcare provider has never seen such a severe case of eczema, find a healthcare provider who has already seen and treated a case like your child’s before.  And don’t blame yourself.  Your baby will outgrow some triggers, like the drooling that accompanies teething.

Marcie Mom: Thank you Lauren for your sharing, many moms can identify with it and hopefully every baby grows out of eczema.

Categories
Living with Eczema

SOMEONE Manages Child with Multiple Allergies

Child Allergies Eczema EczemaBluesThis is a series focused on personal journey with eczema while managing a certain aspect of life. Today, we have a father, known as Spanish Key, who has a daughter with eczema and multiple allergies, and shares how he manages her daughter’s conditions. Spanish Key blogs at End Eczema and also started the Eczema Map Project.

Marcie Mom: Hi Spanish Key, it’s good to have a dad to share. Let’s start with you sharing a little of your daughter’s eczema and allergy history.

Spanish Key: My daughter’s four years old. She’s got moderate-to-severe eczema and mild asthma. Her history is part of an ongoing family history of atopy, since my grandfather, a cousin, and myself all had or have eczema. Shortly after she was born we noticed the eczema and blood in her stool. The blood was apparently from food allergies through breast milk.

We had her skin- and blood-tested and she was positive to virtually everything. The allergist said we should feed her nothing but rice, banana and zucchini. Obviously that was nutritional nonsense so we asked her pediatrician who expanded the list to nine items including chicken and carrot. She ate nothing but those things for two and a half years—and my wife, while breastfeeding her, had to avoid all the major allergens as well.

Her eczema flares up worst on her hands. It happens every six months or so. In between we see it on her feet and scattered all over. Asthma shows up when she gets sick with a cold.

Marcie Mom: You’ve shared about your daughter’s allergies – which would be the ones which have been tested positive and for which she experienced moderate to severe reactions?

Spanish Key: Things are changing over time. We get her skin- and blood-tested once a year, and challenge her orally with new items. There was an exciting moment when we went from a short list of things she COULD eat to a short list of things she COULDN’T eat. Right now the known positives are nuts (all kinds), dairy (all kinds), and sesame. Just last week we introduced beef and coconut. She had no reaction to those. We also know she’s allergic to horse dander—she has horse-riding lessons every two weeks and always comes back blotchy-faced and itchy, so we included that in the testing.

Eczema Food Allergy List
Food Chart at 3 year old

Her dairy and sesame allergies don’t obviously make her skin flare up. Instead, she vomits almost immediately. The allergist says this is not the typical reaction but it’s still most likely an allergy and not an intolerance.

Our biggest fear is not eczema but that she’ll develop an anaphylactic nut allergy. We are not sure whether we should be avoiding nut products ourselves. We eat nuts and peanut butter in the kitchen. This might be good because it is exposing her to small amounts and inducing tolerance—or it might not.

Marcie Mom: How do you manage so many triggers and allergies? Does it affect her nutrition and lifestyle?

Spanish Key: Most of her life we have made all her food from scratch. I do it myself since I’m the cook. I know what goes into her food. In the last year or so we’ve let her have some packaged candy after we read the ingredient list.

For the first four years, we gave her special vitamin powder http://www.solacenutrition.com/products/nanovm/nanovm.html, because all the children’s vitamin pills we could find contained coconut. But as of two weeks ago, she’s been taking regular kiddie vitamins and loving them.

I do my best to balance her diet. But it’s frustrating because she either was a picky eater to begin with or has become one, from lack of variety. Now she is able to eat a wide variety of foods, but she doesn’t like many of them. In practice she eats a lot of pasta, rice, and soy. These foods are not so great for her teeth which are in worse shape than her brother’s. She’s getting enough calories—actually we worry she might be a bit chubby—but she really ought to eat more vegetables. But you could say that about me too!

Marcie Mom: One final question – what would be your top 3 tips to another parent whose child tested positive to lots of allergens?

Spanish Key:

  1. Make all their food yourself from scratch.
  2. If you give them packaged food, always check the ingredients. Always. Most soy sauce contains wheat. Most bread and margarine contain milk. Vitamin pills can contain nuts.
  3. And make sure their teachers know that they have food allergies, because treats often get shared at school.

Marcie Mom: Thank you so much for sharing your journey managing your child’s eczema and multiple allergies (and from a dad’s point of view!).

Categories
News & Research

Coins, Bras and Specs – Nickel Allergy

nickel allergy eczema contact dermatitis EczemaBluesThis is a quick post, as a study had just been released about the new coins in UK, where “nickel-plated coins deposit higher levels of nickel onto skin than cupro-nickel coins, and hence pose an increased allergy risk“. It could also trigger dermatitis/eczema.

Got me interested to dig a little into nickel allergy, and here’s a quick snap shot of what I’ve found:

1. Once sensitized to nickel, it’s usually persist life-long; more common in women with ear-piercing and fashion jewelry and also for certain occupation like hairdresser (article ref). Spectacle frames induced allergic contact dermatitis (study)

2. It can take time to be sensitized to nickel – I’ve often seen people asking if their bra could cause the rash, but they have been wearing a (different) bra months ago and rash only started to appear = it is possible that it’s really the bra cos sensitization takes time. Some bra hooks contain nickel (note: the latex in some bra can also trigger rashes.)

3. A diet low in nickel can improve the eczema – less of cocoa, chocolate, soya beans, oatmeal, nuts, almonds and fresh and dried legumes.

Categories
Living with Eczema

SOMEONE Managed Two Children with Eczema

Ee Laine's boys with eczema, looking cheerful!
Ee Laine’s boys with eczema, looking cheerful!

This is a series focused on personal journey with eczema while managing a certain aspect of life. Today, we have Ee Laine, whose 1st and 2nd sons have eczema since 6-month old and 3-month old, and share how she manages taking care of two children with eczema. 

Marcie Mom: Hi Ee Laine, thanks for taking part in my Friday blog series ‘Someone has Eczema’! Let’s start with you sharing a little of your children’s eczema history – when did eczema start and what’s the severity?

Ee Laine: Most of my struggles happened while we were still living in Australia (we moved to Singapore in Oct 2010). I started noticing red itchy marks on my 1st son after he turned 6 months. His legs especially behind his knees, around the ankles and wrists became either itchy, red and broken, or dry with the skin having a texture of sandpaper.

Our 2nd child had more issues. We started noticing redness at 3 months which could only be controlled by steroidal creams. At 6 month-old after going on solids, his cheeks were red, raw and so bad that one gentle swipe of his fingers will send the skin tearing and bleeding. I remember stirring my corn and pea mash on the stove while keeping a close eye on our baby seated on the high chair right behind me. Just a few seconds of not watching him, he managed to scratch his cheeks and blood went all over his fingers, cheeks and shirt.

Marcie Mom: I had the same experience! I was cooking and turned a few seconds away, and my girl scraped her own neck against the high chair till bleeding!

Share with us: Was it tough to take care of your first child while you were pregnant with the second? And how did you manage when the second child also had eczema?

Ee Laine: It was tough. There was one incident during my second pregnancy that I remember well: my then two-year-old ate a little too much nuts and broke out in hives, rashes and swelling in his lips. I had to rush him to hospital for an Adrenalin jab. Actually my second son had a similar experience in Singapore too, when he managed to eat some Nutella while no one was looking. He too broke in hives with swelling in his lips and was quickly taken to the neighbourhood clinic for a jab.

When we were still in Australia my first son attended childcare while I worked, and the staff was very helpful in applying lotion and making sure he’s okay. Nights were tough because he would wake several times crying from the itch. My husband and I took turns applying more cream and stroking to soothe his skin until he fell asleep. I could not remember ever having a good 7-8 hours sleep. This continued even after we had our 2nd baby.

I stopped work shortly after my second pregnancy. Having 2 young ones with me, I had to multi-task a lot of the time.  I think the worst was the lack of any break from the children as we were in Australia without any family support. Church friends as well as mums I knew from my mother’s group were our greatest support and I’m grateful for that. 

Marcie Mom: We really share much similar experience! I was also very grateful for the support that my home group fellowship gave me when I was going through the toughest first year of taking care of my baby. So you relocated from Australia to Singapore, how was the adjustment?

Ee Laine: We were hoping the move to humid Singapore will improve my older son’s dry skin but it didn’t. Thankfully, although his skin is still dry around the joints and itchy at night, it is not as bad as it was before. We moisturise faithfully after shower, and if it gets really bad, I do an oatmeal soak in the pail for his legs. Exfoliating those dry bits with the oatmeal does wonders.

For my 2nd son, his skin condition was related to the food allergies so the change in environment and climate did not affect him much.

Marcie Mom: One final question – how did you manage your 2nd son’s allergy?

Ee Laine: I started to notice his eczema worsen after introducing solids. After the bleeding incident and a trip to Emergency, the doctors referred him for allergy testing. As I was still breastfeeding then, I randomly picked 2-3 foods to avoid for myself, hoping to identify the triggers going through the breast milk. I went off eggs, nuts and dairy for about a month. The allergy test confirmed his allergies to wheat, eggs and nuts. It was hell as our diet had many things with wheat in them. And I had often fed him bread. But we noticed some improvement after removing the food allergens. It was tough though – when we went out and his baby food finished, the only thing we could feed him was fries. We couldn’t have any Chinese meal outside, as every dish has soy sauce in it and wheat is one of the ingredients found in soy sauce. For home cooked meals, we had to buy tamari sauce instead and have everything wheat free.

Soon after our move to Singapore he grew out of his wheat allergy. Although he is still allergic to eggs and nuts, we find life more manageable. My mom-in-law, who helps look after him on occasions, understands his condition and keeps him safe. As he grows older, we ensure he learns and remembers what he cannot eat and his older brother helps look out for him too. We have to be very vigilant about him accepting food from other people who may not be aware of his allergies. He knows to ask first before putting anything into his mouth, which is good. Every now and again, I get him to ingest a tiny amount of nuts or eggs just to see if he is still allergic to those foods (still some skin reaction around his mouth but no hives and swelling). I hope he’ll overcome his allergies one day.

Marcie Mom: Thanks Ee Laine for taking time to share your journey on both your sons’ eczema – am sure many moms can identify with them!