Eczema in Babies and Food Allergies:

Eczema test

A Comprehensive Guide
Medical Insights & Evidence-Based Management


Understanding Eczema in Babies

Eczema (atopic dermatitis) affects up to 20% of infants, presenting as dry, itchy, and inflamed skin. Emerging research highlights its strong link to food allergies, with 30% of infants with moderate-to-severe eczema developing IgE-mediated food allergies such as egg, peanut, or milk. The dual allergen exposure hypothesis suggests that impaired skin barriers allow allergens to penetrate, triggering immune sensitisation.


The Link Between Eczema and Food Allergies

  • Skin Barrier Dysfunction: Broken skin in eczema facilitates allergen entry, increasing food allergy risk. Infants with eczema before 3 months have a 50% higher likelihood of developing allergies to egg, peanut, or sesame.

  • Genetic Factors: Filaggrin gene mutations and immune dysregulation are key contributors. A 2023 study (M-FAD Program) aims to decode genetic links between eczema and food allergies using biobank data from 60,000 patients.


Management Strategies for Eczema in Babies

1. Skin Care Interventions

  • Emollients: Daily moisturisers may improve skin hydration but do not prevent eczema or food allergies. Cochrane reviews (2021–2022) found emollients increase skin infection risk (RR 1.34) and may elevate food allergy risk (RR 2.53).

    • Key Tip: Avoid moisturisers containing nut oils or dairy to prevent sensitisation.

2. Dietary Approaches

  • Early Allergen Introduction: Introduce allergenic foods (e.g., peanut, egg) by 4–6 months, especially in high-risk infants. This reduces food allergy risk by up to 80%.

  • Maternal Diet: Omega-3-rich diets during pregnancy/breastfeeding may lower eczema risk.


Clinical Trials on Eczema Management

Stay informed with cutting-edge research:

  1. SEAL Trial (2024)

    • Objective: Compare proactive vs. reactive eczema management in infants aged 0–12 weeks.

    • Intervention: Proactive regimen includes daily moisturisers and intermittent steroids.

    • Outcome: Aims to prevent food allergies by restoring skin barriers.

  2. PACI Study (2023)

    • Findings: Proactive steroid use on affected and unaffected skin reduced hen’s egg allergy by 25% vs. conventional treatment.

  3. Cochrane Review (2022) 10

    • Conclusion: Emollients do not prevent eczema (RR 1.03) but increase infection risk.


Practical Tips for Parents

  1. Bathing: Use warm water and fragrance-free cleansers. Limit baths to 10 minutes.

  2. Clothing: Choose 100% cotton to reduce irritation.

  3. Allergen Avoidance: Exclude food-containing skincare products (e.g., oat-based creams).

  4. Monitor Growth: Prolonged steroid use may affect infant growth; regular paediatric reviews are essential.


Future Directions

Research is exploring:

  • Biologic Therapies:  show promise for severe eczema.

  • Probiotics: Limited evidence for eczema prevention but may aid food tolerance with long-term use.


Key Takeaways

  • Manage eczema aggressively to reduce food allergy risk.

  • Early allergen introduction and proactive skin care are critical.

  • Avoid emollients with food-derived ingredients.

For more details on clinical trials, visit SEAL Trial or PACI Study.

Last Updated: April 2025 


Keywords: baby eczema, infant food allergy, eczema clinical trials, skin barrier management, paediatric allergy prevention.

Dr Robert Boyle - MB ChB, MRCPCH, PhD