New research presented at the American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting suggests that the timing of when eczema begins, as well as how long it lasts and how severe it is, may influence a child's ability outgrow food allergies.
"Food allergy and eczema often appear together in childhood, but scientists don't fully understand how one condition affects the other," says Nicole Koulov, 2nd year medical student at University of Texas and ACAAI member who has worked with the FORWARD team under supervision of Mahboobeh Mahdavinia, MD, PhD on this project. "We examined surveys from children with a history of IgE-mediated food allergies that they later outgrew. Our findings highlight that eczema may play a role in shaping the development of oral tolerance to food allergens."
The study analyzed survey responses from caregivers of 855 children aged 0 to 12. Parents reported on the presence and timing of eczema, when it resolved, and how severe it had been. Severity was measured using how much skin was affected and the types of treatments needed to control symptoms, scored on a 0–6 scale.
Results showed that children with longer lasting, and more severe eczema were less likely to outgrow food allergies. Specifically:
- Timing of onset: Children whose eczema began between 4 and 6 months of age had significantly lower odds of outgrowing food allergies compared to those whose eczema started earlier (0–3 months).
- Severity: Greater eczema severity was strongly linked to reduced chances of developing tolerance.
- Duration: The relationship between eczema duration and food allergy resolution was non-linear. The likelihood of outgrowing a food allergy dipped with shorter eczema durations, rose modestly at 8–10 years, and then declined again.
"These findings show that eczema is more than just a coexisting condition – it may directly influence whether children overcome food allergies," said allergist Amal Assa'ad, MD, co-author of the study and ACAAI member. "Our data suggest that the timing and management of eczema could be an important factor in helping children develop tolerance."
The researchers emphasized that while eczema itself does not cause food allergies, the interplay between skin barrier health, immune responses, and allergen exposure may be key to understanding why some children outgrow allergies and others do not.
Abstract Title: Association Between Clinical Features Of Eczema And Outgrowing Of Food Allergies In Pediatric Patients (Full abstract below)
Presenter: Nicole Koulov, BS
