eczema and dairy products

[tallulah1]

My daughter aged 23 months has been suffering from really bad eczema on her face and is currently waiting to see a consultant. She has been prescribed all sorts of emollients, oral antibiotics because it keeps getting infected, topical steroids and is now using Elidel an immunosuppresent. The Elidel and the emollients are keeping it at bay but as soon as she stops the Elidel it immediately flares up again. She eats a lot of yoghurt and when I cut it out of her diet her skin doesn't flare up as much. She doesn't drink milk or have it in anything else because she refuses and rarely eats any other dairy products. I was wondering whether she could have an intolerance to dairy products and is there anyway of finding this out conclusively?

[Dr Helen Brough]

Dear Tallulah1,

Eczema is more likely to be related to food allergy is if started early and has been severe. If the eczema is related to food allergy it is usually related to cow's milk and egg. Other clues in the history are family history of allergies and any gastrointestinal features (severe colic, reflux, loose stools or constipation). There are excellent NICE guidelines on the Management of Atopic Eczema that you can look up online.

It would be worthwhile asking your GP to refer to an allergist to have this assessed properly. This would be based mainly on the history as skin prick testing is not good at determining delayed allergies. If the history has the features described above then usually they would recommend a trial of cow's milk exclusion for 4-6 weeks (under dietetic supervision with an appropriate alternative milk) followed by reintroduction. However eczema is not always related to allergy (food or otherwise). In eczema the skin barrier is impaired and so infections and irritants can cause flares and eczema often waxes and wanes without clear triggers.

Kind regards,