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Online clinic on allergies - Feb 2018

Action Against Allergy (AAA) provides information, advice and support to those made chronically ill through the many different forms of allergy and those who care for them.

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food allergy

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How long to recover

Postby Lara J C on Tue Feb 06, 2018 3:27 pm

I've been advised to cut out certain foods that make me itchy. How long might it take for my body to overcome the allergies? I've been advised to test after 3 months plus, but I think it may take much longer than that? Does everyone overcome food allergies? Its such hard work!
Lara J C
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Re: How long to recover

Postby Dr Anton Alexandroff on Fri Feb 09, 2018 6:47 pm

Dear Lara,

3 months sound very reasonable. I would even say that even 1 month break should be sufficient although in the case of a medication we advise 3 months break, so perhaps go with 3 months.

I hope this is helpful.
With best wishes,

Dr Anton Alexandroff FRCP(UK) PhD CCT(Derm) FRSM FAAD
Consultant Dermatologist and Honorary Senior Lecturer
British Skin Foundation Spokesperson
Harley Street Dermatology Offices, Nuffield Health, Spire and BMI Hospitals, London, Cambridge, Bedford and Leicester

Dr Anton Alexandroff
Consultant Dermatologist, Honorary Senior Lecturer & BSF spokesperson - FRCP, CCT (Derm), PhD, FRSM, FAAD

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Dr Anton Alexandroff
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Re: How long to recover

Postby Dr Tom Marrs on Fri Feb 16, 2018 6:02 pm

This is a great question Lara.

The answer of 'how long to avoid' depends upon whether the adverse effects are caused by an irritant response, an immediate (IgE-mediated) food allergy or a 'delayed' (non-IgE) food allergy.

If someone has had an immediate food allergic reaction (nettle rash urticaria, lip / eyelid swelling, hoarse voice, breathing difficulty or drowsiness) or a clearly positive skin or blood test, this suggests an immediate (and unsafe) (IgE-mediated) food allergy. Symptoms usually resolve on absolute avoidance after a few days, although eczema may take 3-4 weeks to get better in the case of needing to avoid foods with minor amounts of egg. However, non-IgE 'delayed' food allergies only usually get better after complete avoidance for 6 weeks.

Unfortunately, non-IgE 'delayed' milk allergy is common (around 2%) amongst newborn infants, although they often grow out of this in a few years. The incidence in older children is very low, and amongst adolescents it is pretty rare. However, there are no diagnostic tests for this, other than avoidance. The trouble is that sometimes, soya and milk non-IgE allergies can co-exist and where this may be the case, consulting a qualified dietitian or doctor is important.

Some foods, such as spices, can irritate eczema, without involving the IgE immune system. Avoiding these foods may improve symptoms over a few weeks, although it is difficult to determine and measure how this progresses.

I hope this helps. Where allergen avoidance is not working within 6 weeks of absolute avoidance, either the diagnosis is not correct, or the (often challenging) management can be improved, and either way it is important to get more support.

I hope this helps.
Dr Tom Marrs
Consultant in Paediatric Allergy, Director of the Allergy Academy, King's College London, Honorary Senior Lecturer in Paediatric Allergy, King's College London

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