Eczema, allergies and asthma can often be related. Children can certainly develop only one of these but often will have overlap with another. They are known as atopic diseases.
Environmental allergies can be rather common. This includes seasonal allergies such as during the spring and fall to pollen or ragweed. This can also include other environmental allergies such as to pet hair/dander or dust. Common symptoms of environmental allergies include chronic nasal congestion, itchy or watery eyes, sneezy, clear runny nose, scratchy throat, throat clearing or cough from post nasal drip. Simple home remedies that can help improve symptoms include use of an air filter, closing windows, putting allergen-proof covers on your mattress or pillow, keeping pets out of bedrooms, limiting wall-to-wall carpets, and showering at night to rid allergens from the skin and hair. There are over-the-counter medications that can be very helpful for allergies such as antihistamines. If symptoms include fever, colored nasal discharge or any respiratory difficulty it may be more serious and your child should be assessed.
Food allergies can also occur in up to 4-6% of children. They are most likely to occur in babies and toddlers but can develop at any time. Symptoms of food allergy can range from mild to severe. Sometimes mild perioral allergy syndrome can occur with symptoms just around the mouth. The most severe reaction is called anaphylaxis and that can be life-threatening as it is a whole body reaction that can impair breathing and affect heart rate. It needs to be treated promptly with epinephrine (an epi-pen). While any food can cause an allergy, eight food types cause 90% of all reactions: eggs, milk peanuts, tree nuts, fish, shellfish, wheat, soy. Symptoms of an allergic reaction can include vomiting, hives, shortness of breath, wheezing, tight throat/trouble swallowing, swelling of the tongue, weak pulse, pale or blue skin or dizziness/feeling faint. Most food related symptoms occur within 2 hours of ingestion, often they start within minutes. Very rarely the reaction can be delayed longer. If there is concern for food allergy speak with your provider. Testing may include a blood test or skin prick tests. Many children outgrow their allergies, particularly to milk and eggs.
Asthma is a condition where the airways in the lungs narrow and swell and produce extra mucus. This can cause coughing, wheezing or difficulty breathing. Asthma can range from very mild to severe, limiting daily activities. It cannot be cured but symptoms usually can be well managed. Children with mild to moderate asthma often only have symptoms when they are ill with a cold or virus. Others have symptoms with exercise. For those with a history of symptoms or if there is a concern for asthma, North Shore Pediatrics has an asthma clinic to help assess, manage, and educate about asthma. We perform pulmonary function testing (ages 5-6+) and peak flow testing to assess baseline lung function and control of symptoms. We spend additional time reviewing medication use and possible symptom triggers and/or allergies. At the end of the evaluation, if needed we will provide you with a printed asthma action plan to help manage any symptoms which may occur at home, school or elsewhere.
Eczema is also known as atopic dermatitis and is a skin condition that can cause chronic red, dry and itchy skin. It is common in children but can occur at any age. It tends to be long-lasting and can flare periodically although often improves as children get older. There is no cure but many treatment options to help manage the condition including topical creams/ointments, antihistamines and at times oral medications. It helps to use products that are for sensitive skin without any fragrance or smell, often labeled “hypoallergenic.” (This includes for soap, shampoo, lotion, detergent). Using moisturizers and emollients to the skin is helpful. Itching can make the symptoms worse so use of an over-the-counter antihistamine is useful such as diphenhydramine (Benadryl), loratadine (Claritin), cetirizine (Zyrtec) or fexofenadine (Allegra) when age appropriate and if dosed carefully. There are prescription creams to speak to your provider about to lessen flares.