Helping A Child With A Persistent Cough Runny Nose And Wheezing
Gary was four years old when his mother brought him to my Integrative Pediatric Office. Hed had a persistent cough for several months. Throughout the past two years, hed suffered from recurrent bouts of cough, runny nose, and wheezing that required an Albuterol inhaler. For the wheezing, hed taken one course of oral steroids, which he did not tolerate. His behavior became erratic, with irritability, mood swings, and sleep troubles.
At that point, his mother knew she never wanted him to take oral steroids again. She decided to switch to an integrative pediatrician . Her rationale was that the conventional medical approach aimed to control his symptoms, while her intuition was telling her his chronic cough and congestion had some underlying cause that wasnt being addressed.
Garys mother and I combed through his history. Besides the symptoms above, as an infant, he was extremely fussy and colicky. During the office visit, I observed he was a mouth breather, had a runny nose and dark, puffy circles under his eyes, and his breathing was audible . Together, these signs pointed to uncontrolled systemic inflammation.
How Does Diet Effect Eczema
If you’ve ever been recovering from a weekend of alcohol, fast food, and sugary treats, you may know just how important diet is for not just overall health, but your skin as well. “Diet can play a significant role in the overall health of our skin. Identifying any food triggers and minimizing inflammation may help minimize eczema symptoms,” says Melissa Perry, RD, a registered dietitian at Orlando Health. “Eating more whole foods and consuming less processed foods can aid in reducing inflammation in the body and promote a healthy gut. Eating a healthy diet reduces inflammation and promotes a healthy immune system.”
What Should You Do
Your best bet is to choose a well-balanced eating plan. Despite the uncertain links between food and eczema, thereâs no doubt that enjoying plenty of fruits, vegetables, nondairy foods , and whole grains is good for your overall health.
Lawrence Eichenfield, MD, chief of pediatric and adolescent dermatology at Rady Childrenâs Hospital in San Diego professor of pediatrics and medicine at the University of California, San Diego School of Medicine.
Donald V. Belsito, MD, professor of clinical dermatology at Columbia University.
Andrea Cambio, MD, FAAD, medical director of Cambio Dermatology, Cape Coral, Fla.
EczemaNet: “The Truth About âOtherâ Therapies for Atopic Dermatitis.”
Asthma and Allergy Foundation of America: “Atopic Dermatitis.”
USDA: “Dietary Guidelines.”
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What About Babies With Eczema
It is easy for adults to change their diets. But it is a different story for breastfed babies with eczema.
You may be wondering what foods cause eczema in breastfed babies the truth is the mother’s diet could affect the baby.
Therefore, examine your diet if you notice an increase in your baby’s severity of eczema symptoms.
To be specific, tree nuts, cow’s milk, and peanuts are among foods that cause eczema in susceptible babies.
Also, baby formula products might contain eczema triggers. Therefore, you might want to switch from a milk-based formula to a hydrolyzed one. This type is less likely to cause eczema flare-ups.
Try The Soak And Seal Method
On your mark, get set, go! Anytime I read about the soak and seal method I always think of a pit stop during a NASCAR race. Think of yourself as a one-person pit crew: Youve got a set amount of time to hop out of the shower or bathtub, lightly dab yourself dry, and apply moisturizer. Its literally a race against the clock, but this method helps to seal in the moisture, which your skin can never seem to get enough of.
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Eczema And The Leaky Gut Theory Of Autoimmunity
Leaky gut has been linked to the development of eczema . Increased levels of the protein zonulin, often used as an indicator of leaky gut, have also been linked to the presence and severity of eczema .
- Leaky gut, which occurs when the intestinal lining becomes damaged and allows bacteria and food particles to leak into the bloodstream, may also connect to autoimmunity and food intolerances .
- When the immune system encounters misplaced food particles, it may respond to them as though they are threats.
- This hyperactivity can then contribute to the immune system attacking your own cells.
Studies have shown that healing the gut can help treat some autoimmune conditions, including Hashimotos thyroiditis and inflammatory bowel disease . This may be relevant for eczema treatment, given that some research now suggests that it is an autoimmune condition as well .
Foods Rich In Vitamin C
Foods containing vitamin C are notoriously good for your skin. Why?
First, vitamin C is a powerful antioxidant, which means it falls into the above category of anti-inflammatory foods.
Second, vitamin C is needed to form a healthy skin barrier, which helps lock in moisture and prevent dryness and irritation, according to August 2016 research in âNutrition Research and Practiceâ. This study also indicates that people with eczema have lower levels of vitamin C, which implies an association between these elements.
Does Drinking Water Help Eczema?
People with eczema have drier skin, but drinking enough water can help keep the skin hydrated, per the National Eczema Association. According to the University of Missouri System, adults should aim to drink half their body weight in ounces each day to stay hydrated.
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Can Food Actually Cause Eczema
In a small minority of children with egg allergy, regularly eating baked goods containing small amounts of egg may drive low-grade, constant reactions leading to chronic eczema.
For instance, a primary-school child with egg allergy would usually refuse all whole eggs, such as scrambled, boiled, fried or poached eggs, but they might tolerate the small quantities of egg baked into cake and other sweet goods without showing obvious immediate symptoms this pattern might lead to an ongoing eczema flare. This usually seems to happen with egg, rather than other foods.
A far wider range of foods can exacerbate eczema without an actual allergy. For instance, some foods such as fresh tomato, pineapple, citrus and other fruits are acidic on sore or dry, sensitive skin. Some foods, such as chilli spices, have a vasogenic amine response, which causes a nerve-tingly effect or flush the skin.
Finally, some foods, such as tomato sauce, commercial baby foods, spices and food preservatives, can irritate dermatitis, causing non-specific skin inflammation and exacerbating eczema. It is fairly easy to avoid these foods without negatively affecting the diet.
Recommendations For Food Allergy Testing In Patients With Atopic Dermatitis
While testing for food allergies is not warranted in all children with a new diagnosis of AD, it may be helpful in a specific subset of patients. The NIAID expert panel suggests that children less than five years of age with moderate-to-severe AD should be evaluated for a food allergy if they have intractable AD despite optimal management and topical treatment. Children should also be tested if they have experienced an immediate reaction following ingestion of a specific food.13,23
If suspecting an immediate reaction, testing may include SPT and allergen-specific serum IgE tests. However, as stated earlier, these test for sensitization only. Therefore, neither test alone is diagnostic of food allergy, and positive test results must typically be confirmed via food challenge test.
In cases of suspected late eczematous reactions, no accurate laboratory testing is available at this time, as the pathophysiology is unclear. Therefore, DBPCFCs remain the gold standard in diagnosis, with an observation period that extends to two full days. Some researchers have also recommended a diagnostic elimination diet, in which a suspected food is excluded for a period of 4 to 6 weeks. Since improvement in symptoms may be coincidental or due to placebo effect, confirmation by food challenge may still be required.
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Foods That May Cause Allergic Reactions
When it comes to food allergies, peanuts, wheat, eggs, cows milk, soy and shellfish are among the most common culprits. The itchiness caused by these foods and subsequent scratching can then lead to flare-ups or worsening of dermatitis symptoms.
Here are four examples of foods that you may not have realised can cause skin problems:
How Is Allergic Eczema Diagnosed
Your doctor will first examine your skin to determine whether you have allergic eczema. If they suspect you have the condition, theyll need to do further testing to find out exactly what youre allergic to. In most cases, a patch test will be used.
If you need help finding a primary care doctor or allergist, you can browse doctors in your area through the Healthline FindCare tool.
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Moisturize Your Skin Regularly
Because constant scratching tends to break down and damage the protective layer of your skin, its important to moisturize twice daily even when youre not having a flare-up.
Talk to your dermatologist about the best type of over-the-counter emollient for your skin. Be sure to select unscented options.
Other skin care tips:
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Foods That Help Eczema Go Away
Its one thing to know which food may lead to eczema outbreaks. Its another matter to know what foods that help eczema go away. Avoiding inflammation is crucial.Research from professionals studying nutrition and eczema helps steer us toward foods that decrease inflammation.One food source thats high in omega-3 fatty acids is fatty fish. Popular fish in this category are herring, mackerel, salmon and trout. If youre not fond of eating fish, you can instead take supplements, with Healthline recommending patients take at least 250 mg of omega-3.
Another good category is foods that contain high levels of quercetin, which is a flavonoid providing antioxidants and antihistamine, which patients with eczema benefit from because of the strong anti-inflammatory effects. Youll find high amounts of quercetin in fruits and vegetables such as:
- Sourdough bread
As you can see, there are many savory foods in this category, giving you a variety of tasty options to help eczema flare-ups from occurring.
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The Causes Of Garys Inflammation
After a thorough discussion of Garys medical history, I examined the inside of his nose. His nasal mucosa was pale, almost bluish, and swollen shut, so he had to breathe through his mouth.
Environmental allergies often cause the nasal mucosa to be pale and swollen. When I was first out of residency, I used medications to treat the symptoms of patients like Gary. I would have prescribed an inhaled steroid for him, along with an antihistamine for allergies, a topical steroid for the eczema, and a nasal steroid spray for the nasal congestion. This would have addressed most of his inflammatory symptoms during the time of year when his allergies and asthma flared. On top of that, if he had constipation, I would have also given him a laxative.
When I know a child has an increased risk of asthma or any other type of inflammatory issue like allergies, constipation, or reflux, I now look at the bigger picture and ask, How can I reduce this childs overall systemic inflammation and improve all of his symptoms, not just one of them?
As luck would have it, Garys previous pediatrician had done allergy testing through blood work and discovered a severe dust mite allergy. My first question when a child has a dust mite allergy is: How old are his mattress and pillows?
Mattresses and pillows are dust mite havens. One study, conducted at a London hospital, found that up to a third of a pillows weight could comprise bugs, dead skin, and dust mites.
Stay Away From These Foods
Food-sensitive skin reactions usually occur around six to 24 hours after you eat a certain type of food that doesnt agree with your system. To figure out what foods are causing your flare-ups, we often recommend paying attention to the common foods known to aggravate eczema.
Foods that commonly trigger an eczema reaction include:
- Wheat and gluten
- Spices, such as cinnamon and vanilla
- Certain kinds of nuts
Before you ditch anything from your current diet, focus on each food type listed, one at a time, and keep an eye on your skin condition for about four to six weeks to determine if you are sensitive to that type of food. Keeping a food journal helps. If your symptoms seem to worsen after you add a food to your diet, avoid it in the future.
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Similarities And Differences Between The Two Age Groups
In adolescents, butter, margarine and pasta consumption were also positively associated with asthma prevalence. These results are consistent with the ecological study in ISAAC Phase One. Age-specific differences in the relationship between diet and disease could be related to different disease phenotypes., Further investigations are necessary to clarify age-specific patterns for these additional food types.
Regular fruit consumption was consistently significantly protective in most regions in the adolescent group for current and severe wheeze, VQ and current rhinitis, and in children consistently across all centres and for non-affluent countries and all three conditions . This finding is consistent with the previous ISAAC ecological findings and other cross-sectional and cohort studies from mainly affluent countries. Among the biological mechanisms contributing to the favourable effect of fruit consumption on allergic diseases are antioxidants and other biologically active factors.
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Staying away from chemicals and limiting to soak in water for too long will prevent the skin from further irritation. Also, avoid scratching the itchy area well and limit the use of cosmetics.
Besides, you need to avoid certain foods that cause eczema. Letâs us find out about the top foods that can make the disease worse.
IV. Foods That Cause Eczema
Before taking a deep look at foods that may trigger an inflammatory response for those with eczema there are two things you should keep in mind. First of all, an elimination diet should only be carried out under the supervision of a health practitioner, especially when it is applied to small children. The latter note, and also the more important one, is just about the possible eczema triggers. It means that they may not be the actual allergies for your case, so donât be confused with two concepts or it may be life-threatening. These foods below are applied to everyone yet for some, the actual causes may beyond this list. So, if you experience any instant reactions after consuming some typical types of food, even though they do not appear in this list, let ask for help from the doctor for timely actions.
6. Tree Nuts
7. Nightshade Vegetables
8. Acidic Foods
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Is It An Allergy Or Intolerance
If within 10 minutes of eating a meal, your skin reacts, , you are very likely to have an allergy to a food. This immediate immune reaction is called an IgE reaction, a true allergy. If your skin flares up randomly and you cant pinpoint a specific meal or food eaten, but you experience digestive discomfort such as bloating, you may have a food intolerance, an IgG reaction.
Allergies are usually constant throughout your life, or can be grown out of in adulthood. Intolerances on the other hand come and go and are very closely linked to the health of your gut lining. If you have a damaged and inflamed gut lining, you will most likely develop intolerances. If you avoid the foods you are intolerant to, you will then simply develop an intolerance to another food you are eating regularly.
Both IgE and IgG blood tests exist, however only IgE test will be carried out by a Doctor, and can also be carried out as a skin prick testing. Tests are not 100% accurate though, and allergies / intolerances on test results do not always correlate with skin inflammation intensity.
How does an elimination diet work?
If you believe that certain foods are aggravating your skin, the gold standard to identify this, is by following an elimination diet. While this can be very strict for a month or two, it usually identifies problem foods.
Q : How Can Skin Be Maintained And Protected Every Day
It is important to keep skin that is prone to eczema well moisturised every day:
- Moisturisers add moisture and form a barrier that protects the skin, so that it retains moisture. If the protective barrier of skin is damaged eczema frequently develops.
- Apply non-perfumed moisturiser to the face and body twice every day.
- Avoid moisturisers containing food proteins such as goat milk, wheatgerm and nut oils.
- After a bath or shower in lukewarm water, pat the skin dry and apply moisturiser.
- Use non-soap based wash or oil and avoid soap and bubbly products which dry out the skin.
- After swimming , rinse and apply moisturiser.
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Special Diets For Contact Eczema
Contact eczema is a specific type of eczema in which localized skin reactions arise from direct contact with something in the environment, including allergens such as pollen, nickel, and latex.
Some allergens may also be present in food in particular balsam of Peru and nickel and research suggests that avoiding foods that contain these allergens can relieve contact eczema symptoms, according to an article published in March 2014 in the Journal of Clinical and Aesthetic Dermatology.
Balsam of Peru comes from the tree Myroxylon balsamum pereirae and contains a mixture of potential allergens, such as cinnamates and vanillin, chemicals commonly found in flavorings, spices, and certain foods.
If you have a contact eczema related to balsam of Peru, you may find some eczema relief by avoiding:
Nickel is the most common cause of metal allergies and causes more cases of contact eczema than all other metals. Scientists dont fully understand why, but it could be due to sweat leaching nickel from earrings and other jewelry. The nickel then absorbs into skin, causing a rash.
Its also found in a wide range of foods, including grains, shellfish, processed meats, canned food, black tea, nuts, and seeds. Vegetables with especially high nickel content include beans, lentils, peas, and soybeans.
Research suggests that a low-nickel diet may improve dermatological symptoms in people with nickel-related contact eczema.