Treating Eczema in Infancy May Prevent a Lifetime of Allergic Diseases

Researchers say ‘atopic march’ starts with skin cracks, leads to allergies and asthma

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(DENVER, Colorado) – Many babies with eczema go on to develop food allergies, asthma and hay fever, and researchers at National Jewish Health say it’s not a coincidence. The cracks caused by eczema weaken the skin barrier, allowing allergens to penetrate the skin and cause a sequence of allergic diseases, what experts call the “atopic march.” 

     “About a third of patients with eczema will develop food allergies,” said Donald Leung, MD, division head of pediatric allergy and clinical immunology at National Jewish Health. “When common allergic foods are introduced through cracks in the skin rather than through the digestive system, the body recognizes them as invaders and develops an allergy.”

      The atopic march begins in infancy with eczema, progresses with food allergies in the next year or so and often continues with asthma or hay fever a few years later. However, Dr. Leung says there are ways to help stop it in its tracks. “The key to preventing the atopic march is early intervention,” said Leung. “Restoring that skin barrier as soon as eczema develops will keep allergens, food particles and irritants out.”

     To do that, experts recommend what they call “soak and seal,” which involves thoroughly wetting the skin and applying lotion to seal in moisture. Knowing what causes the atopic march is also opening the door to research that will find solutions. Dr. Leung says he hopes new technology will soon allow doctors to easily sequence children’s skin, predict who is at risk for allergies and repair the skin before these conditions develop.

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Ava Segur, 17, applies moisturizing ointment to her skin several times per day. She developed eczema as an infant and later developed several allergies and asthma, a sequence of conditions researchers say are all linked by what they call the “atopic march.”

19-month-old Landon McDonnell undergoes a “soak and seal” at National Jewish Health, a process to seal moisture into the skin of babies with eczema and heal cracks that may lead to the development of allergic diseases.

17-year-old Ava Segur has participated in seven clinical trials at National Jewish Health to help develop treatments for eczema and explore the link between the skin condition and the subsequent development of allergic diseases.

Kriston Kline (right) helps perform a “soak and seal” on her 19-month-old son, Landon, who has eczema. Letting water soak into the skin in a warm bath, then sealing in the moisture with ointment can help heal cracks in the skin and prevent future allergic diseases.

The Segur family frequently cooks at home together to control the ingredients in their food. 17-year-old Ava Segur (left) has several food allergies, part of a sequence of conditions called the “atopic march” that starts with eczema in infancy.