Dr Phil: Will eliminating dairy help to improve eczema symptoms?

Eczema is a common condition, affecting approximately 20% of children in Ireland. Many children will grow out of the skin condition before puberty, but up to 3% of adults continue to suffer from it.

Eczema is inflammation affecting the skin and results in dry, red, hot, and itchy patches and, in more severe cases, can crack and bleed. In infants, it is common on the face, outside of the elbows, and front of the legs, and after a year it is more common in the flexures (front of elbows and behind the knees).

Eczema is usually the result of genetic predisposition or other atopic conditions, such as asthma and allergies. Environmental triggers can also play a role, and this is where dust allergy and food intolerance can come into play. Actual dairy allergy is relatively uncommon, affecting 2% to 8% of the population. A dairy allergy can be severe, causing swelling, hives and dramatic illness immediately after exposure or a delayed response causing skin issues or bowel upset. Excluding dairy is unlikely to improve symptoms among those who do not have an allergy to cow’s milk. For infants or young children, I would strongly recommend talking to your doctor or a registered dietitian before you remove a food group, as a nutritional equivalent will need to be introduced into their diet.

An elimination-and-reintroduction method is helpful for most suspected food sensitivities, excluding coeliac disease, usually diagnosed from a blood test. The technique follows a two-week rotation.

Stop all dairy for two weeks and keep a daily diary of the symptoms. If the symptoms don’t improve, then dairy has nothing to do with the issue. If they improve, this isn’t conclusive, as eczematous symptoms come and go by themselves. After two weeks, reintroduce dairy for two weeks and continue to note the symptoms. If dairy is causing the issue, the symptoms will likely deteriorate within two days of reintroduction.

I would caution against restricting a child’s diet in any particular way without a good reason, as the narrower the food range becomes, the more likely they are to have vitamin deficiencies or for you to have difficulty feeding them in the longer term.

Treating eczema is usually done by replacing soaps and using moisturiser. Your doctor will prescribe steroid ointment and/or antihistamines to reduce itch, if needed. 

It is essential to follow the directions carefully for these treatments. I would recommend anyone with eczema to check irishskin.ie or allergy-ireland.ie for more information.

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