When your child has eczema, your primary focus is usually on their itchy, irritated skin. You try new lotions, switch laundry detergents and do your best to avoid triggers that worsen it.
Eczema is common in babies and young children. But what some parents might not know is that it may be linked to other health issues down the road, like food allergies, asthma and seasonal allergies. Health care experts call it the “atopic march.”
Not every child will follow this pattern but many do. We spoke with Michael O. Daines, MD, a pediatric allergist and immunologist with Banner Health, to learn more about the atopic march, why it happens and how to lower your child’s risk.
What is eczema, and why does it happen?
Eczema, or atopic dermatitis, is a chronic (long-lasting) skin condition. It usually begins in early childhood.
Eczema is not contagious. Your child doesn’t get it from others. It’s caused by problems inside the body, mostly within the immune system and skin.
“Your skin is the first line of defense your body has against the outside world. A healthy skin barrier can keep moisture in and harmful substances out,” Dr. Daines said. “With eczema, this skin barrier is weak, often due to genetics and environmental factors.”
For many children, this weakness comes from not having enough of a protein called filaggrin, which helps the skin hold moisture and block out bacteria.
When the skin barrier is damaged, moisture escapes and germs can get in. That’s why kids with eczema often have dry, itchy and irritated skin. “Everyday things like sweat, heat or even clothes can make it worse,” Dr. Daines said.
What is the atopic march?
“The atopic march is a term used to describe how allergic conditions appear in a certain order,” Dr. Daines said. “It usually starts with eczema in babies, then leads to food allergies, asthma and hay fever (allergic rhinitis) as the child gets older.”
It shapes how your immune system sees the world, so you tend to have more and more allergies. This means eczema doesn’t just affect the skin. It can also influence how your child’s immune system reacts to things like food, pollen or dust.
When the skin barrier is broken, allergens can sneak in. This exposure may train the immune system to overreact.
How common is the atopic march?
A lot of children with eczema go on to develop other allergic problems. The numbers may surprise you.
“Children with eczema are significantly more likely to develop other allergic conditions,” Dr. Daines said. “About one-third of kids with moderate to severe eczema have food allergies.”
Infants with eczema are over 10 times more likely to have peanut allergy and six times more likely to have egg allergy by age one compared to those without eczema.
“Early eczema also increases the risk of developing asthma and hay fever later in childhood,” Dr. Daines said.
What signs should I watch for?
If your child has eczema, watch for signs of other allergic conditions. Here’s what to look for:
- Hives
- Swelling of the face, lips or tongue
- Vomiting, diarrhea or belly pain
- Coughing or wheezing after eating
- Trouble breathing (always call 911 if this happens)
- Coughing, especially at night or after running
- Wheezing (a whistling sound when breathing)
- Shortness of breath
- Tight feeling in the chest
Hay fever (seasonal allergies)
- Sneezing
- Runny or stuffy nose
- Itchy, watery eyes
- Scratchy throat
Talk to your child’s health care provider if you notice these signs. Early care can help your child feel better and may prevent bigger problems later.
What can I do to lower the risk of allergies and asthma?
“Unfortunately, we can’t pick our genetics, but we do have some control over our environment,” Dr. Daines said.
He shared some changes you can make to help protect your child’s skin and reduce allergy risks.
1. Build a strong skin barrier
“The first step is to keep bacteria levels in the skin low with regular bathing using a mild cleanser,” Dr. Daines said. “Follow this up with a hypoallergenic lotion, cream or oil to help keep the skin hydrated.”
Choose gentle, unscented products designed for sensitive skin. Avoid irritating fabrics like wool or stiff synthetics.
2. Avoid triggers
Keep a journal to track what might be making your child’s skin worse. Common triggers include:
- Sweat and heat
- Dust or pet dander
- Harsh soaps or detergents
- Certain foods
Avoid these when possible. Share your notes with your child’s health care provider to help them find patterns.
3. Introduce allergenic foods with care
New research shows that introducing common allergy foods (like peanuts and eggs) early – between 4 and 6 months of age – can actually lower the risk of developing a food allergy. Talk to your health care provider before starting new foods.
4. Treat the itch
Itching can lead to scratching and scratching breaks the skin. This can cause infections.
“Keep nails short to prevent skin damage when scratching, or treat the drive to scratch with medications,” Dr. Daines said.
5. Keep up with check-ups
Regular visits to your child’s provider can help monitor for signs of other allergic conditions.
When should you see a provider?
If your child’s eczema doesn’t improve with basic care or symptoms interfere with sleep, school or daily life, your child’s provider is a great place to start.
“Your child’s pediatrician or health care provider is always the first line of medical advice,” Dr. Daines said.
You should also seek help if:
- Your child has frequent flare-ups
- You notice signs of asthma (like wheezing or coughing at night)
- Your child’s skin gets infected often
- They show allergic reactions after eating (like hives, swelling or vomiting)
- There’s a family history of allergies or asthma
- You want to understand triggers or get allergy testing
Will my child outgrow eczema?
Many children outgrow eczema or see it get better over time. Some food allergies, like milk or eggs, may also go away. But asthma and hay fever often last into adulthood.
Every child is different. There is no way to predict the future. But you can take steps now to improve your child’s health today — and help protect them from more serious problems later.
Takeaway
Eczema is a skin condition and often the first sign of the atopic march. Children with eczema are more likely to develop food allergies, asthma and hay fever. However, regular skin care, trigger tracking and early treatment can help.
Always bring concerns to your child’s health care provider or a Banner Health specialist.
