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Ask Dr. Sears: Dealing With Eczema

Q. My son has had severe eczema since he was 3 months old, due to an allergic reaction to my breastmilk. His pediatrician has now prescribed a topical steroid medication (Ellicon) to treat it. However, my husband recently heard that eczema may be caused by a food allergy and preventable. Could this be true?

Eczema -- dry, scaly, itchy skin -- is usually due to one of three causes:
? A hereditary quirk in the skin which makes it prone to becoming scaly;
? An allergic reaction to something in the child's diet;
? A reaction to something he touches.

Eczema responds well to topical steroid creams, such as the one you are using, yet it's best to use this cream only when the eczema is severe and doesn't respond to more simple measures. Strong steroid creams should not be used on the face. And they should not be used for too long, since they can cause thinning and discoloration of the skin.

In addition to what you are already doing, here are some effective home remedies:

Go fishing. The newest insight into the prevention and treatment of eczema is eating more omega 3's. These healthy fats (found in coldwater fish such as salmon) are particularly valuable for skin health. Serve your child at least four ounces of wild salmon three times a week. If possible, get wild Alaskan salmon. Wild salmon is more likely to be free of mercury and pesticides than farmed salmon. If your child doesn't eat fish, give him a one-gram fish oil capsule daily. Besides being good for the skin, omega 3's improve the health of every organ of the body.

Water your growing child. Hydrate your child well, as dry skin needs extra water. As a general guide, give your child at least an ounce of fluid per pound of body weight per day. Here's another trick to keep your child's skin well-hydrated: After a bath or shower, pat dry with a soft towel rather than rubbing vigorously. Let a slight layer of water remain on the skin, especially over the eczema-prone areas. Then apply a moisturizing lotion over the slightly wet areas. This helps the skin retain some water.

Avoid allergens in your child. The most suspect foods for contributing to eczema are dairy products, wheat, nuts, tomatoes, citrus fruits, egg whites, shellfish, and soy. Eliminate these foods from your child's diet one at a time to see if your child's eczema gets better. Or, eliminate all of these foods for a few weeks, and then reintroduce them into your child's diet one at a time to try to pin down the most likely suspect. Also, certain clothing, especially wool, may irritate allergy-prone skin.

Avoid allergens from you. Regarding your reference to allergies of breastmilk, infants are really not "allergic" to their mother's milk, but they can be allergic to a food in a breastfeeding mother's diet. The only food allergen that has scientifically been proven to cause allergies in a breastfeeding baby is dairy products in a breastfeeding mother's diet. Wheat is another suspect.

Trim little fingernails. Excessive scratching, especially with dirty nails, can make the eczema worse and cause the itchy areas to become infected. Keep your child's fingernails cut short.

With the above measures, your child's eczema should be easily controlled and with time and attention, he should grow out of it.