Eczema and respiratory allergies: two “cousins”

Atopic eczema occurs when the skin over-reacts to certain environmental factors such as pollen, heat, animal hair, and more. Atopic skin is more fragile to begin with, and when these elements penetrate its surface, they trigger those infamous itchy red patches.

Not everyone is affected by pollen. For example, it may be a factor in your child’s eczema, but not that of their friend. As is often the case with triggering factors, pollen is just one piece in a larger puzzle, with a unique combination for each individual. This is why it is so difficult to successfully reduce flare-ups by controlling one’s environment, and those who try often become frustrated when they fail to find “the cause”.

Children with atopic eczema are at higher risk of developing an allergy to pollen, but it does not always get to that point. When an allergy does develop, however, it manifests in the nose, eyes or respiratory system, with the appearance of:

• allergic asthma
• allergic rhinoconjunctivitis (“hay fever”)

Asthma, atopic eczema and hay fever are all different manifestations of the same condition: atopy. Some people with atopy experience all three, either alternately or simultaneously. Others will have just one or two over the course of their life. When eczema appears first, it is often followed by asthma and then rhinitis. This phenomenon is known as the Atopic March.

The term Atopic March refers to the fact that, in the majority of cases, atopy starts off a rather predictable progression: the first manifestation is eczema beginning in the first 6 months of life, followed by asthma by the age of 2 to 4 years, and finally rhinoconjunctivitis.

20% of French people have a respiratory allergy

A child who has one parent with an allergy has a 30% chance of developing an allergy as well

Avoiding pollen may help provide relief from eczema when combined with an adapted cleansing and skin care routine. Avoidance becomes especially crucial, however, in the case of atopic asthma and rhinitis.

Complete avoidance is of course impossible, but you can limit its presence in your immediate proximity:

• maintain your lawn to prevent grasses from flowering
• avoid planting trees that are known potential allergens (e.g.: birch trees)

The following are recommendations from the French association for the prevention of allergies on how to manage allergies during periods of high airborne pollen concentration:

• Air out rooms early in the morning, when there is less pollen in the air
• Wear glasses and a mask that covers the nose and mouth to reduce the amount of pollen you breathe in during peak season
• Avoid going outside in mid-morning and late afternoon, especially for physical activity
• Avoid walking about when the weather is dry, sunny and windy in areas likely to have high amounts of pollen
• Avoid driving with the windows down
• Service the pollen filters in your vehicle regularly
• Change your clothing and wash your hair when you get home
• Do not go outside with wet hair, and avoid hanging clothes to dry outside.

There is some debate around this question. For the sake of simplicity, you could say that tests do nothing to help treat eczema, for all the reasons mentioned above. In some cases, however, they can help confirm the diagnosis of atopy. In the case of asthma or allergic rhinitis, they provide information on the types of airborne allergens you should avoid (various types of pollen, dust mites, etc.).

Research has yet to find any concrete proof that antihistamines provide any relief from eczema. Indeed, the itching (pruritus) associated with eczema has no link to the release of histamine.

Antihistamines are typically used to treat asthma or rhinitis associated with eczema. Antihistamines may be used as a complementary treatment; in particular, those with a sedative effect can help improve sleep, among other things.