When I first received the diagnosis of eczema (AKA atopic dermatitis), I recall learning about it in Physician Assistant (PA) school, the hospital and clinic. I remember it was a skin problem that becomes dry and itchy. Treatment options include anti-histamine, steroids, emollients, etc. It was just a condition that I learned about, nothing more until I experienced it myself. As a health care worker, the conditions we learn become real when it hits close to home. Whether it is something we experience ourselves or in loved ones. The frustrations that I felt with my children having eczema was surreal to say the least. We tried all the standard treatments prescribed by our pediatrician, which helped but not completely. One of the things I kept hearing was, “most children grow out of eczema”. These words meant the world to me because it gave me hope that maybe one day, things could be better… would be better. Are you asking the same question, “did your baby outgrow eczema”? Read on to find out why you should have hope!
Does eczema really go away? Did your baby outgrow eczema?
If you Google about children outgrowing eczema, many authority websites will indeed state that children outgrow atopic dermatitis (AD). Some say that by age of 4-5 years old children outgrow eczema. Others say by the age of 3. There may be occasional flareups and then it may resume again during puberty due to hormones and stress.
About half of those with eczema develop symptoms before they are 1 year old. Almost all children develop symptoms by age of 5 years old. About ¾ of children with eczema will have symptoms resolve before puberty. The rest (a quarter of children) will go on to have eczema as adults or eczema may come back suddenly. (1)
Another paper states that atopic dermatitis persists in children who develop it during ages 2 to 5 years old. It can resolve by age 10 in 80% of children with eczema and by age 20 in up to 95% of afflicted people. (2)
In other words, there is a very good chance your child will outgrow their eczema or eczema will go away with time.
What is the concept of “Atopic March”
Another thing to be aware of is the concept of “atopic march”. This is the idea that children with eczema and food allergies develop allergic rhinitis (AR) and then asthma later in childhood. A prospective study by Ekback in 2014 followed children from infants to age 10 years. It showed that the greater the severity of eczema, the greater the chance of developing allergic rhinoconjunctivitis (AKA itchy nose and eyes) and asthma later in life by age 10 years. They also found that children who had an episode of wheezing during infant years (age 1-year-old) also was more likely to have asthma in the future. (3)
Is family history a risk factor for eczema?
If a family member (ie parents, siblings) has eczema, there is a greater chance for a child to have eczema.
What is the hygiene theory?
The hygiene theory is that children who live in a “sterilized” world are more likely to develop eczema. What I mean by a sterilized world means children who are not exposed to germs from daycare or other allergens (such as no dogs in the home to expose children to various allergens). Children’s immune systems are trainable and adaptable at an early age. So if they are NOT exposed at an early age where the immune system can adapt, they can have bigger reactions later when the immune system is set in its ways (so to speak). (4)
So why do I even bring this up? Well, the idea of treating eczema by avoiding and eliminating foods may not be the best approach in the long run. Yes, it is definitely helpful when they are young and the immune system is immature and the body reacts poorly. As our babies/children grow, we should not avoid these triggers. Rather, they should be slowly introduced (with the supervision of your doctor) in a controlled manner so they build tolerance. There is a growing awareness of this idea and many medical doctors are starting to adopt this practice.
For me, the way I apply this in my life is that I let my children play and touch things and if they get sick, they get sick. I am not throwing caution to the wind, but sometimes when we try to protect our children from “germs”, we inadvertently end up doing more harm than good.
Conclusion
Most children will outgrow eczema, but until that happens we should do our best to keep them healthy and well. Personally, my goals are to maintain their eczema from the inside and out. I continue to moisturize frequently throughout the day. I feed them food that will not trigger their eczema and try to build their tolerance to foods that once bothered them as they get older. I try not to shield them or have them live in a “sterile” world. Yes, it does suck when they get sick, but I tell myself they are building their immunity. I would rather have them sick now than later when their immune system has not been exposed to bacteria and viruses at a later age and has difficulty defending itself. I hope this article answers the question: Did your baby outgrow eczema?