Eczema in infancy does increase the probability of developing allergic rhinitis and asthma later in childhood - this is the allergic march. However, the risk is not fixed at 100 percent, and there is growing evidence that how eczema is managed in infancy may influence the trajectory. Children with eczema who are evaluated for food sensitisation early, whose skin barrier is supported with appropriate emollient use from the beginning, and whose allergic sensitisation is identified and addressed have a different subsequent disease course from those whose eczema is left untreated or managed only with topical steroids without allergy evaluation. The practical message for parents is that eczema deserves a comprehensive assessment rather than a simple prescription - because understanding the allergic underpinning of the eczema is what shapes the approach to preventing what comes next.
Written by Dr. Madhusudan B S, MBBS, DCH, AASC (Allergy Asthma Specialist Course), Consultant Pediatrician and Pediatric Allergy Specialist, Tumkur. Phone: +91 9677180651.
