Eczema and Food Allergies – What You Need to Know.

One of the biggest risk factors for infants developing food allergy is eczema

16th December 2025

5 minutes read time

by Lucy Upton

Leading UK Paediatric Dietitian and Nutritionist. MSc in Nutrition and Dietetics

food illustration of an egg, milk and bread

Inside this article

Why are infants with eczema at higher risk of developing food allergy?
Should you remove food allergens to help manage eczema?
What can you do to reduce the risk of food allergy development?
Can allergy tests help to identify potential food allergies?
Where to get more help

Incidents of food allergy are increasing, and one of the biggest risk factors for infants developing food allergy is eczema. Early intervention and proactive introduction of allergens in children with moderate to severe eczema can significantly reduce their risk of developing a food allergy but how and when you do this is important. In this blog we will look at:

Why does eczema increase the risk of food allergy development
Should you remove food allergens to help manage eczema
Who is at highest risk of developing a food allergy
What can you do to reduce the risk of food allergy development
Can allergy testing help to identify food allergy

Why are infants with eczema at higher risk of developing food allergy?

Infants with eczema are at a higher risk of developing food allergy due to their compromised skin barrier. When infants have eczema, this causes inflammation and damage to the skin’s protective barrier, making it easier for food proteins or allergens to enter the body from their external environment, through their skin, rather than the typical way of food entering through their gut. If food enters the body through the skin rather than through the gut, this may cause the immune system in the skin to see these food proteins as a “threat” and their immune system produces antibodies to defend against the “threat” the next time it comes into contact with it – this is known as sensitisation.

This explains why some children develop symptoms of food allergy the first time they have eaten a food, as their body has already built up a defence (antibodies) against these foods, having already met them via the skin.

It’s important to note that sensitisation does not always lead to food allergy- whilst the immune system has produced antibodies to the “threat” it means their immune system is aware of the allergen but this doesn’t always progress to developing symptoms of food allergy when the food is eaten.

This is why it is important not to rub food products onto your child’s skin before they have been introduced to those foods through their diet- this includes creams which contain food-based derivatives such as almond, oats or coconut- as this could lead to sensitisation and potentially food allergy. Of course, if your child already eats these foods without having an allergic reaction then products containing those foods can of course be used.

Should you remove food allergens to help manage eczema?

In short- no. It’s important that eczema is optimally managed by treating the eczema and then protecting the skin with appropriate moisturisers and other topical treatments such as anti-inflammatory creams e.g. topical steroids . Each infant’s management regimen will be different so it’s important to get support with this to find the right treatment for them.

Only when all standard eczema treatments have been trialled and eczema persists might food exclusion be recommended to help identify if food may be exacerbating existing eczema. Whilst this is possible, it’s important to remember that delayed food allergy may be exacerbating existing eczema but it is not the cause. Exclusion of allergens should only be done under the guidance of a dietitian or medical team so as not to restrict diets unnecessarily and ensure allergens continue to be proactively introduced and reduce longer-term risk of food allergy development.

Who is at the highest risk of developing a food allergy?

We know that eczema can precede food allergy, though sensitisation, but the level of food allergy risk can be dependent on when an infant’s eczema developed, the treatments required, the presence of a food allergy already and family history.

The table below outlines those at the highest risk to those who would have a “standard risk”.

Highest Risk	Babies with severe eczema – eczema that started in the early weeks or months of life, is widespread and/or required the use of regular steroid cream to help manage it
High Risk	Babies who already have a food allergy e.g. cow’s milk protein allergy
Moderate Risk	Babies with mild to moderate eczema or Babies from a family with a history of allergic disease e.g. food allergy, asthma , eczema hayfever
Standard Risk	All other babies

What can you do to reduce the risk of food allergy development?

Whilst exposure of food allergens through the skin can lead to sensitisation, exposure to allergens through the gut can lead to tolerance – this is known as the dual allergen hypothesis.

We have good evidence that shows that proactive early introduction of food allergens, especially foods like egg and peanut, can help to reduce the risk of food allergy development in children, especially those with a higher risk of developing food allergy who may already have sensitisation (2).

Proactive allergen introduction is recommended for all infants but infants with a higher risk of developing a food allergy may benefit from the introduction of allergens from as early as 4 months of age to support tolerance. Your child’s team/ health care professional will advise on if this is appropriate taking into account other factors like your baby’s development and how this could be safely done.

Can allergy tests help to identify potential food allergies?

Food allergy testing alone does not diagnose a food allergy. It can identify sensitisation to a food/ allergen- but remember that sensitisation does not always lead to food allergy and infants/ children can tolerate foods that they are sensitised to.

This is why testing for allergies prior to a food being eaten is not recommended. Firstly waiting times for allergy testing can take weeks or even months (if it is deemed to be appropriate) already delaying the proactive introduction recommended. Secondly, allergy tests, if completed, may show sensitisation and cause a family to delay the introduction of allergens for fear of their child developing an allergic reaction. Delaying allergen introduction can actually increase the risk of food allergy development, not reduce it.

If you suspect your child has developed an immediate reaction to a food after eating it then allergy testing may be performed alongside a detailed history of your child’s reaction taken by an allergy specialist.

If a delayed reaction is suspected, you may be advised to eliminate the suspected allergen from your infant’s diet for a short period of time to confirm this- this should always be supported by a healthcare professional

More information on food allergies can be found here- Link to: How do you know if your child is allergic or intolerant to a food?

Where to get more help

If your child has eczema this may be initially managed by your GP, discuss them with your GP. Your GP should be able to refer you to a Paediatric Dietitian and/or Allergy Doctor. You can also access both of these professionals in the private sector.

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