Allergens in the air and in the food are often triggers for a flare-up of this disorder. If you can furnish a list on how your disease gets activated, the doctor may try to correlate this with a skin (prick or intradermal) or blood (RAST) test. Don’t try to avoid everything that might be considered an allergen without any incriminating evidence. Occasionally, using an air purifier can help reduce allergen exposure at home or in the workplace.

Dust mite allergy is the most important home allergen. Go after the dust mites; almost all atopics are highly sensitive to dust mites. There are dust mite covers to enclose mattresses and box springs. Try Vellux blankets. You may need a dehumidifier to keep relative humidity below 50% since mites thrive in humid environments and an acaracide such as benzyl benzoate (‘Acarosan’) to carpeting. Removal of fitted carpets in the bedroom should be recommended. Get new pillows and wash the duvets and pillows every three months; washes should be hotter than 55°C to kill mites and denature antigens. Reducing upholstered furnishings and regular use of a modern cylinder or upright vacuum cleaner fitted with an adequate filter.

Infantile eczema is often allergy related in the first year of life. Peanuts, wheat, soy, whole milk, eggs and citrus are the common offenders. Great care is needed if the diet is changed because malnutrition can do more harm in the long run than eczema. Lamb, chicken and rice are usually completely safe. Breast milk is the best ‘formula’, and then try soy formulas. If there is no improvement consider goat’s milk. Allergy tests (both skin and blood) are not completely reliable for foods, but may at times be helpful. Eliminate a suspected food, but if no clear benefit is obtained after 4 weeks, do not continue.

As the child grows, many food allergies often fade or disappear. In the small minority of eczema sufferers who get real benefit from food avoidance there is great benefit. Care must be taken to avoid malnutrition when any restrictive diets are used. In small children special diets are difficult to implement, and the help of a dietitian is necessary.

There are studies showing breast feeding may delay the onset of eczema if practiced for at least the first three to six months of life. Some mothers also avoid cows milk and other possible food allergens during pregnancy and nursing, but this is unproven.