Eczema Onset at 4 Months May Reduce the Chance of Outgrowing Food Allergies

A study reported that an earlier onset of eczema between 4 to 6 months, along with greater severity and longer duration, was associated with a reduced likelihood of outgrowing food allergies.1

“Food allergy and eczema often appear together in childhood, but scientists don’t fully understand how one condition affects the other,” said Nicole Koulov, second-year medical student at the University of Texas, in a statement.1 “Our findings highlight that eczema may play a role in shaping the development of oral tolerance to food allergens.”

A 2022 study reported that food allergies affect 30% of children with moderate and severe eczema, leading to symptoms of dry, cracked skin, rash, itchiness, ooziness, and crusted skin.2

Koulov, an ACAAI member who worked with the FORWARD team under supervision of Mahboobeh Mahdavinia, MD, PhD, on this project, presented these findings in the poster, “Association Between Clinical Features Of Eczema And Outgrowing Of Food Allergies In Pediatric Patients,” at the 2025 American College of Allergy, Asthma, & Immunology (ACAAI) Annual Scientific Meeting in Orlando, Florida, from November 6 – 10.

The FORWARD multicenter prospective cohort study included 855 children aged 0 – 12 years with a history of outgrown IgE-mediated food allergies, reported by caregivers via surveys. Investigators assessed the presence and duration of eczema using questionnaires, which captured the timing of onset and remission. A survey on skin distribution and cumulative therapies needed to treat eczema assessed eczema severity.

Generalized additive models revealed a significant non-linear association between eczema duration and food allergy resolution (P <.006). The predicted probability of outgrowing an allergy was lowest at shorter eczema durations, increased modestly for durations of 8–10 years, and then declined again. Greater eczema severity was linked to lower odds of outgrowing a food allergy (P <.001).

The study also revealed that children who developed eczema at 4 – 6 months, compared to 0 – 3 months, had significantly lower odds of food allergy resolution (P =.003).

The researchers noted that, although eczema does not directly cause food allergies, the interaction between skin barrier integrity, immune function, and allergen exposure may help explain why some children outgrow their allergies while others do not.

“These findings show that eczema is more than just a coexisting condition – it may directly influence whether children overcome food allergies,” said allergist Amal Assa’ad, MD, co-author of the study and ACAAI member,” in a statement. “Our data suggest that the timing and management of eczema could be an important factor in helping children develop tolerance.”

This adds to previous FORWARD findings that discovered eczema onset before 4 months correlated with a greater number of food allergies (odds ratio [OR], 1.14, 95% CI: 1.02-1.28) compared to eczema onset after 12 months.3 Eczema onset in children with a food allergy was particularly earlier than in the general population.

FORWARD provides further insight into the link between food allergies and eczema. Last year, HCPLive reported a study with > 8000 pediatric patients from the Pediatric Eczema Elective Registry found that certain food allergies are associated with uncontrolled atopic dermatitis and long-term atopic dermatitis persistence.4 These associations were pronounced in subgroup analyses of milk (adjusted odds ratio [aOR], 1.46), egg (aOR, 1.49), and peanut allergies (aOR, 1.50).

“The observed relationship between food allergy and AD persistence suggests that food allergy is an important prognostic factor for long-term AD outcomes,” wrote investigators of the 2024 study.4

References

1. Study finds link between eczema patterns and children’s ability to outgrow food allergies. EurekAlert! Published November 6, 2025. https://www.eurekalert.org/news-releases/1103483

2. Mehta Y, Fulmali DG. Relationship Between Atopic Dermatitis and Food Allergy in Children. Cureus. 2022 Dec 31;14(12):e33160. doi: 10.7759/cureus.33160. PMID: 36726939; PMCID: PMC9886409.

3. Hikma Abbas H, Mahdavinia M, Jiang J, et al. The age of eczema onset increases the risk of multiple food allergies. Journal of Allergy and Clinical Immunology. 2024;153(2):AB2. doi:https://doi.org/10.1016/j.jaci.2023.11.030

4. Brooks A. Pediatric Food Allergies Linked to Uncontrolled Atopic Dermatitis, Long-Term Prognosis. HCPLive. December 18, 2025. https://www.hcplive.com/view/pediatric-food-allergies-linked-uncontrolled-atopic-dermatitis-long-term-prognosis. Accessed November 29, 2025.