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 Are eczema and hay fever related?

Yes, when they occur in one person. Yet that is where the similarity ends. Many people just have one condition without the other. Some children with both conditions grow out of eczema and continue with hay fever. 

When the two coexist, there is usually a common path. Early childhood provides the easiest explanation. One in five babies develop eczema in their first year of life. Of those, half still have eczema when they become teenagers. Hay fever tends to arrive after eczema. The clue to why they can be related rests in that time sequence.

People with both eczema and hay fever are atopic. Atopic Eczema and Atopic Dermatitis are medical names for eczema. Hay fever is Atopic Rhinitis. Having atopic in the technical names for both conditions implies they are related. It simply means the immune system is reacting with inflammation. Yet it is an entirely different type of inflammation. The inflammation in Atopic Eczema is fundamentally different from that in Atopic Rhinitis. Confused yet? It’s okay… 

There are four definitions of the condition in the book What is eczema? A path to ending the misery. Two come from medical sources and two from consumer groups. The definitions differ. It has been common for decades, yet those who aim to help can’t agree. Confusion is the inevitable outcome. 

That’s why there is no cure for eczema.

Parents of babies with eczema are often warned to expect hay fever to follow. When someone advances from eczema to hay fever and asthma, it is called the ‘Atopic March’. The medical diagnosis is often bleak. Eczema can lead to all three. Demoralising, as well as confusing.

Genetics play a part in eczema. That’s a proven medical fact. Ninety percent of babies born to atopic parents usually develop it too. Another medical fact. The genes a baby inherits are the genes the child must live with. Those genes condemn the child to having the condition. It’s hard to argue with a 90% probability. As a result many parents feel guilty about their child’s condition. 

Yet some children move on from eczema despite being born to atopic parents. They had the condition, and then it went away. How did they escape the 90% trap? Breaking such a hard rule fuels confusion. To help provide clarity, consider this definition of eczema… 

‘Eczema is the protective response to irritants.’ 

That definition allows for it to be a simple irritant response. The protective response continues when more irritant is applied to irritated skin. The condition will continue. 

That irritant is usually the product used to manage the eczema. It may be a moisturiser, emollient, cream, lotion or any other skincare product. If the skin remains irritated when a product is applied, consider that the product may be the irritant. The treatment may be the cause of eczema.

Appreciate that the same irritant may be fine on a healthy area of skin. There will be no protective response if the skin keeps the product out and away from the immune system. When applied to irritated skin it will enhance the irritation.

How can there be a cure for eczema when the treatment is the cause?

There can’t be. The red, itchy, oozing inflammation of the condition is the proper protective response to irritants being applied to irritated, inflamed skin. 

In contrast, hay fever is an antibody response, rather than an irritant response. A person has to be sensitised to the cause of their hay fever. Special immune cells which make special antibodies must be created. For that to happen the specific antigen the person reacts to must be taken to lymph nodes. 

That journey to the lymph nodes is how eczema and hay fever are related.

It requires the condition to be severe enough and to go on for long enough. Then antigens can penetrate the red, oozing patches of skin. Those antigens have nothing to do with the the eczema. They just pass through the oozing porous patches of red skin. Once inside the antigens go to the lymph nodes. New antibody-making cells form here. Those cells then migrate to the nose. The person breathes the antigen in, producing antibodies. Hay fever is the result. 

Antigen passing through irritated skin is the relationship between the two conditions.

Being able to EXplain eczema provides the clue.

 The skin returns to normal when the irritants are no longer applied in eczema. The irritant has no effect if applied to healed, healthy skin.  The eczema goes. You can choose your own wording: the child grew out of eczema or the person moved on from it. However, the product irritates again when applied to dry skin. Then it gets into tiny invisible cracks on patches of dry skin, causing irritation. It’s a simple causal effect each time. The skin need not have a memory.

In complete contrast, the antibody cells in the nose remember the antigen. That can be a life-long memory. The affected person may go for years without showing signs of hay fever. And then suddenly it happens again. 

So eczema and hay fever can be related. If the eczema continues long enough antigens pass through the irritated skin to the lymph nodes. Antigen-specific cells are generated, and move to the nose. 

The person may move on from eczema by avoiding the irritants. There are no memory cells in eczema. In contrast there are memory cells in hay fever. The person can avoid the antigens but the memory cells will remain at the ready.