The Eczema Cause Survey

Firstly a big thank you to the parents who took part in this survey. 110 people responded which is a pretty decent sample size.

Here are the results along with my own analysis which is subject to all the flaws of someone who has no medical training trying to understand complicated medical issues. However to try and make it at least a bit scientific I have referenced a number of studies carried out by people who do know what they are talking about.

So the first questions was:-

 How severe is your childs eczema?

RESULTS

Severe 44.55%

Moderate

38.18%

Mild

17.27%

 

Analysis

It is no surprise that there were more moderate and severe cases than mild. This is not necessarily a true reflection of eczema in the general population. This may be because the more severe the eczema the more likely parents are to seek help and advice on the forums where the survey was conducted.

The next question was

Prior to developing eczema was your child ever given antibiotics and if so when?

RESULTS

My child was never given antibiotics before he/she developed eczema 57.94%

Less than 1 month old

17.76%

Less than 6 months old

12.15%

Less than 1 year old

4.67%

Older than 1 year

3.74%

Other:

3.74%

Analysis

Although the majority of parents reported that the child had not had antibiotics in the first year 35.45% is still a significant proportion. So antibiotics could well be a contributor to eczema. A number of studies 4 & 5 have established a link which is suggested to be a 40% increase in risk of developing eczema. Unfortunately due to the limitation of this free survey tool I cannot see how many of the parents who reported that their child had antibiotics also did not have any family history of eczema. That would be an interesting statistic. I would love to hear from those who did not have eczema in the family to find out if there had been antibiotics administered in the first year of life. (you can leave a comment on this blog or on the forum)

 

The next question was

Is there eczema in your childs family?

Yes. One parent has eczema 38.89%

Neither parent has eczema but other relatives (e.g. grandparents, uncles etc) have eczema.

31.48%

There is no eczema in my childs family

28.7%

Yes both parents have eczema

0.93%

 

Analysis

It was no surprise that a family history of eczema seems to be the biggest factor. A summary of over 100 published reports on genetic association studies through mid- 2009 implicated 81 genes, 46 of which have demonstrated at least one positive association with Atopic Dermatitis. Of these, the gene encoding filaggrin has been most consistently replicated.3

So what the dermatologists tell you is right. However what about the other 28.7 %. What has caused their eczema? Antibiotics maybe. Caesarian? Well this survey is probably not going to be able to answer that question. I have spoken to parents who have no family history of eczema, no antibiotic use and their child was born naturally. So it really is a mystery as to why some children get eczema.

The next question was

Was your child delivered by Caesarian Section

RESULTS

No 77.57%

Yes

22.43%

Analysis

This sounds like a lot but it is actually about the same as the percentage of the general population in the UK that have Caesarians and is less than the US. (This survey covered several countries but mainly UK and US). If Caesarians were a significant contributor to eczema I would expect the percentage in this survey to be much higher.

The research on the link between C section and atopy (allergic diseases) is mixed. A study in Korea2 found no link but another study1 concluded that there was a two fold risk increase but only if there was already a family history of allergies

The final question was

Does your child have food allergies and has either parent ever suffered food allergies??

RESULTS

Yes my child has a food allergy but neither parent has ever had one 49.54%

Yes my child has food allergies and at least one parent has had a food allergy at some time in their life

27.52%

No my child does not have a food allergy

22.94%

This really surprised me. Over 77% have food allergies. I had no idea that food allergies were so common. Some research suggest that proteins in the food penetrate the compromised skin barrier in eczema and get tagged by the immune system as intruders leading to the development of a food allergy.

However there are many studies particularly in the US that suggested a leaky gut is the mechanism by which proteins get into the system and get tagged as intruders. Many of these also suggest that a lack of diversity in the gut bacteria plays a part in leaky gut. This leads back to the antibiotic link because antibiotics wipe out many of the species of helpful bacteria in the gut. Leaky gut does not seem to recognised in the UK as a condition likely to be suffered by the general eczema population.

Conclusion

So my unqualified conclusions from this survey is that genetics are the biggest factor playing a part in eczema while antibiotics in early life probably also play a role. Caesarians on the other hand are probably not such a risk. I have read that at least some of the key bacteria that are not transferred to a child due to a C section can be replaced by breastfeeding.

References

1.  Asthma and atopy in children born by caesarean section: effect modification by family history of allergies – a population based cross-sectional study. Ourania Kolokotroni   et al
2.    Relationship between mode of delivery in childbirth and prevalence of allergic diseases in Korean children. Yeo Hoon Park,et al
3.    An Update on the Genetics of Atopic Dermatitis: Scratching the Surface in 2009 Kathleen C. Barnes, PhD
4.    Early exposure to antibiotics and infections and the incidence of atopic eczema: A population-based cohort study Jochen Schmitt, et al
5.    Antibiotic exposure in the first two years of life and development of asthma and other allergic diseases by 7.5 yr: A dose-dependent relationship Lauren Hoskin-Parr et al

 

 

 

One thought on “The Eczema Cause Survey

  1. Hi Martin, I’ve completed most of your survey. Didn’t do the question about parents and eczema because I (the mother had eczema for a very finite spell as a teenager and nothing since – think it was stress related) however as an adult I have developed a lot of hayfever type (but not food) allergies. But there is no asthma in the family. It is my understanding that the triad of eczema, asthma and allergies may all go together and run in families. There are other allergies in the family but no eczema or asthma that I know of so I believe I am probably the link to the allergic side of things for my daughter. She was born by C-section and went to the baby unit for breathing issues and was fed dairy based formula initially until she could be breast fed. I don;t think she was given antibiotics while she was in the baby unit. Her eczema started at one month of age and was severe by three months old. She had two courses of oral antibiotics for the eczema at this point. We have been doing Dr Aron for just over two months and much improved. She’ll be one year old next week. Will be interested in your results.

    Like

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