Triggers & Allergy
Map of Content — topic group mapped by judgment from infranodus community detection
Members
- Environmental Triggers — Outside factors that irritate the barrier or provoke flares: soaps, heat, fabrics, mites, pets, pollen, climate, pollution, drool, illness.
- Heat and Sweat — Overheating, sweat and sudden temperature change provoke itch and flares; sweat can act as an allergen; rinse off sweat and keep cool.
- Hard Water — High-calcium domestic water; linked to childhood eczema in observational studies, but the SWET trial found water softeners don’t treat it.
- SWET Trial — 2011 UK RCT of 336 children: ion-exchange water softeners gave no benefit over usual eczema care.
- Clothing and Fabrics — Wool and synthetics irritate eczema skin; cotton advised; silk gave no benefit (CLOTHES 2017); bio detergent enzymes not shown to harm.
- CLOTHES Trial — UK RCT (Thomas 2017, PLoS Med): silk garments added no benefit over standard care in 300 children aged 1–15
- Laundry Detergents — Washing powders/liquids; enzyme (bio) detergents did not worsen eczema in an RCT, but residue and perfumed fabric conditioner can irritate.
- Sodium Lauryl Sulfate — Detergent in aqueous cream, toothpaste, shampoo, bubble bath; thinned the skin barrier 12% in 4 weeks (Tsang & Guy 2010); stings eczema.
- House Dust Mites — Bedding mites whose droppings sensitise many eczema patients; Cochrane 2015 found no clear benefit from mite avoidance or mattress covers
- Pollen — Tree/grass pollen can flare eczema on exposed skin in spring/summer; pollen sensitisation is uncommon under 2 but rises through toddlerhood.
- Pets and Eczema — Early-life dog ownership linked with less eczema; cat findings null or harmful with sensitisation or FLG mutation; rehoming is unproven.
- Drool Dermatitis — Irritant rash around the mouth and chin from saliva; common in teething babies and toddlers and can flare facial eczema
- Lip-Licker’s Dermatitis — Saliva irritant dermatitis from lip-licking: red scaly ring matching tongue reach, crosses lip border; worse in winter.
- Irritant Contact Dermatitis — Non-allergic skin damage from repeated contact with irritants (saliva, urine, faeces, soaps); in toddlers mainly face, hands, nappy area.
- Allergic Contact Dermatitis — Delayed (type IV) skin allergy to things touching the skin; ~1 in 3 patch-tested children with AD react; often missed as ‘just eczema’.
- Fragrance Allergy — Contact allergy to perfume chemicals; more common in children with AD; ‘unscented’ products and botanical extracts can contain fragrance.
- Fragrance-Free Labelling — ‘Fragrance-free’ means no added fragrance; ‘unscented’ can hide masking fragrance. The labels aren’t verified, so read the INCI list.
- Compositae Allergy — Contact allergy to daisy-family plants (chamomile, calendula, arnica); ~2–4% of patch-tested children; clusters in atopic kids; lifelong.
- Sesquiterpene Lactones — Reactive daisy-family compounds (chamomile, calendula, arnica) behind Compositae contact allergy, which is commoner in atopic children.
- Patch Testing — Gold-standard test for contact allergy; Pediatric Baseline Series (38 allergens) is for >6 y; toddlers need custom panels.
- Seal of Acceptance — NEA product mark (2008): no Ecz-clusion List ingredients or fragrance, adult patch tests, expert review; not proof it suits every child.
- Food Allergy — Food allergy is common alongside toddler eczema, but mostly a consequence or co-traveller of it, rarely the root cause.
- Elimination Diets — Cutting foods to treat eczema: at best a slight benefit (Oykhman 2022), with real risks of new IgE allergy and malnutrition.
- Dual-Allergen Exposure Hypothesis — Lack’s theory: food protein via inflamed skin sensitises, early eating builds tolerance. Backed by LEAP; behind early-weaning guidance.
- LEAP Trial — RCT (NEJM 2015): early peanut eating in infants with severe eczema/egg allergy cut peanut allergy at 5 y from 13.7% to 1.9%.
- EAT Trial — UK RCT of early (3-month) introduction of six allergenic foods; ITT null, but per-protocol less peanut and egg allergy.
- PreventADALL Trial — Norway/Sweden RCT (2,397 babies): early emollients did not prevent eczema or food allergy; early allergenic foods cut food allergy at 3.
- Skin Prick Testing — Prick test for IgE sensitisation; in eczema up to half of children test positive but PPV is only 30–50%, so history must come first.
- Specific IgE Testing — Blood test for food/aeroallergen IgE; strong NPV but poor PPV in eczema, so only ordered for a matching reaction history.
- Oral Food Challenge — Supervised graded feeding of a suspected food; the reference standard that sorts true allergy from the many false-positive tests in eczema.
- Tree Nut Allergy — IgE allergy to tree nuts; ~3% of children by age 6, linked to eczema; almond and other nut oils on inflamed skin can sensitise.
- Peanut Oil Sensitisation — Peanut (arachis) oil creams on inflamed infant skin linked to later peanut allergy (Lack 2003, OR 6.8); check UK labels for ‘arachis oil’.
Key Relations
House Dust Mites [part-of] Environmental Triggers Hard Water [part-of] Environmental Triggers Environmental Triggers [relates] Allergic Contact Dermatitis Laundry Detergents [part-of] Environmental Triggers Clothing and Fabrics [part-of] Environmental Triggers Drool Dermatitis [relates] Environmental Triggers Pets and Eczema [part-of] Environmental Triggers Heat and Sweat [part-of] Environmental Triggers SWET Trial [contradicts] Hard Water CLOTHES Trial [contradicts] Clothing and Fabrics Fragrance Allergy [relates] Laundry Detergents Skin Prick Testing [relates] House Dust Mites Pollen [part-of] Environmental Triggers Lip-Licker’s Dermatitis [part-of] Irritant Contact Dermatitis Allergic Contact Dermatitis [relates] Lip-Licker’s Dermatitis Sodium Lauryl Sulfate [causes] Irritant Contact Dermatitis Patch Testing [defines] Allergic Contact Dermatitis Compositae Allergy [part-of] Allergic Contact Dermatitis Food Allergy [relates] Allergic Contact Dermatitis Fragrance-Free Labelling [relates] Fragrance Allergy Sesquiterpene Lactones [causes] Compositae Allergy Seal of Acceptance [opposes] Fragrance Allergy Oral Food Challenge [defines] Food Allergy Elimination Diets [causes] Food Allergy Dual-Allergen Exposure Hypothesis [opposes] Elimination Diets Peanut Oil Sensitisation [supports] Dual-Allergen Exposure Hypothesis LEAP Trial [supports] Dual-Allergen Exposure Hypothesis EAT Trial [supports] Dual-Allergen Exposure Hypothesis PreventADALL Trial [relates] Dual-Allergen Exposure Hypothesis Specific IgE Testing [relates] Skin Prick Testing