Who Outgrows Eczema?

Who outgrows Eczema?

by Dr. Frank Lichtenberger MD, PhD

A question that I get asked frequently in clinic is "Will my child outgrow eczema?" The scientific literature states that 75% of those children that develop eczema before the age of 5 will spontaneously outgrow it by adolescence, and that is reassuring to many parents. My old professor in residency used to say "Medical statistics are useful for testing medical students, but don't help with THIS patient." What I take from that statement is a 75% chance is an easy answer, but not what they want to know. What parents want to know is whether their child is in the 75% that outgrows eczema, or the 25% that doesn't. 

Much is known about the science of eczema that wasn't available to us 20 years ago. For example, we now know that about half of Americans that have eczema also have genes that allow for increased moisture to escape through their skin, when this particular gene is only present in 10% of the population. While these kids inherited this particular gene from their parents, much of the time their parents don't have a history of eczema. This disparity points directly to the changing environment. The presence of environmental allergies will frequently follow the severity of the skin condition. The more allergic somebody is, generally the harder is is to control their skin. The harder the eczema is to control, the longer they will have the condition. 

I should also make sure to mention that I only see the more severe cases of eczema as referrals from the local pediatricians, the less severe and less allergic the patient also generally means that they will outgrow the condition. My clinic has a high success rate with the tough cases, this is because we have a comprehensive approach that starts with allergy testing and avoidance, and use all available therapies including wet wraps, UV-B phototherapy, biologics, and allergen immunotherapy. 

So much of the time I won't have a specific answer, but I'm confident that with a comprehensive approach to diagnosis and care, that not only do we give our patients the best chance of outgrowing the condition, we also minimize the impact on their quality of life as they grow out of it. 

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