Study finds link between eczema patterns and children’s ability to outgrow food allergies

ORLANDO (Nov. 6, 2025) – New research presented at the American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting suggests that the timing of when eczema begins, as well as how long it lasts and how severe it is, may influence a child’s ability outgrow food allergies.

“Food allergy and eczema often appear together in childhood, but scientists don’t fully understand how one condition affects the other,” says Nicole Koulov, 2nd year medical student at University of Texas and ACAAI member who has worked with the FORWARD team under supervision of Mahboobeh Mahdavinia, MD, PhD on this project. “We examined surveys from children with a history of IgE-mediated food allergies that they later outgrew. Our findings highlight that eczema may play a role in shaping the development of oral tolerance to food allergens.”

The study analyzed survey responses from caregivers of 855 children aged 0 to 12. Parents reported on the presence and timing of eczema, when it resolved, and how severe it had been. Severity was measured using how much skin was affected and the types of treatments needed to control symptoms, scored on a 0–6 scale.

Results showed that children with longer lasting, and more severe eczema were less likely to outgrow food allergies. Specifically:

• Timing of onset: Children whose eczema began between 4 and 6 months of age had significantly lower odds of outgrowing food allergies compared to those whose eczema started earlier (0–3 months).
• Severity: Greater eczema severity was strongly linked to reduced chances of developing tolerance.
• Duration: The relationship between eczema duration and food allergy resolution was non-linear. The likelihood of outgrowing a food allergy dipped with shorter eczema durations, rose modestly at 8–10 years, and then declined again.

“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. “Our data suggest that the timing and management of eczema could be an important factor in helping children develop tolerance.”

The researchers emphasized that while eczema itself does not cause food allergies, the interplay between skin barrier health, immune responses, and allergen exposure may be key to understanding why some children outgrow allergies and others do not.

Abstract Title: Association Between Clinical Features Of Eczema And Outgrowing Of Food Allergies In Pediatric Patients   (Full abstract below)

Presenter: Nicole Koulov, BS

For more information about treatment of food allergies and eczema, or to find an allergist in your area, visit AllergyandAsthmaRelief.org. The ACAAI Annual Scientific Meeting is Nov. 6-10. For more news and research from the ACAAI Scientific Meeting, go to our newsroom and follow the conversation on X/Twitter #ACAAI25.

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ASSOCIATION BETWEEN CLINICAL FEATURES OF ECZEMA AND OUTGROWING OF FOOD ALLERGIES IN PEDIATRIC PATIENTS
N. Koulov^*1, N. Mirhosseini², C. Onal³, D. Moore¹, C. Warren³, H. Sharma⁴, A. Assa'ad⁵, J. Moy³, R. Gupta³, M. Mahdavinia¹, 1. Houston, TX; 2. Maywood, IL; 3. Chicago, IL; 4. Washington, DC; 5. Cincinnati, OH.

Introduction: The relationship between the development of food allergy (FA) tolerance and eczema is poorly understood. This study evaluates the effects of eczema onset timing, duration, and severity on the subsequent development of oral tolerance. 
Methods: This FORWARD multicenter prospective cohort study included children ages 0 to 12 years with a history of outgrown IgE-mediated FAs as reported by caregiver survey responses. Presence and duration of eczema were determined by questionnaires indicating the timing of eczema onset and remission. The severity of eczema was determined by a survey on skin distribution and cumulative therapies needed to treat eczema (scored on a scale of 0-6).
Results: Among 855 pediatric patients with eczema, generalized additive models estimated a significant non-linear association between eczema duration and FA resolution (p < 0.006), with the predicted probability of outgrowing an allergy declining at lower durations, then rising modestly with durations between 8–10 years before declining again. Greater eczema severity was associated with lower odds of outgrowing a FA (p < 0.001). Compared to onset at 0–3 months, children whose eczema began at 4–6 months had significantly lower odds of resolution (p = 0.003), while later onset groups did not differ significantly. 
Conclusion: An earlier onset of eczema between 4 to 6 months, along with greater severity and longer duration, was linked to a reduced likelihood of outgrowing food allergies. These findings suggest that managing eczema effectively may play a role in promoting the development of food allergy tolerance in children.