What Is the Allergic March?

The “Allergic March” or also known as “Atopic March” is the progression of allergic diseases over time.

What is the sequence of allergic diseases?
The allergic diseases evolve over time with atopic dermatitis or eczema being the first manifestation of allergy; seen in infants and young children. Food allergies are the next to appear over 1-3 years of age. Food allergy is followed by recurrent wheezing or asthma which start around 3-4 years of age. Nasal allergy or allergic rhinitis is the next to appear at the age of around 5-6 years of age. This sequence of allergies may not be followed in all children. The reason for this is not clearly known.

Do all children get all the allergies?
The age of appearance of these allergies can be variable in different children. Not all children will get all the allergies but might get one or two allergies. Some children might just get atopic eczema, some might just get food allergy while some develop only respiratory allergies like asthma or allergic rhinitis.

Can children get allergies without anyone in the family having allergies?
Allergic problems are more common in children with a family history of allergies in parents or grandparents. In some cases allergies can be seen in children with no family members having any allergies.

Why and how are all the allergies related?
Atopic dermatitis or eczema is associated with a defective skin barrier. It is believed that the food allergens penetrate through the skin and sensitize the child to food allergens. When the child gets exposed to these allergens by consuming them through food they can develop allergic reactions to these foods. Some children with atopic dermatitis get sensitized with aeroallergens like dust mites etc. On the other hand asthma, allergic rhinitis or allergic conjunctivitis are related to aeroallergens or allergens in the environment like pollens, dust mites, pet dander, moulds or insects.

Can we prevent children from developing allergies and the allergic march?
Lot of research is going on how allergies can be prevented or how to prevent the progression of allergic diseases, the “Atopic March”. There is no firm evidence to this but things found to be useful are taking probiotics during pregnancy, avoiding exposure to tobacco smoke, pollution and certain viruses. Protecting an infant’s skin with moisturizers may reduce the risk of atopic dermatitis or eczema. Early introduction of peanut and eggs have been shown to reduce the risk of peanut and egg allergy.

If your child has one or more allergic conditions, it is important to have a proper plan for management of allergies including measures to reduce exposure to your allergens and triggers. You need to work with your pediatric allergist or pediatric pulmonologist to make a treatment plan.

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