I'm hoping someone can shed some light on this, as I can't find anything on Google. On and off my son, age 7, gets a terrible rash on his face. I don't think it's eczema (which he has had in the past.) It flairs up very quickly over a couple of days, and looks like small angry pustules. He says it isn't itchy, but does feel tickly if I gently run my finger over it, and painful if it is rubbed e.g when washing. Then it scabs over but can take weeks or months to fully disappear. And when it does, it goes very quickly. He had a gastro appointment earlier in the year who linked it to dairy intolerance; it cleared up when we removed dairy from his diet until last week when it came back with a vengeance. It's just on one side of his face now, but in previous flair ups has been on both. He tested negative for IgA TTG, but his aunt does have Coeliacs disease.
Thank you if you've read this far, hoping for some good ideas.
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Nome11
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It could be something like perioral dermatitis, very commonly linked to food intolerances.
If his coeliac test has come back negative, it's possible he's still gluten intolerant and could be worth a trial without.
I've just had this, and other things to consider are stress, anything touching that side of his face (a new pillow maybe?), teeth issues, hormones (I know he's quite young though).
I found tea tree cream incredibly helpful for clearing it up!
Thanks for your reply; nothing new has been touching his face and he is definitely not pre-pubescent. He did have a very exciting last week of term which may have brought on a stress reaction. I'd love to cut gluten out of his diet to see if it helped, but my husband doesn't want to as he is already dairy free and is a picky eater at the best of times.
Obviously it’s difficult to make suggestions not knowing patient history or daily diet and environmental exposures.
But here goes. This information is based on my own experience and allergy research.
A few ideas:
Has he been exposed to hidden dairy? Quite possibly as cows milk can be in so many things even hidden and even cross contamination - similar to gluten. Especially if particularly sensitive. If the label says ‘May contain milk’. Or particularly flavourings in foods can be derived from milk. Also ‘vegan’ foods are not the same as dairy free when it comes to allergy and can contain hidden milk. Reading allergy labels a must and checking with food manufacturers may be necessary.
Re Dairy / Cows milk allergy and intolerance. A high percentage of patients may also be sensitive to soya. Dairy and soya have similar like proteins that cross react. There’s a lot of scientific medical research on this. Allergy UK has handy factsheets (if not already aware); and NHS Dietetics have information too. Is there soya in his diet? Even just soya lecithin in dairy free / dark chocolate. Or dairy alternatives? Dairy and soya sensitivity can often do go hand in hand.
It’s possible to be gluten intolerant and negative IgA ttg for coeliac disease, as Cooper said. But DH rash is normally intensely itchy.
It may be another sensitivity as kids with one allergy tend to be allergic to at least one or more other allergen. Egg is common in eczema along with dairy.
There are many skin conditions and it may be another type of dermatitis and so it is important to follow up with your Doctor. May be even a referral to a dermatologist. Or allergy clinic (though depending on where you are in the country allergy services may be limited).
Finally, in any skin condition it’s important to get enough essential fatty acids in the diet. Not a lot is needed but it’s possible to be deficient. Coconut dairy alternatives for example are great but lack essential omega 3 and 6. It’s also possible too much omega 9 / oleic acid can displace the essential fatty acids too. (Search Linus Pauling Institute and skin health).
Research fan has made lots of good points.Have you considered having a private blood test done for cross reactive foods. You might need to contact BANT for a knowledgeable nutritional therapist. Forget NHS dietitians they really don't have the experience.
A NT will also be able to advise on supplements which may help. Our modern diets and depleted soils means that it is likely that our nutrition needs are not met. Good health starts in the gut with children too.
If your son has a dairy intolerance then it is quite likely there is something else going on. This does not necessarily mean a lifetime of restrictive eating, this is where guidance will help in someone so young.
Hello,difficult one-I have a similar rash-but not face-mine symmetrical,knees, elbows,sacral area and lower bum/thigh.Can feel red hot and painful.Starts with blisters and ends with scabs.defo-linked with eating gluten and its allies!dairy,soya,wheat based products and egg.Problem with DH,is it needs to be seen by dermatologist and skin sample needs to be taken-not on but close to the lesions/spots-they then use something called immunoflourescene test that has typical pattern to DH.I have loads of other health probs too-related to the rash ocurring and dietary intake.Dont bother asking the Gp,unless they are a good one-needs a dermatology referral, then the descision on what next.
Firstly, read Smartdoc's reply. It is spot on. Also, in my opinion, this looks like DH when it's in the healing process. Your description, its appearance, and the long length of time it takes to disappear are very much in line with how DH behaves. Research (PubMed) has shown that a single gluten exposure aggravates the immune system of a person with Celiac and DH for 3 months. Which makes sense, because a bad DH flare takes that long to subside, barring there is no additional gluten exposure. Oddly enough, the internal gut symptoms clear much quicker, but the skin manifestation takes much longer to calm.
I have severe DH that affects my face along with the bodily areas (symmetrically, but not always) that Smartdoc mentions. Mine does not itch. It burns terribly and tingles when it is accidentally flared. As has been stated, many proteins have similar structures. An over worked and over stressed immune system can start to view many things as the enemy, even without cross contamination. Aside from wheat, barley and rye, my DH is also flared by dairy, gluten-free oats, and soy if I eat too much of it. I'm lucky I can tolerate other grains, as many with Celiac can't.
Here in the states, a Dermatologist's diagnoses of DH is a Celiac diagnosis. You can have Celiac without having Dermatitis Herpetiformis, but you can't have DH without being Celiac. The problem nowadays is finding a derm that actually knows how to perform the testing. Smartdoc explained the process correctly.
I hope its not DH. Celiac is hard enough to deal with, but DH is much harder to deal with than Celiac alone, especially when it's on your face. I wouldn't wish it on anyone.
Accidental allergen exposures seem to be on the rise even with previously safe, trusted brands. I can only speak for the US, but it probably doesn't bode well for any of us no matter where we are; though, I certainly hope I'm wrong.
Thank you everyone for your replies, I really appreciate it. Lots of things to think about - we're in the UK so would have to go through a GP before seeing dermatology. My son did get allergy tested in January and came back mildly allergic to wheat and eggs, but the gastro said to take dairy out of his diet as a first point, which had an amazing effect. My husband is reluctant to remove anything else as our son is already a picky eater and a bit on the small side. I'll show him all your replies and we shall take it from there.
Hope you get your son the correct diagnosis as soon as possible. You have options and it’s great he’s got parents like you looking out for him. Given his age he has an expected and good chance of resolving any allergies.
Wheat, dairy and eggs are the top three allergens causing eczema and dermatitis. So if your son has tested allergic to these they are highly likely the culprits.
With dermatitis the allergy is more likely be delayed reaction so hard to pinpoint. That’s why medicine emphasises patient history along with tests. A knowledgeable doctor needs to be consulted. There’s no such thing as mildly allergic and if this is what you’ve been told it’s wrong. Mild symptoms may be correct. Was it an allergist consultant you seen or your GP? Was it a blood test for igE antibodies and or skin prick testing diagnosis? Or patch testing? The levels of antibodies don’t necessarily correlate with the clinical allergy reaction or not. Skin prick testing, patch testing (especially in dermatitis) and igE more accurate a long with the symptoms (rash).
Sorry this is a long reply! I’m passionate when it comes to allergies and nutrition. Allergic medicine and immunology are complicated subjects. Still scientists are learning. If this info helps anyone all the better.
Coeliac Disease though autoimmune. is classed as a Type 4 hypersensitivity (allergy). Classic allergy (igE, immediate symptoms within 2hrs.) is Type 1 hypersensitivity. Eczema and allergic dermatitis are classed as Type 4 hypersensitivity also.
Did you take wheat and eggs out too? The way to look at it is it’s likely a temporary diet measure. Many kids do outgrow allergies. After a while the foods can be reintroduced to see if it’s resolved or not. This needs to be done under an allergy consultant.
If he has Coeliac Disease (in addition to allergy to wheat, rare but possible), or you intuitively suspect it, go with that and certainly push for the specialist referral to test for DH with a dermatologist. But if that’s a no go. Has he had an endoscopy? You mentioned gastro. it’s the only way to know if have coeliac disease. Though rare not everyone tests positive on the blood test for coeliac. Failing that the genetic test for coeliac disease can all but rule it out.
Thanks again for your replies - I've managed to get a GP appointment but it's not until the end of August. The rash is slowly getting better on the original side which flailed up, there are a few new areas on the other side which are starting to come up now. We have only taken dairy out of his diet, after advice from the paediatric gastro; his wheat and egg allergy were found through blood tests. We weren't offered an allergy consultation, presumably because they don't cause a dangerous reaction. I'm hopeful that he will get a dermatology appointment, but it may well have cleared up before we get to see the GP. I've put a couple of photos up of how the rash is today.
Hi Nome11. Looked at the rash pic. Certainly a reaction to something. Could be food related, could be environmental (or both). But certainly the wheat, dairy and egg blood test results are clues. A shame you have to wait for the GP appointment. If it is allergy related an allergist referral would be called for. Dermatologist are not allergists and are often don’t find the cause when it comes to eczema and dermatitis. Skin prick and patch testing would be worthwhile. Also, in the mean time have you considered a dust mite allergy? Or laundry detergent reaction ( in contact with pillow). I read something similar on the late Dr Morrow Brown website explaining allergies. Fantastic information from a true allergy Doctor. I will find the link.
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