Will My Child “Grow Out” of Eczema?
Many parents have heard the encouraging prediction that most children will outgrow eczema (or “atopic dermatitis (AD)”).
But is this really the case and how can parents know if their child will fall into the lucky percentage of those who do? Let’s look at the research to answer that question!
In a 2013 study, researchers studied the prevalence (or “common-ness”) of eczema in adulthood, whose data could then be used to extrapolate if children really do outgrow eczema. They found that the prevalence of AD in the United States was similar for both children and adults, suggesting that the previous notion that most children grow out of eczema may not necessarily be true. The data instead support the idea that eczema disappears and reappears with age and waxes and wanes throughout the lifetime.
On the other side of the spectrum, there was a large longitudinal study published in 2017 which found that 80% of AD did not persist by 8-years-old. Furthermore, it was found that children who developed AD within the first two years of life had lower risk of persistent disease - conversely, those who developed AD later were more likely to have more persistent disease.
Large population cohort studies also have their limitations, as Dr. Abuabara states in her article. These studies can fall victim to inaccurate recollection and some studies even include general questions that may lead to the over-reporting of prevalence in adulthood. Nonetheless, there still are questions regarding if the eczema that persists into adulthood has a distinct disease process from that of childhood eczema, or if childhood eczema results in a universal predisposition that continues into adulthood. More studies should be conducted in order to determine if the biomarkers for eczema (such as IgE, filaggrin representation) are conclusive with disease in adulthood.
An editorial in the journal, JAMA, argued that eczema may not necessarily “go away” but it may certainly look different in adulthood. There have been, however, advancements in this understanding through a study conducted in 2021 of two large-birth cohorts, where they observed children from birth to midlife and found that the trajectory of the disease in adulthood is modifiable and likely influenced by environmental factors. Furthermore, a 2019 cohort study utilizing the Pediatric Eczema Elective Registry concluded that early-, mid-, and late-onset childhood eczema are clinically distinct from one another.
All in all, while many children may see their eczema improve with age, the condition does not always disappear entirely, instead it may “hibernate”, go on “extended leave”, or morph with age. Research suggests that eczema can persist into adulthood, often changing in how it presents rather than fully resolving or disappearing altogether. Several large-scale studies give us valuable insights but they also have limitations, leaving questions about the long-term nature of the disease. Environmental factors and individual biology likely play a role in whether eczema resolves, continues or reappears later in life.
To answer the question of “will my child outgrow eczema?”, the short answer is “it’s possible,” but the long answer is that eczema may come and go and change over time and make periodic visits throughout the life course.
Global Parents for Eczema Research (GPER) is a nonprofit organization that was founded in 2015 by parents of children with eczema. Frustrated by the lack of evidence-based information and resources around eczema and eczema treatments, they created GPER in an effort to support eczema research and advocate for evidence-based medical decision-making for parents. Our offerings include support and resources for eczema caregivers, research, and public policy work to improve care and treatments for people with eczema.
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