In some children, allergy is not a single illness but a condition that progresses in sequence over the years. A process that begins in infancy with eczema on the skin can later extend to food allergy, allergic rhinitis, and asthma. This sequential transition is called the atopic march (atopic progression). Recognizing the chain is the key to taking early measures and protecting your child's quality of life.

How Does the Chain Progress?

The typical sequence is generally as follows:

  1. Infancy – Atopic dermatitis (eczema): The first link is most often dry, itchy skin. A damaged skin barrier makes it easier for allergens to enter the body.
  2. Infancy – Food allergy: Especially in infants with early-onset and severe eczema, cow's milk allergy and food allergies may accompany the condition.
  3. Preschool age – Allergic rhinitis: In the following years, allergic rhinitis (hay fever) may be added, with persistent runny nose and itching.
  4. School age – Asthma: The last link in the chain is often asthma; it presents with recurrent cough, wheezing, and shortness of breath.

Not every child experiences all of these stages; however, early-onset, severe eczema is an important risk marker for the atopic march.

What Can Be Done to Slow the Chain?

Although it is not always possible to stop the atopic march completely, the following steps can reduce its severity:

  • Protect the skin barrier: In eczema, regular moisturizing and the care recommended by your doctor both soothe the skin and reduce allergen passage.
  • Manage nutrition correctly: Avoid unnecessary and prolonged food restrictions; if a food allergy is suspected, make a plan together with your doctor.
  • Reduce triggers: House dust mites, cigarette smoke, and excessively dry-dusty environments fuel the chain.
  • Regular follow-up: Evaluating an infant with eczema early on makes it possible to catch the subsequent links in time.

What the Family Can Do

If your child has early eczema, a persistent runny nose, or recurrent wheezing, these should be evaluated not separately but as a whole. With the pediatric allergy evaluation at our clinic, we identify the current link, anticipate the next stages, and create a preventive plan.

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This content is for informational purposes only; please consult your doctor for diagnosis and treatment. — Uzm. Dr. Hasan Keleş