Asthma, hay fever and eczema: What you need to know

While it might simply be superstition that bad things come in threes, in some instances it happens to be true.

Asthma, hay fever and eczema may occur together in people who are more sensitive to allergens such as grass pollen, pet dander, dust mites and certain foods.¹

Any of the conditions can occur throughout life, but most diagnoses are made in childhood.

Understanding the basics about each condition and what to do to lessen symptoms can help keep you safer and more comfortable.

“Eczema, allergic rhinitis (hay fever) and asthma are all allergic diseases. They can occur more frequently, either alone or in combination, in people who are genetically susceptible,” says Dr Melanie Wong, clinical immunology/allergy specialist and National Allergy Council Director.

“Allergies can begin at any age, but symptoms of allergic rhinitis (hay fever) often start at early school age,” she says.

About half of children with eczema also develop asthma and about 80% of people with asthma also have allergic rhinitis.²

“The progression from eczema to later developing food allergies, allergic rhinitis and asthma is called the allergic (or atopic) march. People can also develop only one or 2 of these allergic disorders at any age, with or without a family history.”

While asthma, eczema and allergic rhinitis (hay fever) may have some symptoms and triggers in common, they are quite different.³

Asthma is common in Australia, with one in 5 children and one in 9 adults affected.⁴

Asthma impacts the airways in the lungs, causing them to narrow, swell or produce mucus. This can make it hard to breathe.

Symptoms include coughing, wheezing and a tightness or heaviness in the chest.

Asthma symptoms can range from mild to very severe, and in some cases can be life threatening.

“Asthma is best managed under medical supervision, where the need for medication to prevent frequent or severe attacks will be prescribed if needed,” says Dr Wong.

Like asthma, hay fever impacts the airways, but in the upper respiratory system, such as the throat and nose.

“Allergic rhinitis (hay fever) can affect some people all year (perennial allergic rhinitis) and others only during the ‘allergy season’ (seasonal allergic rhinitis), usually during spring,” says Dr Wong.

“People with symptoms all year round tend to be allergic to things constantly in the environment, such as dust mites, whilst people with seasonal symptoms tend to be allergic to grass or tree pollens,” says Dr Wong.

Hypersensitivity to allergens such as pet dander (skin, saliva, fur, feathers), dust mites, grasses, pollen and mould spores all come under the umbrella of allergic rhinitis.

Symptoms include sneezing, itchy eyes, throat or nose, and coughing, and can range from mild to more severe.

“Symptoms of allergic rhinitis can be well controlled in most people by avoidance of allergic triggers, medications, such as antihistamines, nasal steroid sprays and allergy eye drops, allergen immunotherapy or a combination of these,” says Dr Wong.

Eczema, also known as atopic dermatitis, occurs when the skin struggles to retain moisture. This causes the skin to become dry, itchy and irritated, and can lead to painful flare-ups where the skin cracks and bleeds.

Triggers can include allergens such as dust mites, overheating, irritants including sand or dirt, scratching and even stress.⁵

“Eczema tends to reach a peak of severity between the ages of 2 and 4 years old, with many older people who have had infantile eczema only having a tendency to dry skin,” says Dr Wong.

Protecting skin with moisturisers at least twice a day is important, even when you do not have an eczema flare. Taking oral antihistamines, applying wet wraps and using medically prescribed creams and ointments during flare-ups can help to ease symptoms. In severe cases, oral medication and other therapies are prescribed.

While it’s true that having one of these conditions does increase your risk of having the second and third, it is not inevitable.

“There is an allergy gene, which means if your parents or both parents have an allergy your risk of developing an allergy increases,” says Maria Said, CEO of Allergy & Anaphylaxis Australia and National Allergy Council Director.

Some studies suggest that the more severe the case or symptoms, the more likely a person will also develop another of the conditions.⁶

While symptoms may lessen over time and young children can appear to “grow out” of some allergic conditions, Said suggests this may not mean the condition is gone for good.⁷

“But good management and treatment, including some medications and allergen immunotherapy, has shown a high success rate in reducing symptoms leading to an improved quality of life in patients.”

While there’s currently no cure for these conditions, Dr Wong suggests that may change in the future.

“There is ongoing research into and increasing access to allergen immunotherapy and other specialised medications which may change the course and severity of allergic reactions, as well as research into ways to prevent allergy developing.”

If you or a loved one has any of these conditions, it’s important to speak to a GP and get the correct treatment and management plan to both help prevent symptoms and know what to do if an episode occurs.

Allergy & Anaphylaxis Australia has online support resources available. You can also call for help and support on 1300 728 000.