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Highland Park Allergy and Asthma Specialists

  • Writer's pictureHP Allergy and Asthma Specialists

Holidays are always a fun time of year, but as we all know holidays come with stress too. Having food allergies just piles on even more stress. Here are a few tips to help navigate this Thanksgiving if you or a loved one has food allergies.

1.) Be on the look-out for hidden food allergens.

The top 8 food allergens are cow’s milk, egg, wheat, soy, peanuts, tree nuts, fish, and shellfish. These account for more than 90% of all food allergic reactions in the US. Some of these seem easier to spot than others, but with some recipes you never know. It is always best to ask how the meal is prepared if you did not make it. Here are some common “sneaky” food allergens in traditional Thanksgiving cuisine.

  • Turkey. Turkey seems like it would be the safest option. It is clearly not one of the top 8 allergens. While it seems hard to hide food allergens in turkey, they can be hidden in the baste or gravy. The baste or bouillon cubes often contain soy. Many people add wheat to their gravy.

  • Potatoes. Most mashed potato recipes use some kind of cow’s milk in it whether it be milk, cream, or some kind of cheese. Sweet potato casseroles will often have nuts in them. Sweet potatoes can also have marshmallows which contain gelatin. Gelatin is made from the bones, ligaments, and tendons usually of cows or pigs. Some people who have an alpha-gal allergy (allergy to mammalian meat) can react to marshmallows.

  • Stuffing. Stuffing is bread-based so obviously contains wheat. Sometimes butter is used in stuffing. Egg can be used to bind all the ingredients together. Depending on the recipes sometimes soy or tree nuts may be used. Make sure to ask what was used in the stuffing or just avoid it to be safe.

  • Vegetables. Green bean casserole can be staple in some households for Thanksgiving. (You won’t find it in mine. My husband will eat anything but green beans. Lol!) Milk or cream of mushroom soap is often used to prepare this. Some people top green bean casserole with breadcrumbs. If there is a hollandaise sauce for asparagus or other vegetables, this contains eggs.

  • Cranberry Sauce. Cranberry sauce is most likely to be the safest out of the traditional Thanksgiving fare. Usually this will contain cranberries, sugar, and water. Some people will add nuts or other unusual ingredients so make sure to ask first.

  • Pies and Dessert. Pie crusts often have wheat, eggs, and dairy. There are ways to make allergy-free versions. Obviously, pecan pie has tree nuts, but other desserts can have nuts as well. Pumpkin pie can contain condensed milk. Cheesecake is dairy based.

You can check out the following websites for allergy-friendly recipes:

2.) Safety Tips When Preparing the Meal at Home

  • Read the labels in all the food ingredients. You can even take a picture of the labels if you are having guests over just in case anyone asks.

  • Consider making the safe foods first and then putting them in a separate area before making any unsafe foods.

  • Use separate utensils for preparing and serving the dishes to avoid cross contamination.

  • Clean all prep areas and eating areas thoroughly to make sure there are no residual food allergens present.

  • Consider making a plate for your food allergy child ahead of time to be safe. Alternatively, let people with food allergies serve themselves first to lessen the chance of cross contamination.

3.) Be Prepared When Eating Outside Your Home

  • As always, make sure to have your epinephrine autoinjector 2 pack with you wherever you celebrate Thanksgiving.

  • You can call the host in advance to discuss the menu.

  • Feel free to make allergy-safe food to bring.

  • Don’t arrive hungry. Snack or eat before you go so you will not be tempted to snack on foods you are not sure are safe.

  • Lastly, consider bringing a separate meal for whoever is allergic. It does not even have to be Thanksgiving foods.

4.) Try to Make Thanksgiving about more than the Meal.

Consider adding other activities to the day or creating a new family tradition, so that Thanksgiving is not just about the meal itself.

  • Make sure to have everyone tell what they are thankful for.

  • Make a Thanksgiving craft such as a hand turkey placemat.

  • Have the kids write and perform a Thanksgiving play.

  • Play a family flag football game.

  • Run in a turkey trot.

  • Volunteer at a soup kitchen.

  • Have the children take polaroid pictures or print digital ones from the day and make a scrapbook.

  • Watch a Thanksgiving movie.

  • Watch or go to a Thanksgiving parade.

  • Tell the story of your favorite Thanksgiving and why.


Gina M. Lee, M.ED. Tips to Safely Celebrate Thanksgiving with Food Allergies.

  • Writer's pictureHP Allergy and Asthma Specialists

Eczema, also referred to as atopic dermatitis, is an inflammatory skin rash. The skin will get dry, red, and very itchy. Approximately 31 million people in American have eczema. It is the most common chronic skin disease in young children with 10-20% of all children having eczema. Eczema is most common in infants and children usually showing up by age 5, but it can present in adolescents and adults. However, it is unusual to develop eczema after age 60. Eczema is part of the “atopic march”. The atopic march refers to the diagnosis of eczema during infancy, followed by the development of food allergies, then allergic rhinitis (often referred to as hay fever), and finally asthma. Studies have shown that up to 80% of children with eczema develop allergic rhinitis and/or asthma later in childhood.

Why do people get eczema?

Eczema is thought to be caused by a defective skin barrier. The causes of eczema are multifactorial. Genes and environment are both thought to play a role, with genetics playing a larger part. There is not just one gene involved in eczema. One of the most important genes found to play a role in eczema is related to a protein called filaggrin. This is a protein that helps hold moisture in your skin. Many people with eczema do not have enough of this protein or the protein does not work correctly. Eczema is not contagious, meaning you cannot catch it from someone else. It is often hereditary. If your parents have allergies or asthma, you are at increased risk to develop eczema. Environmental factors that are thought to possibly play a role in the development of eczema include climate, growing up in a rural vs. urban setting, exposure to non-pathogenic microorganisms (non-harmful), and water hardness. There have been studies that show increased number of siblings, early daycare exposure, exposure to farm animals, and pet dogs reduce the likelihood of developing eczema. These studies support the theory called the “hygiene hypothesis”. This theory states that exposure to certain germs and infections helps the immune system to develop and teaches to not overreact to harmless substances that cause allergies such as grass, dogs, trees, etc.

What are the symptoms of eczema?

The 2 main symptoms of eczema or severe itching and dry skin. Eczema has a waxing and waning course. You will have times where your skin is clear or much better and then times where your skin is flaring. When flaring, the skin will be extremely itchy with red bumps, flakiness, or blisters. Sometimes there can be weeping or crusting. In darker skin, the skin may be less red or more a deep brown or purply-red color. In chronic eczema, the skin can appear dry and scaly. The skin can crack and bleed. People can often develop secondary infections from scratching the skin. The itch from eczema can be described as unbearable affecting sleep and school/work performance.

How do you treat eczema?

The good news is that most children with eczema will outgrow it. There is no cure for eczema but there are treatments. The most important part of eczema treatment is MOISTURIZE, MOISTURIZE, MOISTURIZE. I always tell my parents/patients that eczema treatment can be time consuming, but it works. Moisturize several times a day if possible. A petrolatum-based moisturizer is the best like Aquaphor or Vaseline. These can be greasy so if you cannot stand the greasiness, you can reserve this for before bed and use a more lotion-like consistency moisturizer during the day. It is important to try to limit baths or showers to 10 minutes or less and use lukewarm water. Pat dry when you get out. The best time to moisturize is right

when you get out of the shower. The next step is usually to use a steroid cream when you have flares. There are a few topical medications that are not steroid-based that also work in eczema. There is a biologic therapy called Dupixent that is approved for moderate-to-severe atopic dermatitis that is not controlled with steroid creams. This should be a conversation between you and your healthcare provider to decide what it the best treatment for you.

There are other factors that can exacerbate eczema. Irritants can make eczema worse. Make sure to avoid fragrances in any moisturizers as well as your soaps and all personal hygiene products. Also, avoid other irritants such as fabric softeners, dryer sheets, bubble baths. Try to use a free and clear detergent. Irritants can also be dryness in the air or extreme heat or cold. Exposure to allergens can also worsen eczema. This can be allergens in the air such as dust or pollens. People often ask me about the role of food allergens. As we said earlier, children with eczema are at increased risk for other allergic conditions including food allergies. There are some children with eczema who will have certain foods which may not cause the stereotypical anaphylactic reaction but could flare their eczema. Milk, egg, wheat, and soy are the most common foods implicated in flaring eczema. We tend to try to not completely remove these foods from their diet unless eczema is severe due to the risk of developing a life-threatening anaphylactic food allergy after removing the food. It is best to speak with an allergic and discuss food allergy testing in this scenario. It is not recommended to test all children with eczema for food allergies as there is a very high false positive rate. This leads to misdiagnosis of and unnecessary food avoidance. Again, this is a very important discussion to have with your allergist.

In summary, it is important to discuss eczema with your healthcare provider and see an allergist for moderate-to-severe eczema. There are many treatment options. It is important to develop a plan that works for you and helps you live your life without eczema getting in the way.

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