Why is eczema in Indian children on the rise?

As a child nutritionist and a mom of twins, I've noticed a troubling pattern in my practice: eczema cases in young Indian children are rising. This itchy, inflamed skin condition, known as atopic dermatitis, is now affecting 15–25% of Indian kids under five, with areas like Mumbai and Delhi seeing even higher rates. The national frequency has doubled in the last two decades. A 2024 ICMR report linked high levels of pollution to a 30% rise in childhood eczema in northern India. What's the driving factor? It's a mix of genetics, weather, exposure to toxins, mother’s diet and the strength of the child’s digestive system. Eczema isn't just a skin issue, it's a red flag for deeper imbalances. Eczema and food sensitivities are common, especially amongst babies and toddlers. However, they should not be considered normal. It is an external sign from the body that something is wrong internally. It deserves proper attention and should be addressed. In Indian children, one of the reasons can be due to genetics. If there is a family history of asthma and/or allergies, there is a high chance your child can show signs of eczema. Eczema is a clear sign that there is trouble in the gut. When the gut is inflamed, the signs can show up on the skin.However, there are a lot of external factors that can cause and worsen eczema. In cities where the air pollution is exceeding WHO limits, this can also aggravate the skin and weaken the immune system. Toxins in our everyday household items can be a silent culprit. Items like fabric softeners, soap, powders, clothes can irritate the skin. The gut-skin axis is crucial for Indian babies. When the gut is weak, there are certain foods babies won’t be able to digest. These are commonly linked to the top 9 allergens: peanuts, tree nuts, wheat, dairy, sesame, fish, shellfish, egg and soy. To figure out triggers, I recommend an elimination diet: Track symptoms for a week, then remove one suspected food (e.g., dairy or wheat) for 7–14 days while noting changes. Reintroduce slowly, one at a time, and observe. If you notice the eczema getting worse then that is the trigger food. Best to eliminate for a month or two till the gut gets stronger and try again.While you eliminate these foods, make sure to include foods that will help heal the gut like bone broth for collagen to repair the gut lining, omega-3 rich sources like nuts, seeds and fatty fish, zinc foods to help with skin barrier get stronger like chickpeas, lentils, pumpkin seeds and of course probiotic rich foods to increase the amount of good bacteria like yogurt, fermented idlis and dosas. Adding turmeric, black pepper and ginger can also have anti-inflammatory effects to help soothe the skin from further irritation. Avoid processed and packaged foods as much as you can for your baby/toddler. You can also consider adding a probiotic supplement to help give them the boost they need of good bacteria. Preventing eczema starts at home. Another important factor to look at is lifestyle. Today, urban Indian kids spend most of their time indoors, missing out on vitamin D from the sun that can boost skin barrier. Not enough sleep also hinders the chance of your child’s recovery. Also, too sterile homes can affect your child’s immunity. All of this is related to their gut health, which then affects their skin and immunity.For Indian babies, external care is also important. Moisturizing daily with coconut oil or unscented creams to strengthen the barrier. Use cotton clothes, avoid synthetic diapers if irritating. Opt for natural soaps, eco-friendly detergents, use air purifiers in polluted cities.It can be frustrating to see our little ones struggling with their skin. Small changes can make a big difference. From looking at what is in their surroundings to what we are feeding them, we can protect our kids' skin from the inside out.