The atopic march refers to the natural history of atopic diseases. They include eczema (or atopic dermatitis), food allergies, allergic rhinitis (or hay fever), and asthma. There is a typical progression when you look at the prevalence of these diseases over time in a large population. (Photo from reference 4.) In genetically predisposed infants, usually eczema is the first manifestation of allergic diseases. Food allergies may also be present. Both peak by age 2 years of age and then fall off. Respiratory diseases rise and persist. 2/3 of patients with atopic dermatitis develop allergic rhinitis later in life. 1/2 of patients with atopic dermatitis develop asthma later in life. The stronger the family history of allergic diseases, particularly in the parents and grandparents, the greater likelihood one of their offspring will be affected. It's chance. The stronger one parent is affected by allergic diseases, any or all of atopic dermatitis, food allergies, allergic rhinitis, and asthma, the greater chance that each offspring will be affected similarly. Finally, to see yours or your child's future, look into the crystal ball, our own parents and grandparents health. If they have had severe or lifelong allergies and the same allergic genes have been passed on, the odds favor history repeating itself. If you can forsee this happening to yourself or your children, take preventative action now!!! Do whatever you can to reduce your or your children's allergic reactions. Consider avoidance and allergen immunotherapy. Regretably, at this point in time, medications have not been shown to alter the natural history of allergic diseases. Medications can very effectively minimize the signs and symptoms, but the underlying fire of atopy still burns on.