Protecting Our Skin to Help Prevent Food Allergies

Food allergies are a growing concern, especially among children, with conditions such as peanut, dairy and egg allergies becoming increasingly common. New research sheds light on the vital role our skin plays in protecting us from food allergies, and how a healthy skin barrier may even prevent them from developing.

The Skin Barrier and Its Role in Allergies

Our skin is our body’s largest organ and serves as a shield against environmental threats, allergens, and irritants. The outermost layer, known as the stratum corneum, is made up of essential proteins and lipids that keep moisture in and harmful substances out. This layer is particularly important for people with sensitive skin, as it plays a key role in protecting against allergens and irritants that can otherwise lead to immune responses and allergies.

Research shows that when the skin barrier is disrupted, as seen in conditions like eczema, it can allow allergens like food proteins to penetrate the skin. When proteins from allergenic foods—such as peanuts, milk, or eggs—pass through damaged skin, they may come into contact with immune cells, potentially leading to a process called sensitisation. Sensitisation is the immune system’s way of “remembering” a substance and reacting to it, which can eventually lead to allergic reactions.

Food Allergies and Eczema: What’s the Link?

Research suggests that children with eczema are at higher risk of developing food allergies, and this connection appears to be linked to skin barrier health. Eczema is a condition where the skin barrier is naturally compromised, leading to dryness, irritation, and inflammation. This weakened barrier allows environmental allergens and food proteins to penetrate the skin more easily, setting off immune responses that may contribute to allergies.

Protecting the Skin Barrier

Given these findings, many experts believe that supporting the skin barrier could help reduce the risk of the development of food allergies, particularly in children who may be more susceptible. There are simple steps parents can take to support their children with eczema at home:

Do:

1. Daily Baths: Give a daily bath in tepid (lukewarm) water for 10–15 minutes to remove bacteria, irritants, and allergens from the skin.
2. Use a Soap Substitute: Choose a non-soap cleanser or cream to wash the skin instead of bubble baths or standard soaps. Apply this to the skin and then rinse off with water. Ask your child’s healthcare professional for advice on which products to use.
3. Pat Dry: After bathing, gently pat the skin dry with a towel rather than rubbing.
4. Moisturise Generously: Use about 250 grams of a clinically proven eczema lotion, cream or ointment per week for young children and 500 grams for older children.
5. Apply Correctly: Smooth a thick layer of moisturiser in downward strokes, following the direction of hair growth.
6. Adjust Moisturiser Based on Season: Use thicker ointments in winter for more moisture retention and lighter creams in summer.
7. Patch Test: Test a new cream on a small area first to check for irritation before applying it all over.
8. Use Clean Application Methods: Take moisturiser out of pots with a clean tool or squeeze from a tube to prevent contamination, and always wash your hands before applying.

Don’t:

1. Avoid Hot Water: Don’t use hot water for baths, as it can worsen itching and irritation.
2. No Bubble Baths or Soaps: Avoid bubble baths and standard soaps that can irritate the skin.
3. Don’t Rub Moisturiser In: Avoid rubbing the moisturiser into the skin, as this can cause irritation. Use smooth, gentle strokes.
4. Avoid Fragranced Creams: Fragrances can irritate sensitive skin, so choose fragrance-free moisturisers.
5. Don’t Dip Hands into Cream Pots: Dipping hands into pots can introduce bacteria. Use clean utensils or squeeze tubes instead.
6. Don’t Overuse Lotions with Preservatives: Lotions often contain preservatives and can be more irritating than ointments, so select suitable products carefully. Speak to your child’s healthcare professional for advice.
7. Avoid Untested Creams on Large Areas: Always perform a patch test to avoid potential widespread irritation.

Could This Approach Really Prevent Food Allergies?

While there is no guaranteed way to prevent food allergies, focusing on skin barrier health presents a promising, low-risk approach. Recent studies suggest that children with healthy skin barriers are less likely to develop food allergies, even if they are exposed to allergens through other routes, like the digestive system. Supporting skin health may therefore help reduce the risk of sensitisation to food proteins, providing an additional layer of protection alongside current dietary guidelines.

Although more research is needed, these insights highlight the importance of skin care in preventing allergies and suggest that it may be beneficial for parents to incorporate these habits early on.

For children with a family history of eczema or allergies, early consultation with a healthcare provider can be beneficial. Healthcare professionals can offer advice on skin care routines and the best products for sensitive skin, reducing the likelihood of skin-related sensitisation.

To read the full report visit: https://doi.org/10.1016/j.anai.2023.12.030.