Frequent moisturization of infants and the development of food allergies

Published: March 1, 2021

Some evidence suggests that food allergy may develop from sensitization to foods through skin contact, especially in the presence of an impaired skin barrier as with eczema.

In this issue of The Journal of Allergy and Clinical Immunology (JACI), Perkin et al used data from the Enquiring About Tolerance (EAT) Study, a population-based randomized clinical trial that recruited 1303 exclusively breastfed 3-month-old infants and their families from England and Wales. At enrollment at 3 months of age, families completed a questionnaire that included questions about the frequency and type of moisturizer applied. Participants were followed up to three years of age and the primary outcome of the original EAT study was the development of food allergy to one or more of the six early introduction foods. Perkin et al tested the hypothesis that regular moisturizer application to infant skin at three months of age might promote sensitization via the skin leading to development of food allergy.

The application of moisturizers to infants at 3 months of age was associated with subsequent food allergy in a dose-response relationship, both in infants with and without eczema at enrollment. Dose-response relationships were also seen with the development of sensitization to both food and airborne allergens.

Frequent skin moisturization in early life might promote the development of food allergy, most likely through sensitization developing via the skin. Moisturization might be facilitating passage of food allergens across the skin barrier or some moisturizers might be damaging the skin barrier and allowing the passage of food allergen, or potentially both might be occurring. The authors recommend that parents wash their hands before moisturizing their babies as a precautionary measure.

The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.

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