A new study by researchers from St. George’s, University of London, supports the “notion that regular application” of moisturizers to young infants’ skin could contribute to the onset of food allergies later in life through a process known as transcutaneous sensitization.
The team, led by Dr. Michael Richard Perkin, MBBS, PhD, tested their hypothesis by evaluating data from the Enquiring About Tolerance (EAT) study, a randomized clinical trial that encompassed 1303 “exclusively breastfed 3-month-old infants and their families.”
Their data was published in The Journal of Allergy and Clinical Immunology under the title, “Association of frequent moisturizer use in early infancy with the development of food allergy.”
According to the scientists, food allergy, an important public health problem, “is thought to develop through transcutaneous sensitization,” a process by which the immune system is exposed and sensitized to antigens within food at the level of the skin, “especially in the presence of skin barrier impairment and inflammation.”
According to their research, the use of moisturizers could be of relevance to this form of food allergy sensitization.
While the sensitization of the immune system to food allergens was classically thought to occur through the gastrointestinal tract, recent years have led to the analysis of other sites, particularly the skin, as important to the pathogenesis and onset of food allergies.
In the EAT study, families provided information regarding the “frequency and type of moisturizer applied,” whether corticosteroid creams were used, and whether the infant had dry skin or eczema at the time of 3 months enrollment, when infants were also assessed “for visible eczema” by the attending professional.
Based on their analysis of data from the EAT study, the scientists noted a “statistically significant dose-response relationship” between food allergy development and “parent-reported moisturization frequency at 3 months of age,” such that “each additional moisturization per week was associated with an ORadj [(adjusted odds ratio) of] 1.20(95% CI 1.13-591.27), p<0.0005 for developing food allergy.”
Infants with visible eczema recorded at the time of enrollment had a corresponding adjusted odds ratio of 1.20 (95% CI 1.11-1.31), p<0.0005 while that of those without visible eczema was 1.18 (95% CI 1.07-1.30), p=0.001. The frequency of moisturization “showed similar dose-response relationships” with food and aeroallergen sensitization by the age of 3.
The scientists concluded that “these findings support the notion that regular application of moisturizers to the skin of young infants may promote the development of food allergy through transcutaneous sensitization” and that “frequent skin moisturization in early life might promote the development of food allergy, most likely through transcutaneous sensitization.”
However, keep in mind that correlation does not imply causation. Further studies evaluating a potential causative relationship between moisturizer use and food allergy onset are warranted.
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