Challenges and Insights in Preventing Food Allergies through Skin Barrier Interventions

Early introduction of food allergens in infants has been effective in preventing food allergies (FA), yet its real-world application faces several challenges. Recent interventions have focused on addressing skin barrier dysfunction as a strategy to prevent allergic sensitization and subsequent FA development. Research into the use of emollients from birth has produced mixed results, with meta-analyses indicating either minimal or no significant impact on FA prevention.

A closer examination of clinical trials reveals variability in the types of emollients used, which may account for these inconsistent findings. Additionally, the protocols for applying emollients differed widely among studies. Although definitive conclusions about their overall effectiveness in preventing FA remain elusive, existing data highlight certain characteristics linked to more successful outcomes.

Notably, effective trials often employed emollients with an acidic pH of 5.5, applied comprehensively to the body, and used in conjunction with topical corticosteroids on affected areas. Establishing a consensus on the best methods to restore skin barrier function could enhance the consistency and clinical applicability of future studies. Until such consensus is reached, clinicians are advised to avoid using products that have been associated with poorer outcomes in the context of FA prevention.

Source: Braun C, Coutier L, Bégin P, Nosbaum A. Skin-centered strategies in food allergy prevention. Pediatr Allergy Immunol. 2024 May;35(5):e14130. doi: 10.1111/pai.14130. PMID: 38693814.

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