TY - JOUR
T1 - Moisturizer therapy in prevention of atopic dermatitis and food allergy
T2 - To use or disuse?
AU - Katibi, Oludolapo Sherifat
AU - Cork, Michael John
AU - Flohr, Carsten
AU - Danby, Simon Geoffrey
N1 - Funding Information:
Disclosures: Professor Cork has been an investigator or consultant for the following organizations: Astellas, Atopix, Boots, Dermavant, Eli Lilly, Galapagos, Galderma, Harvey Water Softeners, Hyphens Pharma, Johnson & Johnson, Kymab, Leo Pharma, L'Oreal, Menlo, Novartis, Oxagen, Perrigo (ACO Nordic), Pfizer, Procter & Gamble, Reckitt Benckiser, Regeneron, Sanofi-Genzyme, and UCB Pharma. Professor Flohr is chief investigator of the UK National Institute for Health Research–funded TREAT (ISRCTN15837754) and SOFTER (ClinicalTrials.gov Identifier: NCT03270566) trials and the UK-Irish Atopic Eczema Systemic Therapy Register (A-STAR; ISRCTN11210918); is a principal investigator in the European Union Horizon 2020–funded BIOMAP Consortium ( http://www.biomap-imi.eu/); leads the EU Joint Program Initiative TRANS-FOODS consortium; and has received investigator-led funding from Sanofi-Genzyme for skin microbiome work through his department. Dr Danby has received research grants from, participated in advisory boards for, or has consulted with Almirall, Astellas Pharma, Bayer, Harvey Water Softeners, Hyphens Pharma, Leo Pharma, L'Oreal, Johnson & Johnson, Merck Sharp & Dohme, Perrigo, Pfizer, and Stiefel-GS. Dr Katibi declares no conflicts of interest to report. Funding: The authors have no funding sources to report.
Funding Information:
Disclosures: Professor Cork has been an investigator or consultant for the following organizations: Astellas, Atopix, Boots, Dermavant, Eli Lilly, Galapagos, Galderma, Harvey Water Softeners, Hyphens Pharma, Johnson & Johnson, Kymab, Leo Pharma, L'Oreal, Menlo, Novartis, Oxagen, Perrigo (ACO Nordic), Pfizer, Procter & Gamble, Reckitt Benckiser, Regeneron, Sanofi-Genzyme, and UCB Pharma. Professor Flohr is chief investigator of the UK National Institute for Health Research–funded TREAT (ISRCTN15837754) and SOFTER (ClinicalTrials.gov Identifier: NCT03270566) trials and the UK-Irish Atopic Eczema Systemic Therapy Register (A-STAR; ISRCTN11210918); is a principal investigator in the European Union Horizon 2020–funded BIOMAP Consortium ( http://www.biomap-imi.eu/ ); leads the EU Joint Program Initiative TRANS-FOODS consortium; and has received investigator-led funding from Sanofi-Genzyme for skin microbiome work through his department. Dr Danby has received research grants from, participated in advisory boards for, or has consulted with Almirall, Astellas Pharma, Bayer, Harvey Water Softeners, Hyphens Pharma, Leo Pharma, L'Oreal, Johnson & Johnson, Merck Sharp & Dohme, Perrigo, Pfizer, and Stiefel-GS. Dr Katibi declares no conflicts of interest to report.
Publisher Copyright:
© 2022 American College of Allergy, Asthma & Immunology
PY - 2022/5
Y1 - 2022/5
N2 - Objective: To critically appraise the evidence for the role of regular moisturizer application in early life to prevent atopic dermatitis (AD) and food allergy (FA). Data Sources: Primary peer-reviewed literature. Study Selections: Original research articles based on systematic reviews, interventional studies, retrospective studies, case-control studies, and cohort studies related to the subject matter. Results: There is good evidence to show that epicutaneous sensitization through a defective skin barrier is important in the development of AD and FA. This supports moisturizer use in prevention because some of them have been proven to restore skin barrier with clear benefits in AD, whereas there is some limited evidence that these products may reduce allergic sensitization. However, moisturizers have varied effects depending on ingredients and formulation, some of which are paradoxical, such as increasing transepidermal water loss and enhancing penetration of substances in the skin. These effects may be responsible for some of the conflicting outcomes of prevention studies, some of which suggest that moisturizers are not useful in prevention of AD and FA, whereas others show a positive trend. Interestingly, there is some suggestion that moisturizers may increase the risk for allergy development perhaps through these paradoxical effects. Conclusion: Although moisturizer use is beneficial in the management of AD, current evidence suggests that it may be ineffective in prevention of AD and FA. Further studies are needed to determine the effects of moisturization on allergic sensitization and inflammation and to investigate whether moisturizer type, frequency, duration, and age of application substantially affect the prevention and development of these allergies.
AB - Objective: To critically appraise the evidence for the role of regular moisturizer application in early life to prevent atopic dermatitis (AD) and food allergy (FA). Data Sources: Primary peer-reviewed literature. Study Selections: Original research articles based on systematic reviews, interventional studies, retrospective studies, case-control studies, and cohort studies related to the subject matter. Results: There is good evidence to show that epicutaneous sensitization through a defective skin barrier is important in the development of AD and FA. This supports moisturizer use in prevention because some of them have been proven to restore skin barrier with clear benefits in AD, whereas there is some limited evidence that these products may reduce allergic sensitization. However, moisturizers have varied effects depending on ingredients and formulation, some of which are paradoxical, such as increasing transepidermal water loss and enhancing penetration of substances in the skin. These effects may be responsible for some of the conflicting outcomes of prevention studies, some of which suggest that moisturizers are not useful in prevention of AD and FA, whereas others show a positive trend. Interestingly, there is some suggestion that moisturizers may increase the risk for allergy development perhaps through these paradoxical effects. Conclusion: Although moisturizer use is beneficial in the management of AD, current evidence suggests that it may be ineffective in prevention of AD and FA. Further studies are needed to determine the effects of moisturization on allergic sensitization and inflammation and to investigate whether moisturizer type, frequency, duration, and age of application substantially affect the prevention and development of these allergies.
UR - http://www.scopus.com/inward/record.url?scp=85127480522&partnerID=8YFLogxK
U2 - 10.1016/j.anai.2022.02.012
DO - 10.1016/j.anai.2022.02.012
M3 - Review article
C2 - 35235817
AN - SCOPUS:85127480522
SN - 1081-1206
VL - 128
SP - 512
EP - 525
JO - Annals of Allergy, Asthma and Immunology
JF - Annals of Allergy, Asthma and Immunology
IS - 5
ER -
