Alex Gazzola looks at why those with eczema and broken skin — especially with a history of atopy or food allergies — may need to take a closer look at their skincare routine.
A new case study described in an article published in The American Academy of Allergy, Asthma and Immunology (AAAAI) from The Journal of Allergy and Clinical Immunology has once again highlighted a truth which is uncomfortable to many of us working in the natural and ‘free from’ skincare community — food proteins in cosmetic products can sensitise atopic individuals and subsequently trigger food allergies.
The case study describes a woman of 55 who experienced severe, first-time anaphylaxis after consuming goats cheese — after several weeks of applying a moisturiser containing goats milk to her eczematous skin, which she had ceased using several months earlier, after having developed redness and rash.
She had no previous history of any kind of adverse reaction to goats’ products.
It is certainly not the first such case — as we have previously reported on a very similar story, several years ago. That time, it was a goats’ milk soap that was the culprit.
Several examples with other food allergens exist in the scientific literature, including a number of curious cases of Japanese women becoming sensitised to wheat via face soaps containing hydrolyzed wheat proteins, suffering to such an extent that some experienced wheat-dependent exercise-induced anaphylaxis (WDEIA).
Furthermore, it has long been speculated that children, especially, may become sensitised to nuts and peanuts through the skin, the evidence for which is well summarised by the Anaphylaxis Campaign here.
“Many creams are currently advertised as ‘natural’ products for the treatment of dry skin or eczema, but they contain a variety of ingredients that may include foodstuffs,” the authors of the most recent case report, Astrid Voskamp, MSc, and Robyn E. O’Hehir, FRACP, PhD, explained.
Animal milks, grains such as oats, and nut oils, are all common ingredients in natural cosmetic products, but the researchers point out that application of these moisturisers to damaged skin could cause food allergen sensitization, leading to severe reactions when the food is subsequently eaten.
“While others have speculated on the association between cutaneous sensitization and development of clinical allergy, our report is the first to demonstrate both clinical and immunological evidence for sensitization to a foodstuff in a patient, through cutaneous use of a moisturizer for the treatment of eczema,” Voskamp said.
At Skins Matter, we are well aware that many of those with food allergies or other food-related sensitivities look for skincare products or ranges which are free from their trigger foods. But do they need to be even more careful — and avoid all potential food allergens, even those to which they are not sensitised, in order to prevent the potential threat of developing additional dietary allergies?
The researchers advised clinicians and patients that skincare ought to be bland, advocating avoidance of agents capable of sensitization — especially foods. This would seem to be particularly important for eczema patients, other atopic individuals, and certainly with respect to applying products on broken skin.
As ingredients are often — and quite correctly — given in Latin on cosmetics, and not always with an English ‘translation’, the FreeFrom Skincare page on my Allergy Insight site may help you identify food allergens — if you consider that you may need to look out for potentially problematic ingredients that lurk in your bathroom cabinet …