Food allergy: skin contact with the allergen did not cause a dangerous reaction

For most parents, sending children to kindergarten or going to the playground is part of the daily routine. But for parents of children with food allergies, even such routine situations can be accompanied by real concern for the children's health. The allergen that endangers the child can be found almost everywhere: an egg in breakfast at kindergarten, sesame in a snack that another child is holding, or traces of milk in food scraps left on the table or playground equipment. In Israel, we have a particularly well-known example: Bamba, one of the most common and beloved snacks, contains peanuts, so parents of children with peanut allergies may find themselves constantly on edge.

A major difficulty is that ensuring the child's safety does not depend only on them; children's safety also requires awareness and consideration from the environment, both in educational settings and in public spaces. The article was originally published on the Davidson Institute of Science Education website.

Although it is known that most allergic reactions to food occur following its ingestion, Dr. Idit Lahover-Rot, director of the Allergy and Immunology Unit at Rambam Hospital, claims that "many families live in a state of constant tension out of fear that even accidental contact of the allergenic food with the skin could cause anaphylaxis." An anaphylactic reaction is an acute and severe allergic reaction that can deteriorate to the point of life-threatening. Without immediate treatment, anaphylactic shock can end in death.

New research: what happens upon skin contact?

A new Israeli study led by Dr. Lahover-Rot examined 182 children aged one to 18 with confirmed food allergies. It is important to note that children with a history of particularly severe allergic reactions, such as those requiring intensive care or multiple doses of epinephrine, were not included in the study.

During the experiment, researchers applied a small amount of the allergenic food to the forearm for 15 minutes. The findings showed that in almost 84 percent of the exposures, no reaction developed, while in about 15 percent of them, a mild local reaction developed on the skin. In only three cases (one percent) was the reaction more extensive, but even then it remained limited to the tested arm. None of the children developed symptoms in other body systems or an anaphylactic reaction.

Risk factors

The researchers found that the degree of risk depends on the individual characteristics of each child rather than the type of food. For example, children with a defect in the natural skin barrier or younger children were more prone to skin reactions. Interestingly, 55 children who had previously reported an allergic reaction following skin contact did not develop any reaction during the controlled exposure in the study.

"Our study shows that with exposure to intact skin, even in children with proven food allergies, the risk of this is extremely low, down to zero. The findings allow us to give families advice based on scientific evidence and reduce concerns that are not supported by data," says Dr. Lahover-Rot.

Important limitations

Despite the positive findings, researchers caution that the study does not show that skin contact with allergenic food can never cause a severe reaction. The researchers tested a small amount of food placed on a limited skin area for only 15 minutes. It is impossible to conclude from the results what will happen if the allergen comes into contact with a larger skin area, damaged skin, or mucous membranes such as the eyes or oral cavity.

Guidelines for families with allergic children remain unchanged: they must be aware of the danger, inform those around them, avoid eating the allergenic food, and carry an epinephrine syringe at all times.