Good news for parents of allergic children: Findings from a new Israeli study

Is it enough for a child with a food allergy to accidentally touch peanuts, milk, or an egg to develop a life-threatening allergic reaction? This is one of the most common fears among parents of allergic children. A new Israeli study, one of the largest of its kind, now provides an answer that may reduce some of the anxiety: among the children who participated in the study, accidental contact of an allergenic food with the skin did not cause a life-threatening systemic allergic reaction.

The study, recently published in the international journal Acta Paediatrica, was conducted at the Meir Medical Center and the Schneider Children's Medical Center (Clalit Group), led by Dr. Idit Lahover-Rot, currently the director of the Allergy and Clinical Immunology Unit at the Rambam Medical Center.

293 children participated in the study, 192 of whom had a proven food allergy. As part of the study, 263 exposure tests were performed, during which the skin of the forearm of the allergic children was exposed for 15 minutes to the food to which they were allergic, under medical supervision. Among the foods tested: cow's milk, eggs, peanuts, sesame, nuts, and almonds.

The findings were consistent: in 220 exposure tests (83.7%), no reaction was recorded. In 40 tests (15.2%), only a mild local reaction appeared, manifested by redness or swelling in the contact area. In three other cases (1.1%), a slightly more extensive skin reaction appeared, but it remained limited to the skin and passed after antihistamine treatment.

The most significant finding was that throughout the study, not a single case of anaphylaxis — an acute and life-threatening allergic reaction — was documented, and no systemic allergic reaction was recorded following skin contact.

The researchers found that young children were slightly more prone to developing a local skin reaction, and that milk allergy was associated with a slightly higher rate of skin reactions. However, even in these cases, no life-threatening reactions were documented.

"The fear is understandable, but it is important that it be based on facts," says Dr. Idit Lahover-Rot. "Many families live in a state of constant alertness out of fear that even accidental contact of the allergenic food with the skin could cause anaphylaxis. Our study shows that when exposed to healthy skin, even in children with a proven food allergy, the risk of a significant reaction is extremely low, to the point of being zero. The findings allow us to provide families with advice based on scientific evidence and to reduce concerns that are not supported by data."

Alongside the reassuring findings, the researchers emphasize that they do not change the accepted medical guidelines. Children with food allergies should continue to avoid eating the food to which they are allergic, carry an adrenaline syringe if necessary, and strictly adhere to preventing oral exposure.

It was also emphasized that the study examined contact of allergenic food with healthy skin only, and did not test situations of contact with injured skin or mucous membranes, where the risk may be different. According to Dr. Lahover-Rot, "The fear of accidental contact with allergenic food can harm the quality of life of children and their families. As long as the accepted medical guidelines are maintained, it is possible to reduce the level of anxiety regarding accidental contact with the food and rely on scientific evidence."