Skin cleaning with soaps and chemicals - so unnecessary! 

Clinical evidence suggests that around 35% of children with food allergies suffer from atopic dermatitis (eczema).

We are sold so many daily practices by marketing and advertising that are absolutely unnecessary. One of these practices is to use soap or cleanser on the skin which undeniably damages the cutaneous protective mechanisms such as the acid pH needed on the skin surface to ward off infective insults or the removal of skin oils that are there to ensure skin integrity. 

Soaps are simply a fat + an alkali and as such this alkaline component totally neutralises the pH of the skin or worse still, changes the acidic mantle to a much more alkaline pH that is not protective. The abrasive nature of wipes may also contribute to damaged skin and should never be used on skin affected by dermatitis or eczema. 

There is absolutely no need for any cleanser apart from water and a gentle sponge and perhaps not even the sponge or washcloth as these could potentially damage the skin as well if not used gently. Water is all you need unless you are a mechanic and need to get rid of grease and oil on the body. For the rest of us, using skin cleansers is not needed. 

The 'March of Allergies' - The Atopic March 

It is an interesting phenomenon where an individual with one allergy goes on to develop more and more allergies. The 'Atopic March' from Atopic Dermatitis (Eczema) to Allergic Rhinitis (nasal allergies) to Asthma is now well established from a multitude of cross-sectional and longitudinal studies². 

Damaged skin shows how easily this can happen. Once skin is compromised, it can set up the itch-scratch-itch cycle that traumatises the skin more and more and this trauma opens up cracks in the skin that are like the Grand Canyon to the microscopic allergens in the air (aeroallergens). 

The air is rich with particulate matter. It is not the clear air we perceive it to be. The next time you see a shard of light coming through a window, take the time to see the particles in the air especially after you put your clothes on or shake those socks of yours. You will be stunned to see these small flecks floating around and entering your airways where the larger particles get caught up in the upper airways and can be coughed up in phlegm but smaller particles can make it all the way down to the smaller airways to set up inflammatory processes. 

This burden of inflammation stemming from the lungs has now been implicated in many of the chronic diseases driven by inflammation, and this includes Cardiovascular Disease, Alzheimer's, Cancers and a recent finding has been the inflammatory process of asthma increases the fracture risk in male children. So inflammation does not just stay in the lungs, it has wide-reaching systemic effects. 

With damaged skin, this particulate matter will fall on the damaged skin and then absorbed into the subcutaneous tissues ultimately stimulating the immune system. It is not hard to see that damaged skin can promote a wide range of allergies¹ and contribute to the 'March of Allergies' seen in many individuals. 

It is not only particulate matter but what the parent may have on their hands while cleaning a baby's skin or changing a bottom. The hands may have handled nuts or seeds or have flour or egg albumin on them and if they handle the baby soon after cooking something the parent can deliver a multitude of food allergens to this damaged skin that can then be absorbed and presented to the immune system cells under the skin waiting to be activated by a foreign substance.

Washing the hands thoroughly is vital before touching a baby's skin if that skin is damaged and vulnerable. 

The take-home message 

Protect your baby's skin by not using soaps, baby wipes or bath gels. These notoriously worsen any allergic skin condition. It is important to remember any sheet or clothing you wash with detergent will also have detergent residue in the fabric. Avoid soaps and essentially, unless your sheets or pillowslips are that dirty, why do you even need a detergent. Simply wash clothes and linen in water with a long soak. 

Avoid skin moisturisers that are laced with Sodium Lauryl Sulphate, perfumes and colourings. Often a simple oil like coconut oil or olive oil may be all you need to moisten the skin. 

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References: 

1. Walker, M.T., Green, J.E., Ferrie, R.P., Queener, A.M., Kaplan, M.H. and Cook-Mills, J.M., 2018. Mechanism for initiation of food allergy: Dependence on skin barrier mutations and environmental allergen costimulation. Journal of Allergy and Clinical Immunology
2. Zheng, T., et al. (2011). "The atopic march: progression from atopic dermatitis to allergic rhinitis and asthma." Allergy, asthma & immunology research 3(2): 67-73.