Preventing allergies through the skin

To inform readers of the current and forthcoming skin barrier interventions that have clinically relevant implications in the prevention of allergic sensitization and atopic diseases.

Peer-reviewed journal articles indexed on PubMed and clinical trials referenced on clinicaltrials.gov were analyzed.

Literature searches from PubMed and clinicaltrials.gov were performed using combinations of the following search terms: prevention, allergy, atopy, skin, cutaneous, microbiome, microbiota, Staphylococcus aureus, atopic dermatitis, eczema, food allergy, and asthma.

The skin barrier represents an entry point for allergic sensitization and T_H2-mediated allergic disorders. Results from clinical trials designed to improve microbiome complexity and reduce S aureus colonization, provide skin barrier enhancement, and deliver epicutaneous immunotherapy are summarized and discussed in the context of primary, secondary, and tertiary prevention of allergic disease.

The skin barrier is a promising target for prevention of allergic disease, though clinical trial results thus far have been mixed, at best.