The Pharmaceutical Journal
Vol 270 No 7241 p391
22 March 2003

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Peanut allergy research is published

Researchers claiming that children's peanut allergy can be caused by peanut oil-based skin creams and soya milk have had their findings published in The New England Journal of Medicine (2003;348:977).

Presenting their early findings two years ago, Professor Jean Golding, Bristol University, warned parents not to use topical preparations containing arachis (peanut) oil on infants (PJ, 9 June 2001, p773).

The published data show that children who suffered rashes over joints and skin creases had more than a two-fold increased risk of peanut allergy. For those whose rashes were oozing or crusting, the odds ratio increased to over 5.

Interviews with parents revealed that almost all of 23 children with confirmed peanut allergy in the study were exposed to creams containing peanut oil in their first six months of life. Overall, these preparations increased the risk of allergy seven times.

Lead researcher Dr Gideon Lack, St Mary's Hospital, London, explained that, in eczema, there is an abundance of immune cells in the skin that could be exposed to substances that cause allergies. The worse the condition, the more likely the allergy, indicating that exposure through inflamed skin is a cause of sensitisation.

But the links were not confined to topical products. Intake of soya milk or soya formula also increased the risk of allergy — by a factor of 2.6. The authors suggest that cross sensitisation may be to blame. The authors also propose that continual exposure through the skin may perpetuate allergy and explain why children are less likely to lose allergy to peanuts than other food.

Their study is part of a larger ongoing project, the Avon Longitudinal Study of Parents and Children involving some 14,000 preschool children. It was designed to find out how environmental and genetic factors might interact to cause health, behavioural or developmental problems.

Peter Lapsley, chief executive of the Skin Care Campaign, urged parents not to stop treating their eczematous children with moisturisers and emollients as it may lead to a deterioration in their condition. "If they are worried, they should speak first with their GP or specialist," he said.

"As far as we can ascertain, none of the emollients and few other products available for GPs to prescribe contain peanut oil. However, parents may like to be cautious of products where ingredients are not listed. Additionally, it is important to put this study into perspective. While the findings are interesting, this is an epidemiological study looking at population trends. It does not prove a clinical link between peanut oil in skin products and allergy in later life. Our recommendation is that parents should avoid using products containing peanut oil, but that they should not worry too much about what has been used historically other than to watch for signs of a reaction to peanuts," Mr Lapsley advised.

Topical products containing peanut oil include Polytar preparations, Hewletts Cream, Zinc Cream, Zinc and Castor Oil Ointment BP, Siopel barrier cream, Calamine oily lotion and Dermovate NN.

Mr Lapsely warned that some baby massage oils may also contain peanut oil.