Can excessive washing really be regarded as the major cause of atopic dermatitis?

The Hygiene Theory of Acquired Immunity and Chronic Periodontitis

“…They argued that removal of the skin barrier results in the direct access of allergens to the resident skin Langerhans cells that then migrate to the regional lymph nodes and stimulate a Th2 response. However, this concept has been challenged 12 in as much as antigen presentation by skin dendritic cells may result in anergy rather than sensitization. Whether this is true for Langerhans cells remains to be determined.…”