PubMed · 15724355
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Curtis P Hamann. 2004. Interpret moisture studies with care.. https://doi.org/10.2310/6620.2004.04019
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Moisturizers are empirically used as prevention and treatment of surfactant and irritant dermatitis. Some products state they not only improve barrier function by providing moisturization but also create an environment optimal for healing. Yet, moisturizer clinical efficacy remains a topic of controversy. We reviewed publication from 1992 to 2006 that quantitatively examines moisturizer effectiveness, as an update of our prior overview, Zhai and Maibach in 1998 (2). We intuitively (in a testimonial sense) believe that moisturizers are sometimes effective for preventing and treating irritant dermatitis. However, moisturizer may not be broadly effective (8, 12) and may be relatively specific against certain acids, bases, hydrophilics, and lipophilics. We need to develop principles of what is formulated in moisturizers to improve efficacy; for this purpose, there is a need for experimental moisturizer models for comparative studies.
BACKGROUND: Several instrumental methods can indirectly assess some specific aspects of cutaneous irritation at the level of the stratum corneum (SC). OBJECTIVE: There is a need for developing more sensitive approaches in this field. METHODS: We assessed a recently introduced innovative tool (SkinChip) based on capacitive pixel-sensing technology in its potential to detect early discrete manifestations of skin irritation. The sensor generates a detailed non-optical picture corresponding to a capacitance map of the skin surface reaching 50 microm pixel resolution. Some topographical details can be easily disclosed and the SC hydration as well. Two surfactant solutions were tested on volunteers. These solutions were applied under test patches for 2 days on the volar forearms. Clinical and SkinChip assessments were performed 3 h after removing the patch. RESULTS: The generated images allowed a precise observation of skin irritation which appeared as a two-step process. Early changes consisted of darker pixels corresponding to overhydrated swollen corneocytes at the irritated sites. Two days later, the same area appeared as white pixels, indicating the loss of corneocyte hydration. CONCLUSION: The SkinChip device appears to be a very sensitive tool for detecting the early steps of surfactant-induced skin irritation affecting the SC.
Wet work is the main cause of occupational contact dermatitis in the cleaning industry. Dermatologists and occupational physicians need to base their primary and secondary prevention for workers in the cleaning industry on the characteristics of wet work exposures. We quantified the burden of wet work in professional office cleaning activities with a continuous standardized observation by trained observers of 41 office cleaners. Duration and frequency of wet work exposure and of different cleaning activities were assessed. Wet work made up 50% of such cleaning work. Within a typical 3-hr shift, a mean frequency of 68 episodes of wet work was observed, which classifies office cleaning as wet work. Skin exposure to irritants was markedly different among cleaners who did the same cleaning activities. Reduction in skin irritation can be achieved by training the workers. Because this group of workers, who have a low level of education, has a high risk of developing irritant hand dermatitis, a special effort on training and instruction should be made. A reduction of exposure can be achieved by: using gloves more often; using gloves for a shorter period of time; using gloves while doing activities that otherwise cause the skin to be in contact with water and cleaning substances and washing hands with water only, reserving soap for when the hands are visibly dirty.