DOCSLIB.ORG

46 Barrier Creams

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
46 Barrier Creams 435 46 Barrier Creams Hongbo Zhai, Howard I. Maibach Contents BCs are also called skin protective creams (SPCs) or protective creams (PCs), as well as protective oint- 46.1 Introduction . 435 ments, invisible glove, barrier, protective or prework 46.2 Definition and Terms . 435 creams and/or gels (lotions), antisolvent gels, and so 46.3 Reasons for Using Barrier Creams . 435 on [1, 9, 18–20]. Frosch et al. [1] consider “skin pro- 46.4 Mechanism of Action and Duration . 436 tective creams” a more appropriate term, since most 46.5 Application Methods and Efficacy . 436 creams do not provide a real barrier, at least not com- 46.6 US Food and Drug Administration parable to stratum corneum. BCs may share charac- Monograph Skin Protectants . 436 46.7 Conclusion . 436 teristics with moisturizers. The target of BCs is in the References . 437 prevention of external noxious substances penetrat- ing the skin, and moisturizers are frequently used for dry skin conditions as well as to maintain healthy skin [21]. 46.1 Introduction Many occupations, such as farmers, forest firefighters, 46.3 Reasons for outdoor workers, hospital workers, and even house- Using Barrier Creams wives may encounter various potential irritants or al- lergens (e.g.,, detergents and poison oak or ivy). Due Occupational contact dermatitis is the most common to exposure to these annoying substances, skin bar- work-related injury involving millions of workers rier function may be damaged. Consequently, irritant worldwide. Avoidance of these irritants or allergens contact dermatitis (ICD) and allergic contact derma- may not be practical for persons whose occupation titis (ACD) may develop. In order to reduce the risk or activities mandate their working in certain envi- of developing ICD and ACD, prophylactic measures ronments. Certain gloves provide protective effects are indicated. Application of barrier creams (BCs) be- for corrosive agents (acids, alkalis, etc.) [4, 22–24]. fore or during work may play an important role in the Protective clothing as well as other personal devices prevention of occupational contact dermatitis. also play a critical role as an important measure in Their efficacy has been widely investigated by industries [25, 26]. However, protective clothing may in vitro and in vivo studies [1–7]. However, their trap moisture and occlude potentially damaging sub- actual benefit remains sub judis in clinical trials stances next to the skin for prolonged periods and [1, 2, 4, 8–14]. Some reports indicate that the inap- increase the likelihood that dermatitis will develop propriate BC application may exacerbate rather than [25, 26]. In practice, BCs are recommended only for ameliorate effects [1, 2, 8–12, 15, 16]. low-grade irritants (water, detergents, organic sol- vents, cutting oils) [4, 10, 16]. The first line of defense against hand eczema is to wear gloves, but in many 46.2 Definition and Terms professions it is impossible to wear gloves because of the loss of dexterity. In some instances, an alternative BCs are designed to prevent or reduce the penetra- would be to utilize BCs. They are also used to pro- tion and absorption of various hazardous materials tect the face and neck against chemical and resinous into the skin, preventing skin lesions and/or other dust and vapors [27]. Many prefer to use BCs rather toxic effects from dermal exposure [1–3, 16, 17]. than gloves because they do not want the hand con- 436 Hongbo Zhai, Howard I. Maibach tinuously sealed inside a glove, which can inhibit skin In vivo and in vitro methods have been developed barrier function [4]. In addition, many gloves do not to evaluate the efficacy of BCs. Recently, Frosch et al. resist the penetration of low-molecular-weight chem- have extensively reviewed their efficacy [1–3, 5–7]. icals. Some allergens are soluble in rubber gloves and may penetrate the gloves and produce severe derma- titis [4, 25, 28]. Allergy to rubber latex has become a 46.6 US Food and Drug growing problem [4, 28]. Furthermore, due to con- Administration Monograph tinuous glove wearing, workers can develop serious Skin Protectants symptoms as part of the contact urticaria syndrome, including generalized urticaria, conjunctivitis, rhi- The US Food and Drug Administration (FDA) identi- nitis, and asthma, etc. [4, 29] (see Chap. 7 “Contact fied 13 skin protectants for over-the-counter (OTC) Urticaria” for further details). products [36]. These ingredients and concentrations are listed in Table 1. In addition, an OTC lotion (containing quater- 46.4 Mechanism of nium-18 bentonite) against poison ivy, oak, or sumac Action and Duration has been approved by the FDA. There is minimal information on barrier creams’ Table 1. US Food and Drug Administration identified 13 skin mechanisms of action. The frequently quoted general protectants and their concentrations rule is that water in oil (W/O) emulsions are effective Ingredients Concentrations against aqueous solutions of irritants and oil in water (O/W) emulsions are effective against lipophilic ma- terials [1, 2, 25 26]; some studies have demonstrated Allantoin 0.5%–2% exceptions [11, 30]. BCs may contain active ingredi- Aluminum hydroxide gel 0.15%–5% ents that are presumed to work by trapping or trans- Calamine 1%–25% forming allergens or irritants [2, 30]. Most believe Cocoa butter 50%–100% they interfere with absorption and penetration of the allergen or irritants by physical blocking – forming a Dimethicone 1%–30% thin film that protects the skin [2, 17, 30, 31]. Glycerin 20%–45% In order to avoid frequent interruptions for reap- Kaolin 4%–20% plication, BCs are expected to remain effective for Petrolatum 30%–100% 3–4 h. Most manufacturers claim that their products last around 4 h. Others recommend use “as often as Shark liver oil 3% necessary” [26]. Several studies document duration White petrolatum 30%–100% of action – with varying results [16, 22, 32, 33]. Zinc acetate 0.1%–2% Zinc carbonate 0.2%–2% 46.5 Application Methods Zinc oxide 1%–25% and Efficacy 46.7 Conclusion The effectiveness of BCs may be influenced by appli- cation methods [34, 35]. A study has been conducted The efficacy of BCs in preventing or reducing ICD to determine which areas of the hands were likely to and ACD has been well documented in many ex- be skipped on self-application of a BC using a fluores- perimental environments. Obviously, BCs may in- cence technique at the workplace [35]. Results showed hibit low-grade irritants, but should not be used as the application of BCs was incomplete, especially on a primary protection against high-risk substances or the dorsal aspects of the hands. Most manufacturers corrosive agents. However, inappropriate BC appli- suggest rubbing thoroughly onto the skin, paying spe- cation may exacerbate irritation rather than provide cial attention to cuticles and skin under nails, letting benefit. In particular, using BCs on diseased skin may the cream dry for approximately 5 min, applying a lead to increased skin irritation [2, 25]. People utiliz- thin layer of BC to all appropriate skin surfaces three ing water, soaps, and detergents daily may benefit by to four 4 times daily. We believe these suggestions are applying BCs frequently. Furthermore, BCs may also important for BC efficacy. shield skin from chemicals, oils, and other substances 46 Barrier Creams 437 and to make them easier to clean at the end of the 10. Frosch PJ, Schulze-Dirks A, Hoffmann M, Axthelm I, workday [26]. To achieve optimal protective effects, Kurte A. Efficacy of skin barrier creams. (I). The repetitive BCs should be used with careful consideration of irritation test (RIT) in the guinea pig. Contact Dermatitis the types of substances they are designed to protect 1993; 28:94–100 against based on specific exposure conditions; also, 11. Frosch PJ, Schulze-Dirks A, Hoffmann M, Axthelm I. Ef- the proper use of BCs should be taught [35, 37]. ficacy of skin barrier creams. (II). Ineffectiveness of a The ideal BCs should be nontoxic, noncomedo- popular “skin protector” against various irritants in the re- genic, nonirritating, nongreasy, and colorless. They petitive irritation test in the guinea pig. Contact Dermatitis should be highly efficacious, but not interfere with 1993; 29:74–77 user’s manual dexterity or sensitivity. They should 12. Frosch PJ, Kurte A, Pilz B. Efficacy of skin barrier creams. be easy to apply and remove, cosmetically acceptable, (III). The repetitive irritation test (RIT) in humans. Con- tact Dermatitis 1993; 29:113–118 and economical. They may be combined with cos- 13. Goh CL, Gan SL. Efficacies of a barrier cream and an af- metic benefits, and contain a high proportion of fatty terwork emollient cream against cutting fluid dermatitis materials (lipids) and can, therefore, also be used for in metalworkers: a prospective study. Contact Dermatitis skin care, specially for rough, dry, or chapped skin. 1994; 31:176–180 Furthermore, the mechanisms of BCs’ action should 14. Treffel P, Gabard B. Bioengineering measurements of bar- be further investigated when evaluating their efficacy. rier creams efficacy against toluene and NaOH in an in vivo single irritation test. Skin Res Technol 1996; 2:83–87 15. Treffel P, Gabard B, Juch R. Evaluation of barrier creams: References an in vitro technique on human skin. Acta Derm Venereol 1994; 74:7–11 1. Frosch PJ, Kurte A, Pilz B. Biophysical techniques for the 16. Zhai H, Maibach HI. Effect of barrier creams: human skin evaluation of skin protective creams. In: Frosch PJ, Klig- in vivo. Contact Dermatitis 1996; 35:92–96 man AM (eds) Noninvasive methods for the quantification 17. Orchard S. Barrier creams. Dermatol Clin 1984; 2:619– of skin functions. Springer, Berlin Heidelberg New York, 629 1993; pp 214–222 18. Guillemin M, Murset JC, Lob M, Riquez J.
Load more

Recommended publications
  • First Prescription Barrier Protection for Hand Eczema/ Dermatitis Improves Appearance and Provides Relief Joseph Bikowski, MD
    CROSMETICEVIEW TECHNIQUE First Prescription Barrier Protection for Hand Eczema/ Dermatitis Improves Appearance and Provides Relief Joseph Bikowski, MD Hand eczema/dermatitis is a widespread disorder that is often difficult to treat and may be debilitating because of its effects on personal appearance and physical health. Direct costs associated with occupa- tional contact dermatitis in the United States have been estimated at more than $1 billion. Tetrix Cream, the first prescription protectant for these disorders, enhances treatment and prevention with an innova- tive barrier protection cream that is water resistant, long lasting, nongreasy and nonirritating, and also reduces itchingCOS and burning. DERM and eczema, sometimes called hand eczema/dermatitis includes occupational, contact, and eczema/dermatitis, involves an inflamma- atopic dermatitis, as well as dyshidrosiform eczema. Dotory response of theNot skin, with distinctive Though Copy it is difficult to establish the precise prevalence features affecting both personal appear- of hand eczema/dermatitis, it is estimated to affect between ance and physical health. Often beginning 2% and 10% of the general population, with 20% to 35% withH minimal signs and symptoms, such as mild scaling of all cases of dermatoses involving the hands.1 and itching, more severe findings include intense itch, Economically, figures from 2004 indicate that the direct erythema, fissures, crusting, papules, edema, and vesicles. costs associated with occupational contact dermatitis in Caused by various endogenous or exogenous factors, hand the United States were approximately $1.6 billion, of which $870 million were attributed to physician and Dr. Bikowski is Clinical Assistant Professor of Dermatology, Ohio clinical services and $747 million to prescription drugs.
    [Show full text]
  • Occupational Skin Disease
    WHAT WE’VE LEARNED ABOUT... Occupational Skin Disease A lay-language research synthesis from the Centre for Research Expertise in Occupational Disease (CREOD) 2015 update www.creod.on.ca Background What is Contact Dermatitis? Contact dermatitis is a skin reaction that looks like a rash or burn. It can be itchy or painful. It’s caused by exposure to an irritant (irritant contact dermatitis) or an allergen (allergic contact dermatitis). First symptoms may appear a day or two after first exposure, or after years of using an irritant or allergen on a regular basis. What is work-related contact dermatitis (WRCD)? Work-related contact dermatitis (WRCD) is dermatitis that’s caused by exposure to an irritant or allergen at work. WRCD is common, especially among people involved in wet work. Dishwashers, cleaners, mechanics, hairdressers and people who work in health care are particularly vulnerable to irritant WRCD. People who work with allergens like resins, rubber chemicals, metals and biocides are vulnerable to allergic WRCD. How well do we understand WRCD? While much is known about WRCD, there is still more to learn about its prevention, its treatment, and how to help workers with WRCD continue or go back to work. Several recent reviews – including an initial systematic review by our group in 2005 – have focused on WRCD prevention. Another focused on WRCD prevention, diagnosis and management. These reviews have all noted the limited amount of available evidence. However, some excellent references do exist, including the book “Controlling Skin Exposure to Chemicals and Wet-Work” by Rajadurai Sithamparanadaraj. GENERAL REFERENCES: Saary JM, Qureshi R, Palda V, et al.
    [Show full text]
  • Skin Barrier Protection
    Dermatology Research and Practice Skin Barrier Protection Guest Editors: Georgios N. Stamatas, Alex Zvulunov, Paul Horowitz, and Gary L. Grove Skin Barrier Protection Dermatology Research and Practice Skin Barrier Protection Guest Editors: Georgios N. Stamatas, Alex Zvulunov, Paul Horowitz, and Gary L. Grove Copyright © 2012 Hindawi Publishing Corporation. All rights reserved. This is a special issue published in “Dermatology Research and Practice.” All articles are open access articles distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Editorial Board Dietrich Abeck, Germany Jane M. Grant-Kels, USA Jean Revuz, France Christoph Abels, Germany Joan Guitart, USA J. Ring, Germany Giuseppe Argenziano, Italy Takashi Hashimoto, Japan Gavin P. Robertson, USA Jorge Arrese, Belgium Jana Hercogova,´ Czech Republic Franco Rongioletti, Italy Khusru Asadullah, Germany H. Honigsmann, Austria Stefano Rosso, Italy Robert Baran, France Drazenˇ Jukic,´ USA Toshiaki Saida, Japan W. F. Bergfeld, USA Jean C. Kanitakis, France Mario Santinami, Italy BrunoA.Bernard,France D. V. Kazakov, Czech Republic Tadamichi Shimizu, Japan Jag Bhawan, USA Lajos Kemeny, Hungary Giuseppe Stinco, Italy Craig G. Burkhart, USA Elizabeth Helen Kemp, UK Markus Stucker, Germany Eung-Ho Choi, Republic of Korea Kaoru Kiguchi, USA D. J. Tobin, UK Enno Christophers, Germany Yasuo Kitajima, Japan Franz Trautinger, Austria Clay Cockerell, USA Rossitza Lazova, USA Uwe Trefzer, Germany I. Kelman Cohen, USA Philip E. LeBoit, USA Helgi Valdimarsson, Iceland Philip J. Cooper, UK Jan A. Marcusson, Norway Vladimir Vincek, USA Jonathan L. Curry, USA Ashfaq A. Marghoob, USA Janine Wechsler, France Vincent J.
    [Show full text]
  • Diaper Dermatitis
    AP: Thank you for joining us on our podcast on Diaper Dermatitis. My name is Annie Poon, I am a third-year medical student at the University of Alberta. I am joined by Dr. Jessica Foulds, a pediatrician here at the U of A. 1 JF: Hi everyone! Before we begin, let’s outline some objectives of this podcast. By the end of this podcast listeners will be able to: Distinguish the term diaper dermatitis from the underlying cause Compare and contrast 3 common causes of diaper dermatitis Identify key questions to ask on the history about a skin condition Counsel caregivers on treatment of irritant dermatitis This podcast will include descriptions of rashes. If you are less familiar with the terminology to describe rash morphology, there is a great PedsCases podcast on Approach to Pediatric Rashes which you might want to listen to first! 2 Let’s start with a case here: You are in a community pediatrician’s office and are seeing 6-month-old girl in follow-up named Allie with complaints of a “diaper rash.” First of all – let’s think aBout our approach to this issue: it’s a common complaint! If the parents are concerned aBout a diaper rash, are we done? Do we have the diagnosis? 3 AP: Well, diaper rash or Diaper dermatitis is just an all-encompassing term for rashes that appear in the diaper area. It is not a diagnosis, only an umbrella term for a sign. 4 JF: Absolutely! So, thinking about the different types of diaper rashes you know or have read about, how would you distinguish them? AP: I like to think of it as rashes caused by the diaper, rashes worsened by the diaper, and those completely independent of the diaper.
    [Show full text]
  • Irritant Contact Dermatitis
    erimenta xp l D E e r & m l a a t c o i l n o i Journal of Clinical & Experimental l g y C f R o e l ISSN: 2155-9554 s a e n a r r u Eberting, J Clin Exp Dermatol Res 2014, 5:6 c o h J Dermatology Research DOI: 10.4172/2155-9554.1000246 Research Article Open Access Irritant Contact Dermatitis: Mechanisms to Repair Cheryl Lee Eberting* Founder and CEO, CherylLeeMD Sensitive Skin Care, and Director of Alpine Dermatology and Laser, Alpine, Utah, USA *Corresponding author: Cheryl Lee Eberting, MD, Founder and CEO, CherylLeeMD Sensitive Skin Care and Director of Alpine Dermatology and Laser, 144 South Main St. Suite 300, Alpine, Ut 84004, USA, Tel: 801-763-7107; Fax: 801-763-7607; E-mail: [email protected] Received date: August 29, 2014, Accepted date: November 13, 2014, Published date: November 24, 2014 Copyright: © 2014 Eberting CL. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Irritant contact dermatitis is an extremely common condition resulting from epidermal exposure to any number of skin irritants. Upon contact with skin irritants, the epidermis develops many identifiable problems including specific epidermal lipid deficiencies, elevated epidermal pH with concomitant suppression of epidermal lipid production, pH- dependent susceptibility to infection, inflammation, and aberrant calcium gradients. By addressing these problems simultaneously, and through irritant avoidance, the treatment of irritant contact dermatitis can be maximized.
    [Show full text]
  • Guide-Occupational-Dermatitis.Pdf
    Recommendations for the Prevention, Detection and Management of Occupational Contact Dermatitis in Health Care Settings October 2019 Public Health Ontario Public Health Ontario is a Crown corporation dedicated to protecting and promoting the health of all Ontarians and reducing inequities in health. Public Health Ontario links public health practitioners, frontline health workers and researchers to the best scientific intelligence and knowledge from around the world. Public Health Ontario provides expert scientific and technical support to government, local public health units and health care providers relating to the following: • communicable and infectious diseases • infection prevention and control • environmental and occupational health • emergency preparedness • health promotion, chronic disease and injury prevention • public health laboratory services Public Health Ontario's work also includes surveillance, epidemiology, research, professional development and knowledge services. For more information, visit publichealthontario.ca. How to cite this document: Ontario Agency for Health Protection and Promotion (Public Health Ontario). Recommendations for the prevention, detection and management of occupational dermatitis in health care settings. Toronto, ON: Queen’s Printer for Ontario; 2019. ISBN 978-1-4868-3689-5 [PDF] Public Health Ontario acknowledges the financial support of the Ontario Government. ©Queen’s Printer for Ontario, 2019 Cover photo DermNet NZ. Irritant dermatitis [Internet]. Hamilton, NZ: DermNet New Zealand; 2003 [cited 2019 Oct 3]. Original picture provided by professor Raimo Suhonen. Available from: https://www.dermnetnz.org/topics/irritant-contact-dermatitis/. Used with permission. Recommendations for the Prevention, Detection and Management of Occupational Contact Dermatitis 2019 i Acknowledgements Public Health Ontario would like to thank Dr. Maureen Cividino, chair of the occupational dermatitis in health care committee (ODHCC), as well as Dr.
    [Show full text]
  • Prescription Versus Over-The-Counter Moisturizers: Unraveling the Mystery Zoe Diana Draelos, MD
    CosmetiC Consultation Prescription Versus Over-the-counter Moisturizers: Unraveling the Mystery Zoe Diana Draelos, MD oisturizers are the single most important cat- Repairing the Skin Barrier egory of products in dermatology. Moisturizer Damage to the skin barrier results in increased water M formulations function as the vehicle in all loss, thus signaling the body that intercellular lipid lotion and cream prescription products. They can carry synthesis must be initiated. The skin barrier is formed corticosteroids, retinoids, benzoyl peroxide, and topical by the protein-rich cells of the stratum corneum with antibiotics to the skin. Moisturizers also are the basis of intervening intercellular lipids. In the viable epidermis, all lotion and cream sunscreens. Further, moisturizers are the nucleated cells possess tight, gap, and adherens junc- an important active agent in all cosmeceuticals allowing tions with desmosomes and cytoskeletal elements that substantiation of claims such as improved skin appear- contribute to the barrier. Moisturizers attempt to mimic ance, reduction in the appearance of fine lines, and alle- the intercellular lipids that are synthesized in the ke- viation of dryness. ratinocytes during epidermal differentiation and then are More recently, moisturizers have adapted to the pre- extruded into the extracellular domains. These lipids are scription realmCOS in the role of barrier repair creams. DERM Is composed of ceramides, free fatty acids, and cholesterol, there a difference between moisturization and barrier which covalently bind to the cornified envelope proteins. repair? It is an interesting question because moisturizers Many moisturizers include these substances in an attempt do not really moisturize the skin. While water may be to provide “natural” ingredients to aid in barrier repair.
    [Show full text]
  • Compositions Comprising a Combination of a Free
    Europäisches Patentamt *EP000975325B1* (19) European Patent Office Office européen des brevets (11) EP 0 975 325 B1 (12) EUROPEAN PATENT SPECIFICATION (45) Date of publication and mention (51) Int Cl.7: A61K 7/48 of the grant of the patent: 17.09.2003 Bulletin 2003/38 (86) International application number: PCT/EP98/08121 (21) Application number: 98963566.9 (87) International publication number: (22) Date of filing: 07.12.1998 WO 99/029293 (17.06.1999 Gazette 1999/24) (54) COMPOSITIONS COMPRISING A COMBINATION OF A FREE SPHINGOID BASE AND A CERAMIDE AND USE THEREOF ZUSAMMENSETZUNGEN, ENTHALTEND EINE KOMBINATION AUS FREIER SPHINGOID-BASE UND CERAMIDE SOWIE DEREN VERWENDUNG COMPOSITIONS COMPRENANT UNE COMBINAISON D’UNE BASE SPHINGOIDE LIBRE ET D’UN CERAMIDE, ET LEUR UTILISATION (84) Designated Contracting States: (74) Representative: Rotenberg, Klaus DE ES FR GB IT NL Goldschmidt AG Patentabteilung Goldschmidtstrasse 100 (30) Priority: 05.12.1997 EP 97203824 45127 Essen (DE) (43) Date of publication of application: (56) References cited: 02.02.2000 Bulletin 2000/05 WO-A-96/16635 WO-A-97/09307 US-A- 5 627 056 (73) Proprietor: Cosmoferm B.V. 2611 XT Delft (NL) Remarks: The file contains technical information submitted (72) Inventor: LAMBERS, Johannes, Wilhelmus, after the application was filed and not included in this Jacobus specification NL-2641 LB Pijnacker (NL) Note: Within nine months from the publication of the mention of the grant of the European patent, any person may give notice to the European Patent Office of opposition to the European patent granted. Notice of opposition shall be filed in a written reasoned statement.
    [Show full text]
  • 52 Barrier Creams and Emollients
    479 52 Barrier Creams and Emollients Hongbo Zhai, Howard I. Maibach Contents called skin protective creams (SPCs)”or protective creams (PCs), as well as protective ointments, 52.1 Introduction . 479 invisible glove, barrier, protective or prework 52.2 Barrier Creams . 479 creams and-/or gels (lotions), antisolvent gels, and 52.2.1 Definition and Terms . 479 so on [7, 12–14]. Frosch et al. [7] consider “skin 52.2.2 Reasons for Using Barrier Creams . 479 protective creams” a more appropriate term since 52.2.3 Mechanism of Action and Duration . 480 most creams do not provide a real barrier, at least 52.2.4 Application Methods and Efficacy . 480 not comparable to stratum corneum. BCs may share 52.2.5 U.S. Food and Drug Administration Monograph Skin Protectants . 480 characteristics with moisturizers. The target of BCs 52.3 Emollients . 480 is in the prevention of external noxious substances 52.3.1 Definition and Terms . 480 penetrating skin, and moisturizers are frequently 52.3.2 Mechanism of Action . 480 used for “dry” skin conditions as well as to maintain 52.3.3 Efficacy . 480 healthy skin [15]. Recently, it has become clear that 52.4 Conclusion . 483 some moisturizers prevent and ameliorate ICD from References . 483 surfactants [15, 16]. 52.2.2 Reasons for Using Barrier Creams 52.1 Introduction Avoiding certain irritants or allergens may not be Contact dermatitis (CD) occurs as a result of contact practical for persons whose occupation or activi- with external factors (irritants and allergens) and ties mandate their working in certain environments. comprises 90%–95% of work-related dermatoses [1].
    [Show full text]
  • Contact Dermatitis
    SUPERVISOR INSTRUCTIONS: • Use toolbox trainings to encourage safety/environmental discussions during monthly meetings with employees. • Campus Services’ employees should maintain the employee sign-in sheet in their department’s safety/environmental compliance binder as a record of training. All other groups should maintain a record of training in accordance with their Division’s training procedures. ontact dermatitis is a localized rash or irritation of the skin caused by contact with an irritating or allergy-causing substance. This type of dermatitis is the most frequent cause C of occupational skin disease; irritating or allergy-causing substances that cause contact dermatitis in many people include poisonous plants such as poison ivy and sumac, cleaning solutions, detergents, industrial chemicals, latex rubber gloves and cosmetics. Contact dermatitis most often occurs on the hands, wrists and forearms, although any area may be affected. Dusts, vapors and mists can spread the irritants and expose other areas such as the eyelids, face, ears and neck. Symptoms include itching, inflammation, swelling, burning, skin lesions, rashes, blisters, cracking and peeling of the skin. The skin may also become raw, scaly and thickened. These symptoms appear on the area of skin exposed and generally take anywhere from several days to weeks to heal. The reaction may vary from slight to severe and the dermatitis fades only if the skin no longer comes into contact with the allergen or irritant. Types of Contact Dermatitis Allergic Contact Dermatitis is inflammation caused by exposure to a substance to which the person has become hypersensitive or allergic. The reaction may vary depending on the irritant, body part and sensitivity of the individual.
    [Show full text]
  • Interventions for Preventing Occupational Irritant Hand Dermatitis
    Interventions for preventing occupational irritant hand dermatitis Andrea Bauer, MD, MPH Department of Dermatology University Hospital Carl-Gustav-Carus Technical University Dresden Occupational irritant hand dermatitis • Occupational irritant hand dermatitis (OIHD) is an important cause of morbidity in the working population • Definition: OIHD is an inflammatory reaction of the skin after contact to various irritants – Acute (redness, edema, vesiculation) – subacute (redness, papules, infiltration) – chronic dermatitis (redness, lichenification, scaling, hyperkeratosis, fissuring) Acute hand dermatitis Subacute hand dermatitis Chronic hand dermatitis Epidemiology • Incidence of occupational skin disease in western industrial countries – North Bavaria: 6,7 cases/10.000 worker/year (Dickel et al. Contact Dermatitis 2001:44:258-259 – Saarland: 6,8 cases/10.000 worker/year (Dickel et al. Contact Dermatitis. 2002:46:197-206) – Europa: 5-19 cases /10.000 worker/year (Diepgen & Coenraads IAOEH 1999:72:496-506) – USA: 7,6 –10 cases /10.000 worker/year (Burnett et al. Am J Ind Med 1993:34:568-573, Kaufmann et al. Am J Public Health 1998:88:1047-1051) Occupations under risk Register data from North Bavaria (1990-99) all occupations n=3097 6,7 hairdresser n=856 97,4 baker n=140 33,2 pastry cooks n=45 20,6 tiler n=47 19 medical occupations n=481 7,3 cooks n=113 6,6 metal worker n=129 6,4 construction workers n=149 5,4 service staff n=199 3,4 wood workers n=73 2,6 Electrical worker n=69 1,2 0 20 40 60 80 100 120 per 10.000 workers/year Dickel et al.
    [Show full text]
  • Update on the Use of Topical Agents in Neonates
    Update on the Use of Topical Agents in Neonates Marty O. Visscher, PhD Topical agents include anything that touches the infant's skin. The skin is crucial to the way the infant perceives and responds to the care environment and, therefore, in neurodevelopment. Psychological stress negatively affects the barrier. The full-term infant has well-developed epidermal barrier despite spending 9 months being submerged in water. Vernix caseosa is a natural topical agent that facilitates stratum corneum barrier development through protective and adaptive mechanisms. Its properties include hydration, wound healing, antiinfection, and acid mantle development. The ontogeny of neonatal skin development and vernix biology provide the basis for assisting barrier maturation in premature infants, treating compromised skin and selecting topical agents. The published research on the effects of topical products on premature and damaged neonatal skin is very limited, especially for adequately sized randomized controlled clinical trials. Health care providers have keen interest and the skills to identify improved treatments through outcomes-based research. Keywords: Skin barrier; Neonate, Topical agent; Stratum corneum; Compromised skin Overview and Perspective action (cluster communication), better hearing/speech, and lower behavior symptom scores.5 Tactile stimulation via The article will review topical products in infants. Conceptually, repeated stroking increased circulating lactate levels by 200% we define topical products in the broadest sense to include in the neonatal rat model.6 These findings demonstrate the anything that touches or interacts with infant skin. The skin is a critical role of simple infant-caregiver skin-based interactions on primary care interface vitally important in any patient-caregiver the cognitive development of the infant.
    [Show full text]