Water protective effect of barrier creams and moisturizing creams: a new in vivo test method

Abstract

Frequent exposure to water is an important risk factor for the development of irritant hand eczema. Evaluation of cream efficacy in protecting against water is difficult. A new non-irritant, non-invasive method is introduced, based on evaluation of colour intensities when an aqueous solution of crystal violet is applied to the skin, after pretreatment with different creams. By skin reflectance measurement, differences in colour intensity were objectified. Measurements of transepidermal water loss were also performed, 2 barrier creams and a moisturizer were tested on the dorsal and volar aspects of the hands. One barrier cream contained silicone, the other solid particles. The moisturizer had a high content of lipid. In one experiment, the immediate effect of the creams in protecting against water was evaluated. In a second experiment, the water resistancy of the creams was tested, using a standardized water immersion procedure (4 x 20 min). The barrier cream with particles gave the best immediate protection (dorsal 76%, volar 69%). The moisturizer was intermediately protective (dorsal 57%, volar 34%), while very little protection was found for the silicone-containing cream (dorsal 16%, volar 10%). The water immersion procedure resulted in only minor changes in protection for each cream. When comparing transepidermal water loss in the treated areas with pretreatment values, a reduction was recorded only for the particle-containing barrier cream. The colour method described may be used as a quick and easy test of the protective effect of creams against water.

Effectiveness of Barrier Creams against Irritant Contact Dermatitis

“…We identified 39 controlled trials (table 1) investigating the effect of BCs against skin irritants in a total of 929 volunteers (172 men, 279 women and 481 unspecified subjects) with healthy skin (n = 28), hand dermatitis (n = 1), skin sensitized to a specific allergen (n = 4) and 1 study on latex glove allergens [6,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52]. From these 39 papers, studies on excised skin [18,24,40,41,43,46] have been discarded, and only trials on subjects with healthy and non-sensitized skin were retained, reducing the list to 27 papers detailed in table 1.…”

“…One must also take into account skin temperature, pH, the thickness of the layer of cream, the number of applications, drying time before exposure, time required for application, time in contact with the irritant, concentrations and quantities of the irritant agents, areas of the body studied (back, hands or forearms), subjects studied (gender and ethnicity), presence or absence of occlusion and the length of the study [4,28,41,53]. Human skin is also characterized by an interindividual variability [22].…”

“…Overall, the studies have not taken into account friction movements which occur in realistic situations nor do they consider perspiration, resulting in an overestimation of the efficacy of BCs [28,57]. …”

“…Indeed, after saturation, the agents sequestered in the layer of cream continue to penetrate the skin [18,28] if the substances are not inactivated by BCs. This explains the potential of some BCs to induce contact dermatitis [4] and to increase the skin's susceptibility to irritants [61].…”

Nanotechnology, Inflammation and the Skin Barrier: Innovative Approaches for Skin Health and Cosmesis

“…Nanomaterials have been incorporated into new barrier cream formulations in order to provide increased cosmetic appeal, more elegant textures and added benefits. These nanoparticulate formulations are superior to traditional creams in their ability to minimize water loss and prevent irritation while producing formulations with a thinner texture [23]. Wissing and Muller found that oil in water emulsion incorporating SLN provided a significantly improved hydration benefit over a conventional moisturizer in a human trial [24].…”