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A double-blind, randomized study to assess the effectiveness of different moisturizers in preventing dermatitis induced by hand washing to simulate healthcare use.
Br J Dermatol. 2010 May; 162(5):1088-92.BJ

Abstract

BACKGROUND

Healthcare-associated infection is an important worldwide problem that could be reduced by better hand hygiene practice. However, irritant contact dermatitis of the hands as a result of repeated hand washing is a potential complication that may be preventable by the regular use of an emollient.

OBJECTIVES

To assess the effect of moisturizer application after repeated hand washing (15 times daily) vs. soap alone.

METHODS

In a double-blind, randomized study, the effect of five different moisturizers on skin barrier function was determined by assessment after repeated hand washing over a 2-week period in healthy adult volunteers. Assessments of transepidermal water loss (TEWL), epidermal hydration and a visual assessment using the Hand Eczema Severity Index (HECSI) were made at days 0, 7 and 14.

RESULTS

In total, 132 patients were enrolled into the study. A statistically significant worsening of the clinical condition of the skin as measured by HECSI was seen from baseline to day 14 (P = 0.003) in those subjects repeatedly washing their hands with soap without subsequent application of moisturizer. No change was seen in the groups using moisturizer. Subclinical assessment of epidermal hydration as a measure of skin barrier function showed significant increases from baseline to day 14 after the use of three of the five moisturizing products (P = 0.041, 0.001 and 0.009). Three of the five moisturizers tested led to a statistically significant decrease in TEWL at day 7 of repeated hand washing. This effect was sustained for one moisturizing product at day 14 of hand washing (P = 0.044).

CONCLUSIONS

These results support the view that the regular application of moisturizers to normal skin offers a protective effect against repeated exposure to irritants, with no evidence of a reduction in barrier efficiency allowing the easier permeation of irritant substances into the skin as has been suggested by other studies. Regular use of emollient in the healthcare environment may prevent the development of dermatitis.

Authors+Show Affiliations

Skin Research Centre, University of Leeds, Leeds LS1 3EX, UK. tinawilliams@doctors.org.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20199550

Citation

Williams, C, et al. "A Double-blind, Randomized Study to Assess the Effectiveness of Different Moisturizers in Preventing Dermatitis Induced By Hand Washing to Simulate Healthcare Use." The British Journal of Dermatology, vol. 162, no. 5, 2010, pp. 1088-92.
Williams C, Wilkinson SM, McShane P, et al. A double-blind, randomized study to assess the effectiveness of different moisturizers in preventing dermatitis induced by hand washing to simulate healthcare use. Br J Dermatol. 2010;162(5):1088-92.
Williams, C., Wilkinson, S. M., McShane, P., Lewis, J., Pennington, D., Pierce, S., & Fernandez, C. (2010). A double-blind, randomized study to assess the effectiveness of different moisturizers in preventing dermatitis induced by hand washing to simulate healthcare use. The British Journal of Dermatology, 162(5), 1088-92. https://doi.org/10.1111/j.1365-2133.2010.09643.x
Williams C, et al. A Double-blind, Randomized Study to Assess the Effectiveness of Different Moisturizers in Preventing Dermatitis Induced By Hand Washing to Simulate Healthcare Use. Br J Dermatol. 2010;162(5):1088-92. PubMed PMID: 20199550.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A double-blind, randomized study to assess the effectiveness of different moisturizers in preventing dermatitis induced by hand washing to simulate healthcare use. AU - Williams,C, AU - Wilkinson,S M, AU - McShane,P, AU - Lewis,J, AU - Pennington,D, AU - Pierce,S, AU - Fernandez,C, Y1 - 2010/03/01/ PY - 2010/3/5/entrez PY - 2010/3/5/pubmed PY - 2010/6/29/medline SP - 1088 EP - 92 JF - The British journal of dermatology JO - Br J Dermatol VL - 162 IS - 5 N2 - BACKGROUND: Healthcare-associated infection is an important worldwide problem that could be reduced by better hand hygiene practice. However, irritant contact dermatitis of the hands as a result of repeated hand washing is a potential complication that may be preventable by the regular use of an emollient. OBJECTIVES: To assess the effect of moisturizer application after repeated hand washing (15 times daily) vs. soap alone. METHODS: In a double-blind, randomized study, the effect of five different moisturizers on skin barrier function was determined by assessment after repeated hand washing over a 2-week period in healthy adult volunteers. Assessments of transepidermal water loss (TEWL), epidermal hydration and a visual assessment using the Hand Eczema Severity Index (HECSI) were made at days 0, 7 and 14. RESULTS: In total, 132 patients were enrolled into the study. A statistically significant worsening of the clinical condition of the skin as measured by HECSI was seen from baseline to day 14 (P = 0.003) in those subjects repeatedly washing their hands with soap without subsequent application of moisturizer. No change was seen in the groups using moisturizer. Subclinical assessment of epidermal hydration as a measure of skin barrier function showed significant increases from baseline to day 14 after the use of three of the five moisturizing products (P = 0.041, 0.001 and 0.009). Three of the five moisturizers tested led to a statistically significant decrease in TEWL at day 7 of repeated hand washing. This effect was sustained for one moisturizing product at day 14 of hand washing (P = 0.044). CONCLUSIONS: These results support the view that the regular application of moisturizers to normal skin offers a protective effect against repeated exposure to irritants, with no evidence of a reduction in barrier efficiency allowing the easier permeation of irritant substances into the skin as has been suggested by other studies. Regular use of emollient in the healthcare environment may prevent the development of dermatitis. SN - 1365-2133 UR - https://www.unboundmedicine.com/medline/citation/20199550/A_double_blind_randomized_study_to_assess_the_effectiveness_of_different_moisturizers_in_preventing_dermatitis_induced_by_hand_washing_to_simulate_healthcare_use_ L2 - https://doi.org/10.1111/j.1365-2133.2010.09643.x DB - PRIME DP - Unbound Medicine ER -