Impact of glove occlusion on cumulative skin irritation with or without hand cleanser–comparison in an experimental repeated irritation model

Abstract

Irritant contact dermatitis remains a substantial problem in the food processing industries. Irritants that are weak by themselves, such as glove occlusion and mild detergents, could interact to produce contact dermatitis. To model the irritant action of an antibacterial hand cleanser and glove occlusion, with sodium lauryl sulfate (SLS) as a positive control. The effects of a pre-exposure cream and a post-exposure cream were also investigated. A modified repeated short-time occlusive irritation test with 20 healthy volunteers, and application of irritants over 4 days, with pre-exposure and post-exposure creams and overnight glove occlusion, was performed. The changes in transepidermal water loss (TEWL) served as a measure of the irritant damage to the epidermal barrier. The antibacterial cleanser and the glove occlusion separately induced only minor increases in TEWL. When combined, the two showed a tandem effect, as the TEWL increase was significantly higher, and was similar to that seen with the positive control, SLS. The pre-exposure and post-exposure creams alone significantly mitigated the cumulative irritation, and this effect was strongest when the two creams were combined. Irritant contact dermatitis may develop through the tandem effects of long-term glove occlusion and the accumulation of barrier damage from hand washing, even when mild hand cleansers are employed.