Abstract
The frequency of hand hygiene has increased due to the COVID-19 pandemic, but there is little evidence regarding the impact of water exposure and temperature on skin. The aim of this study is to evaluate the effect of water exposure and temperature on skin barrier function in healthy individuals. A prospective observational study was conducted. Temperature, pH, transepidermal water loss (TEWL), erythema and stratum corneum hydration (SCH) were measured objectively before and after hot- and cold-water exposure and TempTest® (Microcaya TempTest, Bilbao, Spain) contact. Fifty healthy volunteers were enrolled. Hot-water exposure increased TEWL (25.75 vs. 58.58 g·h−1·m−2), pH (6.33 vs. 6.65) and erythema (249.45 vs. 286.34 AU). Cold-water immersion increased TEWL (25.75 vs. 34.96 g·h−1·m−2) and pH (6.33 vs. 6.62). TEWL (7.99 vs. 9.98 g·h−1·m−2) and erythema (209.07 vs. 227.79 AU) increased after being in contact with the hot region (44 °C) of the TempTest. No significant differences were found after contact with the cold region (4 °C) of the TempTest. In conclusion, long and continuous water exposure damages skin barrier function, with hot water being even more harmful. It would be advisable to use cold or lukewarm water for handwashing and avoid hot water. Knowing the proper temperature for hand washing might be an important measure to prevent flares in patients with previous inflammatory skin diseases on their hands.
Highlights
Publisher’s Note: MDPI stays neutralThe skin is the largest organ in the human body and accomplishes regulatory and defensive functions that reside in the epidermis, mainly in the stratum corneum [1]
As there is no solid evidence regarding the effect of water exposure and temperature on skin, the objective of this study is to evaluate the impact of water exposure and temperature on cutaneous homeostasis and skin barrier function
A significant correlation has been found between transepidermal water loss (TEWL) and temperature, as temperature promotes the mass transfer of water from the stratum corneum to the environment [26]
Summary
Publisher’s Note: MDPI stays neutralThe skin is the largest organ in the human body and accomplishes regulatory and defensive functions that reside in the epidermis, mainly in the stratum corneum [1]. To evaluate the epidermal barrier, measurements of transepidermal water loss (TEWL) are usually performed [2]. Other parameters to assess epidermal function are the stratum corneum hydration (SCH), pH of the skin surface, temperature, erythema and melanin index [4]. These parameters can change depending on the anatomical location and can be affected by skin diseases such as psoriasis or atopic dermatitis [4]. Skin-related studies should not be based on a single parameter to cover all the functions of the epidermal barrier, as an integrated and multiparametric approach is needed to evaluate the properties of the skin barrier [5]. The epidermal barrier is necessary to maintain cutaneous homeostasis and protect the body against multiple external factors, such as environmental conditions, chemical stress and ultraviolet radiation [6]
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