Baby Shampoo Research Articles

The effect of lid hygiene on the tear film and ocular surface, and the prevalence of Demodex blepharitis in university students

AimTo evaluate the effect blepharitis lid cleansers have on the tear film and ocular surface, and to examine the prevalence of Demodex folliculorum in a young population. MethodsForty-eight university students completed a randomised, controlled, investigator-masked, eight-week clinical trial. Three eyelid hygiene products were investigated: blepharitis eyelid cleanser (OCuSOFT® Lid Scrub® PLUS foam), diluted baby shampoo (10% Johnson’s® No More Tears ®) and a tea-tree based face wash (dr.organic®). Cooled boiled water was used as a control. Subjects attended for four visits: baseline, two weeks, four weeks and eight weeks. At each visit, subjective symptoms, non-invasive tear break up time, ocular surface staining and Demodex folliculorum investigation were assessed to evaluate any positive or negative effect on the tear film and ocular surface. Osmolarity was also measured at baseline and week eight only. ResultsThe overall prevalence of Demodex folliculorum found at baseline was 15%. Subjective symptoms improved in all groups, including control. There was no significant difference in mean osmolarity between the groups or within each group after eight weeks. There was a significant increase in osmolarity inter-eye variability in the baby shampoo group (5.5 ± 5.4 vs 15.2 ± 9.5; p = 0.03). There was no significant change in non-invasive tear break up time or ocular surface staining demonstrated after eight weeks of eyelid hygiene. ConclusionA low prevalence of Demodex folliculorum can be found in a young population. All blepharitis lid cleansers used demonstrated subjective improvement in symptoms, with no negative effects on tear break-up time or ocular surface staining. The blepharitis eyelid cleanser and tea-tree based face wash revealed no adverse effect on mean osmolarity or inter-eye variability. Similarly, baby shampoo did not cause a significant increase in mean osmolarity, however, a significant increase in inter-eye variability was found; suggesting a possible increase in ocular surface inflammation.

Three-tier testing approach for optimal ocular tolerance sunscreen

Background: Poor ocular tolerance of sunscreens is partially responsible for poor compliance in use of sunscreens. A three-tiered approach for the testing of ocular tolerance for such products is described that includes an in vitro test for ocular irritation, an in vitro test for the activation of pain receptors, and finally a clinical study involving ocular instillation of the product under controlled conditions followed by ophthalmologic and subjective self-evaluation on a graded scale. We report the results for a new water-based facial sunscreen (SCFW) with very good ocular tolerance.Methods: The ocular irritation potential of SCFW was determined using the EpiOcular™ human cell construct which constituted the first-tier testing. Briefly, the tissues were exposed to SCFW and appropriate positive and negative controls for 15 minutes to 24 hours. After treatment, the tissues were rinsed and cytotoxicity determined. The calculated ET50 value (time at which relative viability decreased 50%) was then used to determine the ocular irritation potential. In the second-tier testing, the sting potential of SCFW was determined by employing the NociOcular assay that measures the activation of TRPV1 (transient receptor potential cation channel subfamily V member 1) specific receptors linked to pain sensation in a neuronal model with over-expression of functional TRPV1 channels. Finally, as the third-tier testing, SCFW was tested in a clinical study with instillation of product into the ocular cul-de-sac and ocular irritation was evaluated after 30 seconds, 15 minutes, and 60 minutes by an ophthalmologist. Participating subjects were also asked to score sensation on a scale of 0 to 3 from slight prickliness to severe stinging. Assay control reference product with known good ocular tolerability (10% baby shampoo) was concurrently tested.Results: In the in vitro topical application assay using the EpiOcular™ construct, no significant cytotoxicity was observed in the tissues exposed to SCFW, indicating minimal ocular irritation potential. In the in vitro NociOcular assay, the cells exposed to the prepared dilutions of SCFW showed minimal TRPV1 specific activity, indicating minimal ocular sting potential. In the in vivo study, no statistically significant differences were found in terms of subjective or objective eye irritation assessment between SCFW and 10% baby shampoo.Conclusion: SCFW showed negligible ocular irritation potential in tier 1, minimal potential to activate pain receptors in tier 2, and good ocular tolerability that was comparable to 10% baby shampoo in tier 3 testing. The results suggest that SCFW has good eye tolerance and that the tiered approach can be used to evaluate facial sunscreens for ocular tolerability.

The Use of Aromatherapy to Reduce Chemotherapy-Induced Nausea in Children With Cancer: A Randomized, Double-Blind, Placebo-Controlled Trial.

Chemotherapy-induced nausea can be distressing and difficult to manage in children with cancer. The purpose of this study was to investigate the utility of ginger aromatherapy in relieving chemotherapy-induced nausea in children with cancer. This randomized, double-blind, placebo-controlled study of 49 children with cancer explored whether inhalation of the aroma of essential oil of ginger during chemotherapy decreased nausea compared with a placebo (water) or control (Johnson's baby shampoo) measured by prechemotherapy and postchemotherapy assessment with the Pediatric Nausea Assessment Tool (PeNAT). While well received, well tolerated, nontoxic, and noninvasive, ginger aromatherapy did not significantly decrease nausea in patients enrolled in this study. Among 21 patients who indicated feeling nausea prechemotherapy, 67% reported improvement, 5% worsening, and 28% no change in their postinfusion PeNAT score. We failed to detect a statistical significant difference in the change in PeNAT scores among the three groups.

Comparing the short-term effect of two different lid hygiene products on ocular signs and symptoms

Purpose: A variety of lid hygiene products are advocated for the management of blepharitis. Research has demonstrated patient preference for commercial formulations compared to “home remedies” such as diluted baby shampoo (DBS). This study investigated the short-term ocular and tear film effects of two different lid hygiene products. It was hypothesised that DBS would have greater adverse effects compared to the commercial formulation.

Middle ear irrigation using a hydrodebrider decreases biofilm surface area in an animal model of otitis media.

ObjectiveTo compare the safety and efficacy of manual and powered irrigation of the middle ear using saline or 1% baby shampoo to treat biofilm‐forming bacterial middle ear infections.BackgroundBiofilms play a major role in recalcitrant otitis media and are challenging to treat. Many therapeutic strategies have been attempted and the role of topical therapies is still being investigated. Topical irrigation using saline or 1% baby shampoo and the use of a hydrodebrider have been investigated in biofilms involved in chronic rhinosinusitis and their role within the middle ear is yet to be determined.MethodsTwenty‐two adult chinchillas underwent bilateral trans‐bullar inoculation of non‐typable biofilm forming Haemophilus influenza followed by unilateral middle ear irrigation 5 days later using saline administered via a powered hydrodebrider or manual irrigation of saline or 1% baby shampoo. Contralateral inoculated ears served as control and were not irrigated. Two days following irrigation, the bullae were harvested and processed for scanning electron microscopy to assess biofilm surface area. Auditory brainstem responses were performed before bacterial inoculation and prior to euthanasia.ResultsManual and powered irrigation were effective in reducing the surface area of biofilm when compared to the control group. The hydrodebrider demonstrated to be more effective at eradicating biofilm than manual irrigation, especially in areas of difficult access, such as the ventral portion of the chinchillas' bullae. There was no difference in manual irrigation of saline when compared to 1% baby shampoo. Irrigations either manually or using the hydrodebrider did not affect hearing, the vestibular system or facial function.ConclusionMiddle ear biofilms can be treated safely and effectively with rinses using either normal saline or 1% baby shampoo administered manually or with a powered hydrodebrider.Level of EvidenceNA.

See you in Denver!

May is a wonderful month, spring is in the air and we celebrate Mother’s Day. May is also the month before the AANP National Conference. I can almost feel the mountain air and see the breathtaking beauty of the Rocky Mountains. The Denver area has a lot to offer for everyone from the outdoor adventurer to the lover of culture. I personally like the Molly Brown House, the US Mint, the gold mines and the nearby Coors Brewery. I also enjoy the sights on the scenic Mount Evans Byway. If you do not have time to take in some sights, the national conference is a good way to have your own adventure. You will have opportunities to earn CE, network with colleagues, mingle with AANP leadership and become involved in your national organization. Some exciting activities are planned for this year's conference including a live concert performance by Musicians on Call, and a chance to help families with newborns by donating to Newborns in Need. At this year’s conference there will some exciting activities which include a live performance from Musicians on Call, and a chance to help mothers and newborns by donating to Newborns in Need. A program of Denver Health Foundation, Newborns in Need exists to provide every baby that is delivered at Denver Health Hospital a good start on life through the donation of a Warm Welcome bag that contain diapers, a sleep sack, bibs, socks, hats, pajamas, blankets, baby lotion, baby shampoo, a stuffed animal and a book. The program also provides portable cribs, strollers and car seats for parents who are unable to afford them and is sustained entirely through private donors. In 2017, they distributed nearly 3,400 Warm Welcome bags, each with a retail value of approximately $120. AANP will give our attendees the opportunity to help this initiative through monetary donations as well as items for the welcome bag. Stay tuned for more information. Make your plans now to be at AANP’s 2018 National Conference. It is one you won’t want to miss. I look forward to seeing you in Denver!

Baby Shampoo to Relieve the Discomfort of Tear Gas and Pepper Spray Exposure: A Randomized Controlled Trial.

IntroductionOleoresin capsicum (OC) or pepper spray, and tear gas (CS) are used by police and the military and produce severe discomfort. Some have proposed that washing with baby shampoo helps reduce this discomfort.MethodsWe conducted a prospective, randomized, controlled study to determine if baby shampoo is effective in reducing the severity and duration of these effects. Study subjects included volunteers undergoing OC or CS exposure as part of their police or military training. After standardized exposure to OC or CS all subjects were allowed to irrigate their eyes and skin ad lib with water. Those randomized to the intervention group were provided with baby shampoo for application to their head, neck, and face. Participants rated their subjective discomfort in two domains on a scale of 0–10 at 0, 3, 5, 10, and 15 minutes. We performed statistical analysis using a two-tailed Mann-Whitney Test.ResultsThere were 58 participants. Of 40 subjects in the OC arm of the study, there were no significant differences in the ocular or respiratory discomfort at any of the time points between control (n=19) and intervention (n=21) groups. Of 18 subjects in the CS arm, there were no significant differences in the ocular or skin discomfort at any of the time points between control (n=8) and intervention (n=10) groups.ConclusionIrrigation with water and baby shampoo provides no better relief from OC- or CS-induced discomfort than irrigation with water alone.

A Midline Mediastinal Parathyroid Cyst

The use of alternative medicine in chronic rhinosinusitis (CRS) continues to increase in popularity, for the most part without meeting the burden of being based on sound clinical evidence. New and emerging treatments, both natural and developed, are numerous, and it remains a challenge for otolaryngologists as well as general practitioners to keep up to date with these therapies and their efficacy. In this systematic review, we discuss a number of alternative therapies for CRS, their proposed physiologic mechanisms, and evidence supporting their use. This analysis is based on our review of the English-language literature on alternative therapies for CRS (we did not include any therapies that are already recommended by accepted professional bodies). Data collection was performed using the PubMed database (not restricted to MEDLINE due to the nature of the subject matter), the Cochrane databases, and bibliography searches. We found that while many of the alternative therapies we reviewed might have a firm basis in science, they lack any clinical evidence to support their use specifically for CRS. Some emerging therapies, such as therapeutic ultrasonography and phonophoresis, show some promise, based on a growing body of positive evidence. In addition, the use of baby shampoo, thyme honey, and bromelain additives to saline lavage in CRS are all supported by clinical evidence, as is Sinupret, an oral preparation that contains echinacea. However, higher levels of evidence gleaned from large, well-designed, prospective, randomized, controlled trials are needed before any of these therapies can be recommended.

Assessment of efficacy of topical azithromycin 1.5 per cent ophthalmic solution for the treatment of meibomian gland dysfunction

BackgroundThe aim was to evaluate the clinical efficacy of topical azithromycin 1.5 per cent ophthalmic solution in treatment of the clinical signs and symptoms associated with meibomian gland dysfunction (MGD).MethodsIn this retrospective study, 35 patients with MGD were treated with topical azithromycin 1.5 per cent ophthalmic solution for 30 days. Topical azithromycin 1.5 per cent ophthalmic solution was prescribed twice daily for two days and then once daily for a total of 30 days. Daily lid hygiene with dilute baby shampoo was instructed for all patients. Patient total symptom score, meibomian gland grading score, Schirmer score with anaesthetic, tear film break‐up time (TFBUT) and corneal fluorescein staining score were evaluated at baseline and after one and three months.ResultsPatient total symptom score, meibomian gland grading score, Schirmer score with anaesthetic, TFBUT and corneal staining score reduced significantly from the baseline to the first month (p < 0.05, for each); however, at the third month, there was no significant difference from baseline in the meibomian gland grading score, Schirmer score with anaesthetic, TFBUT and corneal fluorescein staining score (p > 0.05, for each).ConclusionThese results demonstrate that topical azithromycin 1.5 per cent ophthalmic solution appears effective in the short‐term treatment of the clinical signs and symptoms associated with MGD.

Randomized double-masked trial of eyelid cleansing treatments for blepharitis

PurposeTo compare the efficacy of a dedicated eyelid cleanser and diluted baby shampoo in the management of blepharitis. MethodsForty-three participants with clinical blepharitis signs were enrolled in a prospective, randomized, double-masked, paired-eye trial. A dedicated eyelid cleanser (TheraTears® SteriLid®) was applied to the eyelids of one eye (randomized) and diluted baby shampoo (Johnson's® No More Tears®) to the fellow eye, twice daily for 4 weeks. Tear film parameters, ocular surface characteristics, symptomology and cytology markers were assessed at baseline and day 28. ResultsBaseline measurements did not differ between treatments (all p > 0.05). The eyelid cleanser was preferred over baby shampoo by the majority of participants (p < 0.001). Improvements in the tear lipid layer, inferior lid wiper epitheliopathy (LWE), cylindrical collarettes, and MMP-9 expression were limited to the dedicated eyelid cleanser (all p < 0.05), and a greater decrease in SANDE symptoms score was also observed (p = 0.04). Meibomian gland capping and MUC5AC expression worsened with baby shampoo treatment (both p < 0.05). SPEED symptoms score, superior LWE, seborrhoeic lash crusting, and trichiasis decreased significantly following application of both treatments (all p < 0.05), but did not differ between treatments (all p > 0.05). ConclusionClinical improvements in blepharitis occurred with both treatments. However, only the dedicated eyelid cleanser proved effective in reducing ocular surface inflammation, and was the preferred therapy. Long term impact of decreased goblet cell function secondary to baby shampoo treatment requires further exploration.

Safety and compatibility of a new nourishing baby shampoo and tip to toe wash with stearic acid

Safety and compatibility of a new nourishing baby shampoo and tip to toe wash with stearic acid

An empirical investigation of brand resilience through disclosure of negative information: a consumer preference perspective

Many consumer brands present some level of harm. Consumers, however, are not always aware of the level of harm involved (Rundle-Thiele et al., 2008). A repeated measure Best-Worst design was used to measure consumers' stated choice preference for three brands of baby shampoo before and after information on the effects of petrochemicals on baby's skin was disclosed. A total of 323 valid questionnaires were collected before and a total of 79 valid questionnaires were collected after information disclosure. Preferences for the brand containing petrochemicals decreased and preferences for one competing brand which contained natural ingredients increased following disclosure of information on the effects of petrochemicals on baby skin. This study contributes to the literature showcasing how a repeated measure Best-Worst design can be used to predict the consequences of disclosing harmful information on brands to the public and, how consumers' purchase preferences can be predicated according to brand resilience.

An empirical investigation of brand resilience through disclosure of negative information: a consumer preference perspective

Many consumer brands present some level of harm. Consumers, however, are not always aware of the level of harm involved (Rundle-Thiele et al., 2008). A repeated measure Best-Worst design was used to measure consumers' stated choice preference for three brands of baby shampoo before and after information on the effects of petrochemicals on baby's skin was disclosed. A total of 323 valid questionnaires were collected before and a total of 79 valid questionnaires were collected after information disclosure. Preferences for the brand containing petrochemicals decreased and preferences for one competing brand which contained natural ingredients increased following disclosure of information on the effects of petrochemicals on baby skin. This study contributes to the literature showcasing how a repeated measure Best-Worst design can be used to predict the consequences of disclosing harmful information on brands to the public and, how consumers' purchase preferences can be predicated according to brand resilience.

Chronic Rhinosinusitis in Patients with Cystic Fibrosis

Chronic rhinosinusitis (CRS) is highly prevalent in patients with cystic fibrosis (CF) and accounts for significant morbidity and contribution to CF lung disease. Mutations of the cystic fibrosis transmembrane regulator gene occur with increased prevalence in patients with CRS without CF, suggesting some contribution to CRS pathophysiology. Nasal polyps (NPs) occur with increased prevalence in patients with CF of all ages and have a more neutrophilic appearance with fewer eosinophils and increased submucosal glandular elements in comparison to NPs from patients without CF. Mainstays of medical treatment include isotonic saline irrigations and topical intranasal glucocorticoids, with some evidence that topical intranasal glucocorticoids reduce NP size. Although inhaled hypertonic saline (7%) has been widely studied as a mucolytic agent for CF lung disease, there are no reports of its use in CF CRS. Mucolytics have also not been studied as a treatment for CRS in CF, and most evidence does not support their use for CF lung disease. Nasally nebulized dornase alfa (recombinant human deoxyribonuclease) following sinus surgery shows promise for treatment. Other unproven therapies include addition of baby shampoo to isotonic saline to potentially thin mucus and help prevent biofilm formation. There are no data to support the use of low-dose oral macrolide antibiotics or the use of prophylactic oral antibiotics for CRS in patients with CF. However, there is some support for the use of topical antibiotics, including colistimethate sodium or tobramycin, administered as a sinus irrigation or antral lavage in patients following sinus surgery when susceptible bacteria are cultured. Key components of CF sinus surgical management include extensive surgery to ensure that the maxillary, frontal, sphenoid, and ethmoid sinuses are all widely opened with smoothing of bony overhangs to prevent mucus retention and bacterial recolonization, postoperative meticulous daily nasal irrigations, and appropriate use of culture-directed topical antibiotics. There are no data yet on whether CF-targeted therapies, including ivacaftor or ivacaftor combined with lumacaftor, have an impact on CF CRS.

Effect of chlorhexidine bathing in preventing infections and reducing skin burden and environmental contamination: A review of the literature.

Chlorhexidine bathing is effective in reducing levels of pathogens on skin. In this review, we examine the evidence that chlorhexidine bathing can prevent colonization and infection with health care-associated pathogens and reduce dissemination to the environment and the hands of personnel. The importance of education and monitoring of compliance with bathing procedures is emphasized in order to optimize chlorhexidine bathing in clinical practice.

Safety assessment of a baby shampoo: A practical example of a global animal-free integrating approach in the personal care industry

Safety assessment of a baby shampoo: A practical example of a global animal-free integrating approach in the personal care industry

Current and Emerging Therapeutic Strategies for the Treatment of Meibomian Gland Dysfunction (MGD).

Meibomian gland (MG) dysfunction (MGD) is a multifactorial, chronic condition of the eyelids, leading to eye irritation, inflammation and ocular surface disease. Initial conservative therapy often includes a combination of warm compresses in addition to baby shampoo or eyelid wipes. The practice of lid hygiene dates back to the 1950s, when selenium sulfide-based shampoo was first used to treat seborrhoeic dermatitis of the eyelids. Today, tear-free baby shampoo has replaced dandruff shampoo for MGD treatment and offers symptom relief in selected patients. However, many will not achieve significant improvement on this therapy alone; some may even develop an allergy to the added dyes and fragrances in these products. Other manual and mechanical techniques to treat MGD include MG expression and massage, MG probing and LipiFlow(®). While potentially effective in patients with moderate MGD, these procedures are more invasive and may be cost prohibitive. Pharmacological treatments are another course of action. Supplements rich in omega-3 fatty acids have been shown to improve both MGD and dry eye symptoms. Tea tree oil, specifically the terpenin-4-ol component, is especially effective in treating MGD associated with Demodex mites. Topical antibiotics, such as azithromycin, or systemic antibiotics, such as doxycycline or azithromycin, can improve MGD symptoms both by altering the ocular flora and through anti-inflammatory mechanisms. Addressing and treating concurrent ocular allergy is integral to symptom management. Topical N-acetylcysteine and topical cyclosporine can both be effective therapeutic adjuncts in patients with concurrent dry eye. A short course of topical steroid may be used in some severe cases, with monitoring for steroid-induced glaucoma and cataracts. While the standard method to treat MGD is simply warm compresses and baby shampoo, a more tailored approach to address the multiple aetiologies of the disease is suggested.

Vaginal prep in the operating room

Baby shampoo may be considered as a possible alternative agent for vaginal prep, but with only one study found on the subject, a recommendation for a change in clinical practice can't be made at this time.

Market trends in baby skin care products and implications for clinical practice.

Although the U.S. pediatric skin care market is a $1.7billion industry, little is known regarding the usage pattern of skin care products in very young children. We have begun to recognize that common over-the-counter skin care products may have positive or negative effects on skin barrier function. Thus, knowing what and how skin care products are used early in life is important. The goal of the current study was to better understand skin care product use in the United States using market research data. We found that the prevalence of use was greater than 50% for all skin care product categories and age groups. Premoistened cleansing wipes and cloths were the most frequently used product, followed by baby oil and lotion and body and baby powder. Baby bath and shampoo products were used at least five times per week per household, and caregivers generally preferred products that were fragrance-free and made for sensitive skin. Lower-income households reported a higher frequency of product use and were less likely to purchase fragrance-free products or ones that were made for sensitive skin. Our findings suggest that the prevalence of pediatric skin care product use is high and conflicts with current recommended skin care guidelines. Product use and preferences may also vary according to race and ethnicity and household income level.

Seborrheic dermatitis of the eyelid

Seborrheic (say: seb-uh-ree-uh) dermatitis is a chronic inflammatory skin condition presenting as dry whitish scales or greasy scales. Can involve the scalp, eyebrows, forehead, face, trunk, or skin folds. Dandruff and cradle cap are both forms of seborrheic dermatitis. The severity of seborrheic dermatitis can be lessened by controlling the risk factors and by paying careful attention to skin care. Seborrheic dermatitis of the eyelid margin usually responds to gentle cleaning of the lid margins nightly as needed, with undiluted Johnson and Johnson baby shampoo using a cotton swab. Remove thick scales by applying warm olive or mineral oil and then wash off several hours later with Dawn washing detergent and a soft bristle tooth-brush. For dense scalp scaling, 10% Liquor Carbonic Detergents (LCD) in nivea oil may be used at bedtime, covering the head with a shower cap. This should be done nightly for 1-3 weeks. Once controlled, washing with zinc soaps or selenium lotion with periodic use of steroid cream will help maintain remission. Recently, creams classified as topical immune modulators are being used which suppresses the immune system to treat inflammation. Further, it is thought that sunlight improves seborrheic dermatitis. In some persons, the condition gets better in the summer, especially after outdoor activities.