title: Protective creams fail to prevent solvent-induced cumulative skin irritation - results of a randomized double-blind study.
abstract: BACKGROUND
  Occupational skin contact with lipophilic substances is a risk factor for the development of irritant hand dermatitis. Skin protection creams form part of the personal protective equipment, and some are claimed to protect against lipophilic irritants. However, their benefit against solvents is under debate.
  
  
  OBJECTIVE
  To evaluate the efficacy of barrier creams claimed to protect against lipophilic irritants in a newly developed repetitive irritation model.
  
  
  METHODS
  Thirty-five healthy volunteers were enrolled in a double-blind, randomized study, and six barrier creams were evaluated against irritation induced by two occupationally relevant model solvents, n-octane and cumene. Clinical scoring and bioengineering methods (capacitance and transepidermal water loss measurements) were used to quantify the irritant reactions.
  
  
  RESULTS
  None of the test products offered protection against n-octane-induced clinical irritation or stratum corneum dehydration. One test product significantly aggravated the skin irritation induced by both irritants, and a second one enhanced dehydration induced by n-octane only.
  
  
  CONCLUSIONS
  The lack of efficacy and the aggravation of skin irritation induced by two of six test products stress the need for standardized efficacy testing of occupational skin protection products.
authors.affiliation: Department of Dermatology, University Hospital Jena, 07743, Jena, Germany.
authors.forename: Sibylle
authors.initials: S
authors.lastname: Schliemann
authors.forename: Peter
authors.initials: P
authors.lastname: Kleesz
authors.forename: Peter
authors.initials: P
authors.lastname: Elsner
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D001555:Benzene Derivatives / Q000008:administration & dosage / Q000009:adverse effects*; D057005:Bioengineering; D017453:Dermatitis, Irritant / Q000209:etiology / Q000517:prevention & control*; D009783:Dermatitis, Occupational / Q000209:etiology / Q000517:prevention & control*; D004311:Double-Blind Method; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D007509:Irritants / Q000008:administration & dosage / Q000009:adverse effects; D016014:Linear Models; D008297:Male; D009795:Octanes / Q000008:administration & dosage / Q000009:adverse effects*; D020011:Protective Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D063465:Skin Cream / Q000627:therapeutic use*; D012997:Solvents / Q000008:administration & dosage / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D001555:Benzene Derivatives; D007509:Irritants; D009795:Octanes; D020011:Protective Agents; D012997:Solvents; C015763:cumene; C026728:octane
keywords: barrier creams; bioengineering; efficacy; irritant contact dermatitis; repetitive irritation model; solvents