title: Protective effects of topically applied CO2 -impregnated water.
abstract: OBJECTIVE
  The'positive effect'of CO2 -impregnated water (mechanical process of producing carbonated therapeutic waters for medical use) on the skin of the hands was reported by 76% of 107 users questioned. The present study intends to evaluate this effect by using bioengeneering methods.
  
  
  METHODS
  In 20 healthy volunteers, mild to moderate irritation was induced on both hands using a standardised washing procedure. One hand was rinsed with CO2 -impregnated water (carbonic acid) once daily for 1 min, the other with tap water as the control. Baseline values and values 30 min after application were recorded by measuring transepidermal water loss (TEWL), skin humidity (SH), microcirculation of the blood (BF) and skin surface pH. Wilcoxon's signed rank test was used for statistical analysis; P-values of less than 0.05 were considered to be significant.
  
  
  RESULTS
  Baseline TEWL, BF and pH tended to be lower (in some cases significantly lower) in the test regions treated with carbonic acid, whereas baseline SH tended to be higher (in some cases significantly higher). TEWL and pH were significantly lower for the side treated with CO2 30 min after application, whereas in some cases SH was significantly higher compared with the control side. Visual comparison revealed a lesser degree of irritation for the region treated with CO2 in comparison with the control side.
  
  
  CONCLUSIONS
  The results show that the skin physiology parameters of irritated skin are favourably influenced by the topical application of CO2 -impregnated water. Although those test regions treated with carbonic acid did not remain uninfluenced by repeated irritation in clinical comparisons, the irritation was more intensive in the test regions treated with fresh water.
authors.affiliation: Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrtick, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Bock
authors.affiliation: Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrtick, Germany.
authors.forename: H J
authors.initials: HJ
authors.lastname: Schwanitz
keywords: CO2-impregnated water (carbonic acid); hand protection; skin physiology parameters; skin surface pH