Irritant potential of different washing procedures used for heavy‐duty soiling: Short and intense or longer and mild?

Abstract

AbstractBackgroundTo prevent irritant contact eczema even in occupational fields with heavy‐duty soiling, it is generally recommended to use ‘mild’ hand cleansers (mild detergent without grits, MC). On the other hand, since grit‐containing cleansers (GC) show a higher washing power that minimizes washing time, their usage is generally preferred in specific occupational fields.ObjectivesTo compare whether a shorter, intense washing period might cause less skin damage than a longer washing period with an MC.MethodsDifferences in cleaning time were first verified in a pilot study using standardized model dirt. In the main study, the forearms of 35 healthy volunteers were washed with three standardized procedures over a period of 3 days, either using 2 min of MC with/without hand brush or 1‐min GC. Clinical scoring, transepidermal water loss (TEWL), corneometry, colourimetry and scaliness/roughness (Visioscan) were used to evaluate the epidermal barrier, topography and irritation.ResultsThe pre‐study showed that washing time doubled when using MC vs. GC. Using GC resulted in stronger barrier disruption, even after a shorter washing period – median ΔT4–T1 TEWL 0.96 g/m2/h vs. 4.91 g/m2/h respectively, p < 0.0001. The most harmful procedure for the skin was the additional application of a hand brush (18.86 g/m2/h).ConclusionsShort‐time washing with GC damages the skin barrier more significantly in comparison to a longer application of an MC. When washing with MC, the strongest irritant reaction occurred when accompanied with hand brushing.