A Review of Anti-Irritants, Part I: Barrier Cream Efficacy on Contact Dermatitis*

Mar 1, 2011 | Contact Author | By: Howard I. Maibach, MD, University of California School of Medicine; and Hongbo Zhai, MD, University of California
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Title: A Review of Anti-Irritants, Part I: Barrier Cream Efficacy on Contact Dermatitis*
anti-irritantsx barrier creamx dexpanthenolx dimethiconex glycerinx petrolatumx aluminum chlorohydratex ICDx tape strippingx ROIT evaluationx
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Keywords: anti-irritants | barrier cream | dexpanthenol | dimethicone | glycerin | petrolatum | aluminum chlorohydrate | ICD | tape stripping | ROIT evaluation

Abstract: This column is the first of a two-part series about anti-irritants. Part two will appear in the April 2011 issue. While the first part covers anti-irritants, irritant reaction and barrier cream efficacy, part two will summarize the efficacy of moisturizers and anti-irritant substances and provide an overall interpretation of both parts I and II.

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HI Maibach and H Zhai, A Review of Anti-Irritants, Part I: Barrier Cream Efficacy on Contact Dermatitis,* Cosm & Toil 126(3) 156 (2011)

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Irritant contact dermatitis (ICD) is a common form of irritation that can occur when human skin is exposed to potential irritants such as surfactants, cutting oils, etc.1, 2 Minimizing exposure to such irritants is recommended but often not practical since exposure is unavoidable in some occupations including farming, firefighting, medicine, etc. To counteract or suppress irritation responses in the skin, anti-irritant agents are employed. These ingredients, whether naturally occurring or man-made, used alone or in formulations, possess the capacity to reduce irritation caused by acute and chronic exposure to irritants.3

To fully prevent or reduce the risk of developing ICD, anti-irritant agents such as barrier creams (BCs) and moisturizers are widely utilized.4–9 Though BCs and moisturizers are not identical, probably due to their ambiguous definitions, the terms BC and moisturizer are often used interchangeably in the literature and the marketplace. The target of BCs is to prevent external noxious substances from penetrating skin, usually in an occupational setting,5, 7–9 whereas moisturizers are frequently used for dry skin conditions as well as to maintain healthy skin.4, 6, 9–11 However, moisturizers and BCs share characteristics, thus it can be difficult to distinguish between the two. Therefore it is suggested that the standard term skin protectant be used when referring to anti-irritants;12 several terms and definitions commonly used in reference to skin protection are summarized in Table 1. Although numerous ingredients have been formulated into finished skin protection products, the US Food and Drug Administration (FDA) has only endorsed 13 ingredients for over-the-counter (OTC) products (see Table 2).

Based on an extensive literature review, this column describes studies and data related to the proposed efficacy of anti-irritant agents for reducing ICD in human skin. To compile this review, a literature search in PubMed, EMBASE and Scopus was conducted, and only research discussing either the prevention or treatment of irritation in human skin was considered. Studies and data conducted on non-human skin were excluded, and emphasis was placed on the studies that included quantitative and qualitative results as well as those that followed evidence-based dermatological guidelines.

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Table 1. Common Terms and Definitions Relating to Skin Protection

Table 1. Common Terms and Definitions Relating to Skin Protection

Moisturizers and BCs share characteristics, thus it can be difficult to distinguish between the two. Therefore it is suggested that the standard term skin protectant be used when referring to anti-irritants;12 several terms and definitions commonly used in reference to skin protection are summarized in Table 1.

Table 2. Skin Protectants Identified by the FDA and Their Concentrations

Table 2. Skin Protectants Identified by the FDA and Their Concentrations

Although numerous ingredients have been formulated into finished skin protection products, the US Food and Drug Administration (FDA) has only endorsed 13 ingredients for over-the-counter (OTC) products (see Table 2).

Footnotes

*Adapted from H Maibach, Anti-irritant agents, in The Chemistry and Manufacture of Cosmetics: Cosmetic Specialties and Ingredients, 2nd edn, ch 1, ML Schlossman, ed, Allured Business Media, Carol Stream, IL USA (2010) pp 1–39
a Kerodex 51 is a cream manufactured by Medtech Inc., Jackson, WY USA.
b Kerodex 71 is a cream manufactured by Medtech, Inc., Jackson, WY USA.
c PGV plus Lad-Fos (LF) is a cream manufactured by 3M Company, St. Paul, MN USA.
d Vaseline is a product manufactured by Unilever.
e Dardia Lipo Cream, Lipo Milk and Lipo Ointment are products manufactured by Intendis GmbH, Berlin.

Biography: Howard I. Maibach, MD, University of California, San Francisco

Howard I. Maibach, MD, is a professor of derma­tology at the University of California School of Medicine, San Francisco. His labor­atory has been interested in and has published exten­sively on derm­ato­pharma­cology and dermatotoxicology.

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