Impact of glove occlusion on cumulative skin irritation with or without hand cleanser–comparison in an experimental repeated irritation model

BACKGROUND: Irritant contact dermatitis remains a substantial problem in the food processing industries. Irritants that are weak by themselves, such as glove occlusion and mild detergents, could interact to produce contact dermatitis. OBJECTIVES: To model the irritant action of an antibacterial hand cleanser and glove occlusion, with sodium lauryl sulfate (SLS) as a positive control. The effects of a pre-exposure cream and a post-exposure cream were also investigated. METHODS: A modified repeated short-time occlusive irritation test with 20 healthy volunteers, and application of irritants over 4 days, with pre-exposure and post-exposure creams and overnight glove occlusion, was performed. The changes in transepidermal water loss (TEWL) served as a measure of the irritant damage to the epidermal barrier. RESULTS: The antibacterial cleanser and the glove occlusion separately induced only minor increases in TEWL. When combined, the two showed a tandem effect, as the TEWL increase was significantly higher, and was similar to that seen with the positive control, SLS. The pre-exposure and post-exposure creams alone significantly mitigated the cumulative irritation, and this effect was strongest when the two creams were combined. CONCLUSIONS: Irritant contact dermatitis may develop through the tandem effects of long-term glove occlusion and the accumulation of barrier damage from hand washing, even when mild hand cleansers are employed.