barrier cream

For hand care they are designed to protect against the harm from detergents and other irritants. To help prevent the spread of pathogens, health care providers are required to wash their hands frequently. Frequent hand washing can result in chronic damage termed irritant contact dermatitis which includes dryness, irritation, itching, and more seriously, cracking and bleeding. Irritant contact dermatitis is very common among nurses, ranging from 25% to 55%, with as many as 85% relating a history of having skin problems. The World Health Organization has considered the use of barrier creams and has found their efficacy to be "equivocal" and too expensive to be considered in health-care settings where resources are limited.{{cite web | url=https://www.ncbi.nlm.nih.gov/books/NBK144008/ | title=WHO Guidelines on Hand Hygiene in Health Care: First Global Patient Safety Challenge Clean Care Is Safer Care | publisher=WHO Press | date=2009 | accessdate=October 2, 2015}}

The Centers for Disease Control and Prevention found "Two recent randomized, controlled trials that evaluated the skin condition of caregivers demonstrated that barrier creams did not yield better results than did the control lotion or vehicle used. As a result, whether barrier creams are effective in preventing irritant contact dermatitis among health-care workers remains unknown."{{cite journal | url=https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5116a1.htm | title=Guideline for Hand Hygiene in Health-Care Settings |author=John M. Boyce |author2=Didier Pittet | journal=Morbidity and Mortality Weekly Report | date=October 17, 2002}}

The Great Ormond Street Hospital Manual of Children's Nursing Practices 2012 book found that "disposable nappies are effective in drawing fluid away from the skin and can be changed less frequently in the absence of stools, making regular application of barrier creams unnecessary in most children."{{cite book|author=Susan Macqueen|title=The Great Ormond Street Hospital Manual of Children's Nursing Practices|url=https://books.google.com/books?id=Fnl6ak_T2hEC&pg=PA181|date=June 18, 2012|publisher=John Wiley & Sons|isbn=978-1-4051-0932-1|pages=181–}}

Barrier creams have been used in industry to protect workers' skin from the contaminants encountered in occupations such as nurses, hairdressers, employees in the food processing industry, cleaners, metal workers, printers, bricklayers etc.

A 2018 Cochrane review concluded that the use of moisturizers alone or in combination with barrier creams may result in important protective effects for the prevention of Occupational Irritant Hand Dermatitis (OIHD) Barrier creams can be applied before exposure to potential irritants,{{cite book |vauthors=Schliemann S, Elsner P | year = 2014 | chapter = Prevention of Hand Eczema: Barrier Creams and Emollients | title = Textbook of Hand Eczema | pages = 273–278 | doi = 10.1007/978-3-642-39546-8_26 | publisher = Springer| isbn = 978-3-642-39545-1 }} but are not typically used as the main protection against hazardous substances.{{cite journal |vauthors=Kurpiewska J, Liwkowicz J |title=[Barrier creams in prevention of hand dermatoses] |language=Polish |journal=Medycyna Pracy |volume=65 |issue=2 |pages=297–305 |year=2014 |pmid=25090859}} They are a poor substitute for protective clothing for workers;{{cite book|author=Richard J. G. Rycroft|title=Textbook of Contact Dermatitis|url=https://books.google.com/books?id=FmKAMSWEjd4C&pg=PA989|date=January 1, 2001|publisher=Springer Science & Business Media|isbn=978-3-540-66842-8|pages=989–}} in particular, gloves provide greater protection.{{cite book |editor1-last=Lebwohl |editor1-first=Mark G. |editor2-last=Heymann |editor2-first=Warren R. |editor3-last=Berth-Jones |editor3-first=John |editor4-last=Coulson |editor4-first=Ian |title=Treatment of Skin Disease: Comprehensive Therapeutic Strategies |url=https://books.google.com/books?id=hRryAAAAQBAJ&pg=PA336 |date=September 19, 2013 |publisher=Elsevier Health Sciences UK |isbn=978-0-7020-5236-1 |pages=336–}} However barrier creams are reasonably effective for protection of the face against some airborne substances. Active barrier creams containing silicone, tartaric acid, glycerin, and other ingredients are said to be beneficial for some chromate-sensitive construction workers.

The efficacy of barrier creams is controversial. They have not been demonstrated to be useful in preventing hand eczema.{{cite book|author1=Robert L. Rietschel|author2=Joseph F. Fowler|author3=Alexander A. Fisher|title=Fisher's Contact Dermatitis|url=https://books.google.com/books?id=dQBAzfyCeQ8C&pg=PA333|year=2008|publisher=PMPH-USA|isbn=978-1-55009-378-0|pages=333–}} According to the National Safety Council, "shielding lotions can keep the skin from drying out".{{cite book|title=Safety & Health: SH|volume=172-173|url=https://books.google.com/books?id=mdUJAQAAMAAJ&q=shielding+lotion|year=2005|edition=Digitized June 1, 2010|publisher=The Council}}

A 2002 review found "some reports indicate that inappropriate BC (barrier cream) application might induce a deleterious rather than a beneficial effect."{{cite journal |vauthors=Zhai H, Maibach HI |title=Barrier creams--skin protectants: can you protect skin? |journal=Journal of Cosmetic Dermatology |volume=1 |issue=1 |pages=20–3 |year=2002 |pmid=17134447 |doi=10.1046/j.1473-2130.2001.00006.x|s2cid=80542190 }} Skin that has been moisturized by barrier cream may be more susceptible to irritation by sodium lauryl sulfate, which can permeate hydrated skin more easily due to its hydrophilia. When handling hazardous molecules such as sodium hydroxide, ingredients in barrier cream could react and induce skin irritation. Barrier creams that contain petroleum jelly or certain oils may cause rubber or latex gloves to deteriorate.

The mechanism of barrier cream varies by product.{{cite journal |vauthors=Corazza M, Minghetti S, Bianchi A, Virgili A, Borghi A |title=Barrier creams: facts and controversies |journal=Dermatitis |volume=25 |issue=6 |pages=327–33 |year=2014 |doi=10.1097/DER.0000000000000078 |pmid=25384222|s2cid=24884588 }} Three categories of barrier creams are used: water repellent creams, water-soluble creams, and creams designed for special applications.{{Cite book|title = Principles of Construction Safety|url=https://books.google.com/books?id=6jF22-zcLJcC&pg=PA177|publisher=John Wiley & Sons|date=2008-06-09|isbn= 9780470763353|first=Allan St John|last=Holt|page=177}} Moisturizing barrier cream acts as a lubricating film on the skin to prevent depletion of water (transepidermal water loss) in the skin's outermost layer, the stratum corneum. This may have a protective effect against irritant contact dermatitis and allergic contact dermatitis, which often result from such depletion. These barrier creams can be classed as occlusives (which prevent loss through a hydrophobic effect), humectants (which absorb water from the dermis and environment due to hygroscopy), or hydrating agents (which both moisturize the skin and maintain its water content). Barrier creams may contain substances such as zinc oxide, talc or kaolin to layer over the skin. Other barrier creams are intended to protect the skin from some external agents, though they are not sufficient to provide a complete barrier.

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Category:Skin care