Effects of water temperature on surfactant‐induced skin irritation

Berardesca, Enzo; Vignoli, G. P.; Distante, F.; Brizzi, P.; Rabbiosi, G.

doi:10.1111/j.1600-0536.1995.tb00751.x

Cited by 75 publications

(47 citation statements)

References 9 publications

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“…Water alone has been shown to be capable of eliciting irritant skin responses, particularly as the temperature of the water increases. 32,33 However the changes seen when using water alone could be attributed to the physical rubbing action that occurred during the washing procedure, rather than any direct irritant effect of the water itself.…”

Section: ■ Discussionmentioning

confidence: 99%

The Effect of Washing and Drying Practices on Skin Barrier Function

Voegeli

2008

Journal of Wound, Ostomy &Amp; Continence Nursing

108

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PURPOSE:The aim of this study was to explore the potential contribution to skin damage caused by standard washing and drying techniques used in nursing.DESIGN: An experimental cohort design was used, with healthy volunteers (n = 15) receiving 6 different washing and drying techniques to the volar aspect of the forearm. Subjects underwent 3 washing and drying techniques on each arm; each technique was repeated twice, separated by a 2-hour rest period. METHODS:Skin integrity was assessed by measuring transepidermal water loss (TEWL), skin hydration, skin pH, and erythema. Comparisons were made between washing with soap or water alone, and drying using a towel (rubbing and patting) or evaporation. The significance of any difference was assessed by nonparametric analysis. The study was approved by the local research ethics committee, and all volunteers gave informed consent. RESULTS:TEWL was seen to increase following each type of wash, and increased further following repeated washing. Drying of the skin by patting with a towel increased TEWL to give readings identical to those obtained from wet skin. There was an increase in skin pH with all washing and drying techniques, particularly when soap was used. Erythema also increased with repeated washing, particularly when soap was used. No significant changes were observed in skin hydration as measured by a corneometer, although there was a tendency for the values to decrease with washing.CONCLUSIONS: These data suggest that washing with soap and water and towel drying has a significant disrupting effect on the skin's barrier function. There is tentative evidence to suggest that a cumulative effect may exist with damage increasing as washing frequency increases. Drying the skin by patting with a towel offers no advantage to conventional gentle rubbing as it leaves the skin significantly wetter and at greater risk of frictional damage. ■ IntroductionThe promotion and maintenance of skin integrity remains one of the most common challenges facing healthcare professionals. Estimates suggest that basic skin care, consisting of washing and drying patients, accounts for 12% to 17% of total nursing time in a typical acute care setting. 1 However, this activity increases significantly during the care of individuals with urinary or fecal incontinence, as washing and drying forms the cornerstone of skin care for this group, in order to prevent irritation and skin breakdown. Globally it is suggested that over 200 million people suffer from significant urinary incontinence, and therefore are at risk of skin breakdown. 2 In the United Kingdom alone, Durrant and Snape 3 suggest that 50% of nursing home residents have urinary incontinence, and overall incidence rates of 40% to 70% in the UK elderly population are reported by the Royal College of Physicians. 4 Early work by Lyder 5 claimed that perineal dermatitis and skin breakdown occurs in 35% of hospitalized elderly patients with incontinence, rising to 41% of individuals in long-term care settings, demonstrating the significance ...

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Section: ■ Discussionmentioning

confidence: 99%

The Effect of Washing and Drying Practices on Skin Barrier Function

Voegeli

2008

Journal of Wound, Ostomy &Amp; Continence Nursing

108

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“…Both the concentration and temperature of a given surfactant modulate the irritation induced [2, 3, 6, 8]. A number of in vivo and in vitro methods have been developed with the aim to quantify the irritant and corrosive potential of substances following contact with the skin.…”

Section: Discussionmentioning

confidence: 99%

Microwave Corneosurfametry and the Short-Duration Dansyl Chloride Extraction Test for Rating Concentrated Irritant Surfactants

Goffin

Pierard

2001

Dermatology

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Background: There are ethical concerns to conduct in vivo tests in the animal and human to provide evidence that cosmetics and other topical products are safe. Objective: To compare two methods, namely the short-duration dansyl chloride extraction test and the microwave corneosurfametry bioassay, to test the irritation potential of concentrated surfactant systems. Methods: Five surfactants and water were tested using the in vivo test and the bioassay. Results: A significant linear correlation was found between data yielded by the two procedures. Conclusion: The short-duration dansyl chloride extraction test and the microwave corneosurfametry bioassay provide similar information. The latter has the advantage of being safe.

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“…It would be logical to say that the above is a universally accepted protocol, however more often, the following factors are not considered. 11 compared water temperatures and showed significant association with skin irritation with warmer temperatures. The use of very hot water for hand washing should therefore be avoided as it increases the likelihood of skin damage.…”

Section: Water and Water Qualitymentioning

confidence: 99%