S1 guideline on occupational skin products: protective creams, skin cleansers, skin care products (ICD 10: L23, L24) – short version

Abstract

Job-related hand dermatitis heads up the list of reported occupational diseases. So-called skin products - understood to mean protective creams, skin cleansers and skin care products - are used for the primary and secondary prevention of job- related hand dermatitis. In the interests of evidence-based medicine, the only preventive measures and/or occupational skin products that should be used are those whose potential uses and efficacy are underpinned by scientific research. To this end, the Arbeitsgemeinschaft für Berufs- und Umweltdermatologie e.V. (Working Group for Occupational and Environmental Dermatology, ABD) of the DDG (German Dermatological Society) and the Deutsche Gesellschaft für Arbeits- und Umweltmedizin (German Society for Occupational and Environmental Medicine, DGAUM) have summed up the latest scientific findings and recommendations in the updated guideline. The benefit of the combined application of protective creams and skin care products in the primary and secondary prevention of work-related contact dermatitis has been widely confirmed by recent clinical-epidemiological studies. The guideline clearly explains the necessity of demonstrating the efficacy of protective creams and cleansing products by means of in vivo methods in the sense of repetitive applications. Transferable standardised testing systems designed to examine the irritation potential and thus the compatibility of occupational skin cleansers and the reduction of irritation by protective skin creams have now been developed and validated by multicentre studies for skin protection creams and cleansers. The status of the current assessment of the safety of occupational skin products is also summarised.

Health education decreases incidence of hand eczema in metal work apprentices: Results of a controlled intervention study

“…In line with this, a prospective intervention study by Kütting et al demonstrated that skin conditions in metalworkers improved most when using both skin care products and barrier creams, followed by using barrier creams alone . However, there is an ongoing discussion whether barrier creams are truly effective in prevention of HE …”

Guidelines for diagnosis, prevention, and treatment of hand eczema

“…Practical literature‐based recommendations referring to this are summarized in Table 6. Regarding barrier creams, evidence for their efficacy 65,66 is limited. They may only be effective against certain irritants and may sometimes even intensify the irritant skin response 67–69 .…”

“…71 this strategy is supported by a few controlled prospective studies in apprentices. 27,38,66,[68][69][70][71][72][73][74] Individuals with previous or current AD are particular at risk for development of OHE, however, primary information should be given to everyone. With regard to secondary prevention of work-related HE, some interventions based on health education and ready access to personal protective equipment failed to show a clear benefit.…”

“…Emollients/barrier creams Apply emollients on your hands during the working day but especially after work and before bedtime. 38,66,71,192,195,207,208 It may be reasonable to use a lighter emollients lotion during the day and a greasier, preferably fragrance-free, lipid rich moisturizer before bedtime. 71 this strategy is supported by a few controlled prospective studies in apprentices.…”

Handekzeme: Ätiologie, Diagnostik und therapeutisches Management

“…Zur Erfassung einer atopischen Hautdiathese ist die Erhebung des Erlanger Atopie-Scores hilfreich [11]. Eine Pricktestung oder eine Bestimmung spezifischer IgE-Antikörper auf häufige Inhalationsallergene können ergänzend erfolgen, um ggf.…”