The efficacy of a moisturizer (Locobase) among cleaners and kitchen assistants during everyday exposure to water and detergents. The efficacy of a protective cream in a real-world apprentice hairdresser environment. [Efficacy of the use of barrier creams in the prevention of dermatological diseases in textile dyeing and printing plant workers: results of a randomized trial].
Workers exposed to various irritants are widely advised to use moisturizers. To evaluate the efficacy of a moisturizer (Locobase), we studied 111 cleaners and kitchen workers during everyday exposure to water and detergents. All took part in a standardized interview. After randomization, 1/2 the workers (n = 56) used Locobase during a period of 2 weeks (period L), followed by a period without any emollient (period C), or vice versa (n = 55). Clinical assessment and measurements of the skin surface temperature, electrical capacitance and transepidermal water loss (TEWL) were performed on the fingers, hands and arms on entry to the study, after 2 weeks and 4 weeks, or at drop out. The final evaluation showed that 70 (63%) were able to complete the study; 23 (21%) completed period L, but withdrew from period C after a mean of 6 days because of progressive dryness of the skin and eczema; and 12 (11%) were excluded because they used topical corticosteroids or emollients. The remaining 6 (5%) participants were lost to follow-up. Clinically, we observed a significant increase in dryness (p < 0.001) during periods of no treatment (period C), and normalization of the skin texture during use of Locobase. Clinical observations were confirmed by statistically significant differences (p < 0.001) in the electrical capacitance (epidermal hydration), which decreased during period C and increased to pre-study values during period L. No significant differences were found in skin temperatures and TEWL rates.(ABSTRACT TRUNCATED AT 250 WORDS) The object of this study was to compare the protective action of a new barrier cream (Excipial Protect, Spirig Pharma AG, Egerkingen, Switzerland) to its vehicle in the context of hand irritation of apprentice hairdressers caused by repeated shampooing and exposure to hair-care products. This was a double-blind cross-over comparing Excipial Protect (containing aluminium chlorohydrate 5% as active ingredient) against its vehicle alone. The efficacy of the creams was evaluated taking into account: (1) clinical scores by researchers, (2) biometric measurements, (3) subjective opinions of the subjects. An analysis of variance was performed considering order of application, degree of atopy, and reported number of shampoos. We observed very little difference in efficacy between the protective cream and its vehicle. The presence, however, of aluminium chlorhydrate in the protective cream was shown to have a positive effect against work-related irritation. The cosmetic qualities of the creams seemed, to the participants, to be as important as their real protective and hydrating properties, an important factor in compliance issues. A total of 942 workers of 13 dyeing and printing factories in the area of Como (N. Italy) were examined in order to detect skin complaints on the hands and forearms. Of these, 868 were eligible for and consented to participate in a controlled and randomized experiment aimed at assessing the efficacy of using barrier creams in practical circumstances. 657 workers underwent all three control examinations arranged over about one year. In the randomized group for treatment with barrier creams the cumulative incidence of objective skin lesions was significantly lower than in the group in which no particular recommendation of use was made (44.5% versus 54.4% positive for objective examination in at least one of the three control examinations after recruitment: 95% confidence limits of the difference between 2%-17% percentages; 39.9% versus 47.0% in subjects who were negative at the recruitment examination, 59.0% versus 76.8% in subjects who were positive at the recruitment examination). The use of a hydrocarbon cream was significantly more effective than using a silicone cream (95% confidence limits of the differences of cumulative incidences: -10.9% +20.7% comparing silicone creams with non-treatment; 2.8%-20.2% comparing hydrocarbon creams with non-treatment).
Although the findings of this review were generally positive, no statistical significance was reached. We conclude that at present there is insufficient evidence for the effectiveness of most of the interventions used in the primary prevention of OIHD. This does not mean that current measures are necessarily ineffective, as the limited studies to date have been rather small and of poor quality. Larger well designed RCTs are now needed in different workplaces to establish the effectiveness of various preventative strategies.