Gloves Can Create Skin Irritation, Negative Skin Barrier Effects

In addition to known irritant exposure, wearing gloves on a regular basis can lead to irritant contact dermatitis.

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According to a recent study,¹ due to the material often used in watertight protective gloves, heat and moisture are often trapped by occlusion effects.

In the study, which took place from November to December 2016, researchers sought to determine the effects of wearing gloves on several factors, including inflammation, skin irritation, and epidermal barrier impairment.

Participants (n=24) ranged in age from 20 to 60 years old, were skin types I through IV, and did not have any skin lesions or existing on their hands or arms.

Patients with tattoos, high hair density, topical medication use, or high ultraviolet exposure in the hand or arm regions were excluded from participation. Additionally, patients who were pregnant, lactating, were being treated with immunosuppressive drugs, or who had severe and chronic skin diseases or a known allergy to components of the gloves were also excluded.

Prior to the start of the study, all participants were instructed to refrain from directly applying detergents, emollients, moisturizers, or topical medications to their hands or arms.

On day 1 of the study, researchers marked 5 test areas on each respective participants’ arms, totaling 10 test areas. Each area was 2 cm in diameter and spaced the same distance apart from one another.

In order to then induce skin irritation, researchers applied 6μL of a 1% sodium lauryl sulfate (SLS) solution dissolved in deionized water to 9 of the test areas, which were then covered with Finn chambers. The last test area was left untreated.

24 hours later, all Finn chambers were removed from participants’ arms. 4 of the test areas that had been irritated using the SLS solution were covered in a square patch containing several materials. These included a semipermeable membrane (SYM), occlusive material (OCC), cotton combined with occlusive material (COT/OCC), and a semipermeable membrane combined with occlusive material (SYM/OCC).

“To the best of our knowledge, this is the first study systematically assessing the effect of semipermeable membranes made of SYM on resolution of inflammation and epidermal barrier impairment after experimental skin irritation when applied alone or in combination with occlusive glove material mimicking the use as glove liner and comparing the results with the effects of occlusive material alone or in combination with COT material,” study authors wrote.

Depending on the material, the test areas were covered in different ways. OCC and SYM test areas were adhered on all 4 sides using medical tape, and combination patches were adhered only to 3 sides. The 4-sided application was intended to mimic glove wear at the fingertips while the 3-sided application was set to mimic the lower, exposed part of the glove wherein climate and water vapor leakage factors could be taken into account.

All participants had their test areas covered for 6 to 8 hours on day 2, and again on days 3 through 5. Days 6 and 7 were considered break days, wherein no testing was completed. Days 8 and 9 included the same pattern of testing and covering for a period of 6 to 8 hours.

Several bioengineering parameters were evaluated throughout the study, including erythema, skin surface hydrogen ion concentration, skin humidity, and transepidermal water loss. These parameters were evaluated at baseline, 1 hour after initial irritation application, 24 hours before covering test areas, before the fourth and fifth covering of test areas, and 24 hours after the sixth test area covering.

Using a clinical visual score (VS), researchers conducted clinical scoring of the test areas.

“After skin irritation with SLS 1% for 24 hours, visible skin inflammation and epidermal barrier impairment were detected in all irritated test areas of all 24 volunteers,” study authors wrote. “Values of the VS and bioengineering parameters did not differ significantly among the irritated test areas.”

At the conclusion of the study, researchers also found that areas covered by combination materials, and the SYM material, showed better results when covered for 8 hours as opposed to 6 hours.

Additionally, in all test areas, the SLS irritation impaired the epidermal barrier function in as few as 3 coverings. Initially, skin humidity decreased slightly from baseline; by day 5, test areas covered with a combination SYM/OCC material had significantly higher skin humidity values than those covered with OCC or those that were uncovered.

Levels of erythema increased significantly from baseline in all test areas that had been irritated. Additionally, VS also increased significantly from baseline after skin irritation. However, there were no significant pH value differences between the test areas, though OCC, SYM/OCC, and COT/OCC coverings led to significant pH value increases.

Study limitations included participant removal of covers, the difference in cover application (3 sides versus 4 sides), and the length of time that the test areas were covered.

“The study indicates that SYM is well-tolerated on experimentally pre-irritated skin. Moreover, it shows that gloves made of SYM or COT are able to counteract the delayed resolution of inflammation and epidermal barrier impairment caused by occlusive glove material when applied as liners on pre-irritated skin,” study authors wrote. “Our results support the recommendation to use glove liners under occlusive protective gloves, especially in those who already suffer from ICD [irritant contact dermatitis] of the hands. In addition, the data suggest that comfort gloves made of semipermeable materials are well tolerated and could be thus, a good alternative for gloves made of COT in patients with ICD of the hands.”

Reference

1. Heichel T, Brans R, John SM, et al. Effects of impermeable and semipermeable glove materials on resolution of inflammation and epidermal barrier impairment after experimental skin irritation. Contact Dermatitis. 2023. doi:10.1111/cod.14317