Prevention of Hand Eczema: Barrier Creams and Emollients

Abstract

Hand eczema is the most frequent manifestation of occupational skin disease. It may also occur in the household or as an endogenous condition. Barrier creams (BCs) are one of the common measures to prevent contact dermatitis of the hands. BCs share some common characteristics with emollients and moisturizers that are used to maintain healthy skin. There are, however, some differences between BCs and skin care products that need to be addressed. BCs are designed to diminish the irritant impact of the known key factors of skin irritation that are related to wet work, namely, hand washing and exposure to hot water or detergents and other mild irritants. In addition, BCs may facilitate the removal of visible dirt from the skin surface. BCs are intended to be applied prior to procedures and exposures that have irritant potential. In the prevention of occupational hand dermatitis, the “3-step occupational skin protection concept” includes skin cleansers and skin care products, in addition to BCs. The latter are meant as postexposure products that help to restore the physiological epidermal skin barrier. In this section, definitions, efficacy, intended application areas, appropriate application, and educational aspects as well as the assumed mechanisms of action and limitations of BCs are presented.