Skin protection creams in medical settings: successful or evil?

Corneosurfametry and corneoxenometry are two in vitro bioessays which were selected for their good reproducibility, sensitivity and ease of use. A Kruskal-Wallis ANOVA test followed by the Dunn test was realized to compare series of data obtained.Significant differences in efficacy were obtained between the two assayed skin protection creams. One of the two tested creams showed a real protective effect against mild irritants, but the other tested cream presented an irritant potential in its application with mild irritants.The differences observed for the two tested skin protection creams were probably due to their galenic composition and their possible interactions with the offending products. As a result, the present in vitro bioassays showed contrasted effects of the creams corresponding to either a protective or an irritant effect on human stratum corneum.The regular and repetitive use of cleansing and antiseptic products for hand hygiene in medical settings is typically at risk for inducing irritant contact dermatitis (ICD) [1-3]. Indeed, repeat chemical aggressions generate subclinical alterations of the stratum corneum (SC), and impair the natural barrier against various chemical xenobiotics and microorganisms. As a result, skin becomes imperceptibly harsh and ICD ensues.In order to minimize the risk for developing ICD, prophylactic measures are offered including the application of skin protection creams (SPC) [4]. SPC are marketed for preventing or reducing the adsorption, penetration and absorption of irritants into the skin [4-6]. In practice, their use remains subject to a lively debate. In general, there is a lack of evidence of their efficacy. Some authors even suggest that inappropriate SPC applications are prone to induce additional irritation rather than benefit [7-9].Various in vivo and vitro methods were developed in recent times for evaluating SPC efficacy [10-16]. Each of the methods probably presents some advantages but also disadvantages. In vit