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Moisturizers in the Prevention and Treatment of Hand Eczema

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Abstract

Hand eczema is common and multifactorial. A wide range of approaches is available for the management of the condition, in which moisturizing creams or emollients are important treatment adjuncts, both in the acute phase and to prevent outbreaks of eczema. However, moisturizers contain a great variety of ingredients that have different effects on the skin, some of which may be deleterious. The products can be regulated as pharmaceuticals, medical devices, and cosmetics.

The first-generation moisturizers were occlusive emollients based on petrolatum to reduce transepidermal water loss (TEWL) and to allow the epidermis to heal itself. The second-generation moisturizers contained humectants to bind water and lipids for temporary barrier improvement. Today’s “regular” moisturizers offer occlusive and humectant activity. The future products have occlusive and humectant properties and will contain ingredients for stimulating barrier repair based upon different dry syndromes. Products that not only diminish dryness symptoms but also repair the skin barrier and prevent barrier disruption would be the most valuable moisturizers. Thus, more evidence on their effectiveness compared to no treatment and compared to a reference or placebo is needed.

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References

  1. Meding B, Swanbeck G. Occupational hand eczema in an industrial city. Contact Dermatitis. 1990;22(1): 13–23.

    CAS  PubMed  Google Scholar 

  2. Meding B, Wrangsjo K, Jarvholm B. Fifteen-year follow-up of hand eczema: persistence and consequences. Br J Dermatol. 2005;152(5):975–80.

    CAS  PubMed  Google Scholar 

  3. Halkier-Sorensen L. Occupational skin diseases. Contact Dermatitis. 1996;35(1 Suppl):1–120.

    CAS  PubMed  Google Scholar 

  4. Meding B, Swanbeck G. Prevalence of hand eczema in an industrial city. Br J Dermatol. 1987;116(5):627–34.

    CAS  PubMed  Google Scholar 

  5. Bryld LE, Agner T, Kyvik KO, Brøndsted L, Hindsberger C, Menné T. Hand eczema in twins: a questionnaire investigation. Br J Dermatol. 2000;142(2):298–305.

    CAS  PubMed  Google Scholar 

  6. Rystedt I. Long-term follow-up in atopic dermatitis. Acta Derm Venereol Suppl (Stockh). 1985;114:117–20.

    CAS  Google Scholar 

  7. Thyssen JP, Carlsen BC, Menné T, Linneberg A, Nielsen NH, Meldgaard M, et al. Filaggrin null mutations increase the risk and persistence of hand eczema in subjects with atopic dermatitis: results from a general population study. Br J Dermatol. 2010;163(1):115–20.

    CAS  PubMed  Google Scholar 

  8. Palmer CN, Irvine AD, Terron-Kwiatkowski A, Zhao Y, Liao H, Lee SP, et al. Common loss-of-function variants of the epidermal barrier protein filaggrin are a major predisposing factor for atopic dermatitis. Nat Genet. 2006;38(4):441–6.

    CAS  PubMed  Google Scholar 

  9. Weidinger S, Illig T, Baurecht H, Irvine AD, Rodriguez E, Diaz-Lacava A, et al. Loss-of-function variations within the filaggrin gene predispose for atopic dermatitis with allergic sensitizations. J Allergy Clin Immunol. 2006;118(1):214–9.

    CAS  PubMed  Google Scholar 

  10. Garg A, Chren MM, Sands LP, Matsui MS, Marenus KD, Feingold KR, et al. Psychological stress perturbs epidermal permeability barrier homeostasis: implications for the pathogenesis of stress-associated skin disorders. Arch Dermatol. 2001;137(1):53–9.

    CAS  PubMed  Google Scholar 

  11. English J, Aldridge R, Gawkrodger DJ, Kownacki S, Statham B, White JM, et al. Consensus statement on the management of chronic hand eczema. Clin Exp Dermatol. 2009;34(7):761–9.

    CAS  PubMed  Google Scholar 

  12. Elias PM, Hatano F, Williams ML. Basis for the barrier abnormality in atopic dermatitis: outside-inside-outside pathogenic mechanisms. J Allergy Clin Immunol. 2008;121(6):1337–43.

    CAS  PubMed Central  PubMed  Google Scholar 

  13. Buraczewska I, Berne B, Lindberg M, Törmä H, Lodén M. Changes in skin barrier function following long-term treatment with moisturizers, a randomized controlled trial. Br J Dermatol. 2007;156(3):492–8.

    CAS  PubMed  Google Scholar 

  14. Held E, Sveinsdottir S, Agner T. Effect of long-term use of moisturizer on skin hydration, barrier function and susceptibility to irritants. Acta Derm Venereol. 1999;79(1):49–51.

    CAS  PubMed  Google Scholar 

  15. Zachariae C, Held E, Johansen JD, Menné T, Agner T. Effect of a moisturizer on skin susceptibility to NiCl2. Acta Derm Venereol. 2003;83(2):93–7.

    CAS  PubMed  Google Scholar 

  16. Vilaplana J, Coll J, Trullás C, Azón A, Pelejero C. Clinical and non-invasive evaluation of 12 % ammonium lactate emulsion for the treatment of dry skin in atopic and non-atopic subjects. Acta Derm Venereol (Stockh). 1992;72:28–33.

    CAS  Google Scholar 

  17. Held E, Sveinsdottir S, Agner T. Effect of long-term use of moisturizers on skin hydration, barrier function and susceptibility to irritants. Acta DermVenereol (Stockh). 1999;79:49–51.

    CAS  Google Scholar 

  18. Hoare C, Li Wan Po A, Williams H. Systematic review of treatments for atopic eczema. Health Technol Assess. 2000;4(37):1–191.

    CAS  PubMed  Google Scholar 

  19. Sörensen A, Landvall P, Lodén M. Moisturizers as cosmetics, medicines, or medical device? The regulatory demands in the European Union. In: Lodén M, Maibach HI, editors. Treatment of dry skin syndrome. The art and science of moisturizers. Berlin/Heidelberg: Springer; 2012. p. 3–16.

    Google Scholar 

  20. Kibbe AW. Handbook of pharmaceutical excipients. 3rd ed. London: Pharmaceutical Press; 2000.

    Google Scholar 

  21. Barany E, Lindberg M, Lodén M. Unexpected skin barrier influence from nonionic emulsifiers. Int J Pharm. 2000;195(1–2):189–95.

    CAS  PubMed  Google Scholar 

  22. Rawlings AV, Harding C, Watkinson A, Banks J, Ackerman C, Sabin R. The effect of glycerol and humidity on desmosome degradation in stratum corneum. Arch Dermatol Res. 1995;287:457–64.

    CAS  PubMed  Google Scholar 

  23. Froebe CL, Simion A, Ohlmeyer H, Rhein LD, Mattai J, Cagan RH, et al. Prevention of stratum corneum lipid phase transitions in vitro by glycerol – an alternative mechanism for skin moisturization. J Soc Cosmet Chem. 1990;41:51–65.

    CAS  Google Scholar 

  24. Mattai J, Froebe CL, Rhein D, et al. Prevention of model stratum corneum lipid phase transitions in vitro by cosmetic additives – differential scanning calorimetry, optical microscopy, and water evaporation studies. J Soc Cosmet Chem. 1993;44:89–100.

    CAS  Google Scholar 

  25. Fluhr JW, Mao-Qiang M, Brown BE, Wertz PW, Crumrine D, Sundberg JP, et al. Glycerol regulates stratum corneum hydration in sebaceous gland deficient (asebia) mice. J Invest Dermatol. 2003;120(5):728–37.

    CAS  PubMed  Google Scholar 

  26. Schmid-Grendelmeier P, Wyss M, Elsner P. Contact allergy to dexpanthenol. A report of seven cases and review of the literature. Dermatosen. 1995;43:175–8.

    Google Scholar 

  27. Reynolds JEF. Martindale: the extra pharmacopoeia. 13th ed. London: The Pharmaceutical Press; 1993.

    Google Scholar 

  28. Anonymous. Final report on the safety assessment of panthenol and pantothenic acid. J Am Coll Toxicol. 1987;6:139–163.

    Google Scholar 

  29. Laden K. Natural moisturization factors in skin. Am Perfum Cosmet. 1967;82:77–9.

    CAS  Google Scholar 

  30. Jacobi OK. Moisture regulation in the skin. Drug Cosmet Ind. 1959;84:732–812.

    CAS  Google Scholar 

  31. Rawlings AV, Harding CR. Moisturization and skin barrier function. Dermatol Ther. 2004;17 Suppl 1:43–8.

    PubMed  Google Scholar 

  32. Candi E, Schmidt R, Melino G. The cornified envelope: a model of cell death in the skin. Nat Rev Mol Cell Biol. 2005;6(4):328–40.

    CAS  PubMed  Google Scholar 

  33. Middleton J. Development of a skin cream designed to reduce dry and flaky skin. J Soc Cosmet Chem. 1974;25:519–34.

    CAS  Google Scholar 

  34. Rawlings AV, Davies A, Carlomusto M, Pillai S, Zhang K, Kosturko R, et al. Effect of lactic acid isomers on keratinocyte ceramide synthesis, stratum corneum lipid levels and stratum corneum barrier function. Arch Dermatol Res. 1996;288:383–90.

    CAS  PubMed  Google Scholar 

  35. Berardesca E, Distante F, Vignoli GP, Oresajo C, Green B. Alpha hydroxyacids modulate stratum corneum barrier function. Br J Dermatol. 1997;137(6):934–8.

    CAS  PubMed  Google Scholar 

  36. Wehr R, Krochmal L, Bagatell F, Ragsdale W. A controlled two-center study of lactate 12 % lotion and a petrolatum-based cream in patients with xerosis. Cutis. 1986;37:205–9.

    CAS  PubMed  Google Scholar 

  37. Swanbeck G, Rajka G. Antipruritic effect of urea solutions. Acta Derm Venereol (Stockholm). 1970;50:225–7.

    CAS  Google Scholar 

  38. Rosten M. The treatment of ichthyosis and hyperkeratotic conditions with urea. Aust J Derm. 1970;11:142–4.

    CAS  Google Scholar 

  39. Dattner AM. From medical herbalism to phytotherapy in dermatology: back to the future. Dermatol Ther. 2003;16(2):106–13.

    PubMed  Google Scholar 

  40. Shelton RM. Aloe vera. Its chemical and therapeutic properties. Int J Dermatol. 1991;30:679–83.

    CAS  PubMed  Google Scholar 

  41. Andreassi M, Stanghellini E, Ettorre A, Di Stefano A, Andreassi L. Antioxidant activity of topically applied lycopene. J Eur Acad Dermatol Venereol. 2004;18(1):52–5.

    CAS  PubMed  Google Scholar 

  42. Godfrey D. Preservation of moisturisers. In: Loden M, Maibach HI, editors. Treatment of dry skin syndrome. The art and science of moisturizers. Berlin: Springer; 2012. p. 355–66.

    Google Scholar 

  43. Linsen G, Goossens A. Allergic contact dermatitis from ethylhexylglycerin. Contact Dermatitis. 2002;47(3):169.

    CAS  PubMed  Google Scholar 

  44. Mortz CG, Otkjaer A, Andersen KE. Allergic contact dermatitis to ethylhexylglycerin and pentylene glycol. Contact Dermatitis. 2009;61(3):180.

    PubMed  Google Scholar 

  45. Stausbol-Gron B, Andersen KE. Allergic contact dermatitis to ethylhexylglycerin in a cream. Contact Dermatitis. 2007;57(3):193–4.

    PubMed  Google Scholar 

  46. Lundstrom A, Egelrud T. Cell shedding from human plantar skin in vitro: evidence of its dependence on endogenous proteolysis. J Invest Dermatol. 1988;91(4):340–3.

    CAS  PubMed  Google Scholar 

  47. Denda M, Katagiri C, Hirao T, Maruyama N, Takahashi M. Some magnesium salts and a mixture of magnesium and calcium salts accelerate skin barrier recovery. Arch Dermatol Res. 1999;291(10):560–3.

    CAS  PubMed  Google Scholar 

  48. Lodén M, Olsson H, Skare L, Axéll T. Instrumental and sensory evaluation of the frictional response of the skin following a single application of five moisturizing creams. J Soc Cosmet Chem. 1992;43:13–20.

    Google Scholar 

  49. Nicholls S, King CS, Marks R. Short term effects of emollients and a bath oil on the stratum corneum. J Soc Cosmet Chem. 1978;29:617–24.

    Google Scholar 

  50. Garber CA, Nightingale CT. Characterizing cosmetic effects and skin morphology by scanning electron microscopy. J Soc Cosmet Chem. 1976;27: 509–31.

    Google Scholar 

  51. Rhodes LE, Diffey BL. Fluorescence spectroscopy: a rapid, noninvasive method for measurement of skin surface thickness of topical agents. Br J Dermatol. 1997;136(1):12–7.

    CAS  PubMed  Google Scholar 

  52. Johnson R, Nusbaum BP, Horwitz SN, Frost P. Transfer of topically applied tetracycline in various vehicles. Arch Dermatol. 1983;119(8):660–3.

    CAS  PubMed  Google Scholar 

  53. Holden C, English J, Hoare C, Jordan A, Kownacki S, Turnbull R, et al. Advised best practice for the use of emollients in eczema and other dry skin conditions. J Dermatolog Treat. 2002;13(3):103–6.

    CAS  PubMed  Google Scholar 

  54. Loden M, Buraczewska I, Halvarsson K. Facial anti-wrinkle cream: influence of product presentation on effectiveness: a randomized and controlled study. Skin Res Technol. 2007;13(2):189–94.

    PubMed  Google Scholar 

  55. Lynfield YL, Schechter BA. Choosing and using a vehicle. J Am Acad Dermatol. 1984;10:56–9.

    CAS  PubMed  Google Scholar 

  56. Schlagel CA, Sanborn EC. The weights of topical preparations required for total and partial body inunction. J Invest Dermatol. 1964;42:253–6.

    CAS  PubMed  Google Scholar 

  57. Ivens UI, Steinkjer B, Serup J, Tetens V. Ointment is evenly spread on the skin, in contrast to creams and solutions. Br J Dermatol. 2001;145(2):264–7.

    CAS  PubMed  Google Scholar 

  58. Lodén M, Lindberg M. The influence of a single application of different moisturizers on the skin capacitance. Acta Derm Venereol. 1991;71(1):79–82.

    PubMed  Google Scholar 

  59. Lodén M. The increase in skin hydration after application of emollients with different amounts of lipids. Acta Derm Venereol. 1992;72(5):327–30.

    PubMed  Google Scholar 

  60. Buraczewska I, Brostrom U, Loden M. Artificial reduction in transepidermal water loss improves skin barrier function. Br J Dermatol. 2007;157(1):82–6.

    CAS  PubMed  Google Scholar 

  61. Saary J, Qureshi R, Palda V, DeKoven J, Pratt M, Skotnicki-Grant S, et al. A systematic review of contact dermatitis treatment and prevention. J Am Acad Dermatol. 2005;53(5):845.

    PubMed  Google Scholar 

  62. Kelterer D, Fluhr JW, Elsner P. Application of protective creams: use of a fluorescence-based training system decreases unprotected areas on the hands. Contact Dermatitis. 2003;49(3):159–60.

    CAS  PubMed  Google Scholar 

  63. Kresken J, Klotz A. Occupational skin-protection products–a review. Int Arch Occup Environ Health. 2003;76(5):355–8.

    CAS  PubMed  Google Scholar 

  64. Hannuksela A, Kinnunen T. Moisturizers prevent irritant dermatitis. Acta Derm Venereol. 1992;72(1):42–4.

    CAS  PubMed  Google Scholar 

  65. Fluhr JW, Gloor M, Lehmann L, Lazzerini S, Distante F, Berardesca E. Glycerol accelerates recovery of barrier function in vivo. Acta Derm Venereol. 1999;79(6):418–21.

    CAS  PubMed  Google Scholar 

  66. Held E, Lund H, Agner T. Effect of different moisturizers on SLS-irritated human skin. Contact Dermatitis. 2001;44:229–34.

    CAS  PubMed  Google Scholar 

  67. Lodén M. Barrier recovery and influence of irritant stimuli in skin treated with a moisturizing cream. Contact Dermatitis. 1997;36(5):256–60.

    PubMed  Google Scholar 

  68. Kucharekova M, Schalkwijk J, Van De Kerkhof PC, Van De Valk PG. Effect of a lipid-rich emollient containing ceramide 3 in experimentally induced skin barrier dysfunction. Contact Dermatitis. 2002;46:331–8.

    CAS  PubMed  Google Scholar 

  69. Man MQ, Feingold KR, Elias PM. Exogenous lipids influence permeability barrier recovery in acetone-treated murine skin. Arch Dermatol. 1993;129(6): 728–38.

    CAS  PubMed  Google Scholar 

  70. Mortz CG, Andersen KE, Halkier-Sørensen L. The efficacy of different moisturizers on barrier recovery in hairless mice evaluated by non-invasive bioengineering methods. A model to select the potentially most effective product. Contact Dermatitis. 1997;36:297–310.

    CAS  PubMed  Google Scholar 

  71. Ramsing DW, Agner T. Preventive and therapeutic effects of a moisturizer. An experimental study of human skin. Acta Derm Venereol. 1997;77(5): 335–7.

    CAS  PubMed  Google Scholar 

  72. Held E, Agner T. Comparison between 2 test models in evaluating the effect of a moisturizer on irritated human skin. Contact Dermatitis. 1999;40(5):261–8.

    CAS  PubMed  Google Scholar 

  73. Williams C, Wilkinson SM, McShane P, Lewis J, Pennington D, Pierce S, et al. A double-blind, randomized study to assess the effectiveness of different moisturizers in preventing dermatitis induced by hand washing to simulate healthcare use. Br J Dermatol. 2010;162(5):1088–92.

    CAS  PubMed  Google Scholar 

  74. Ghadially R, Halkier-Sorensen L, Elias PM. Effects of petrolatum on stratum corneum structure and function. J Am Acad Dermatol. 1992;26(3 Pt 2):387–96.

    CAS  PubMed  Google Scholar 

  75. Zettersten EM, Ghadially R, Feingold KR, Crumrine D, Elias PM. Optimal ratios of topical stratum corneum lipids improve barrier recovery in chronologically aged skin. J Am Acad Dermatol. 1997;37:403–8.

    CAS  PubMed  Google Scholar 

  76. Imokawa G, Akasaki S, Hattori M, Yoshizuka N. Selective recovery of deranged water-holding properties by stratum corneum lipids. J Invest Dermatol. 1986;87(6):758–61.

    CAS  PubMed  Google Scholar 

  77. Lodén M, Barany E. Skin-identical lipids versus petrolatum in the treatment of tape-stripped and detergent-perturbed human skin. Acta Derm Venereol. 2000;80(6):412–5.

    PubMed  Google Scholar 

  78. Chamlin SL, Kao J, Frieden IJ, Sheu MY, Fowler AJ, Fluhr JW, et al. Ceramide-dominant barrier repair lipids alleviate childhood atopic dermatitis: changes in barrier function provide a sensitive indicator of disease activity. J Am Acad Dermatol. 2002;47(2):198–208.

    PubMed  Google Scholar 

  79. Man MM, Feingold KR, Thornfeldt CR, Elias PM. Optimization of physiological lipid mixtures for barrier repair. J Invest Dermatol. 1996;106(5): 1096–101.

    Google Scholar 

  80. De Paepe K, Derde MP, Roseeuw D, Rogiers V. Incorporation of ceramide 3B in dermatocosmetic emulsions: effect of the transepidermal water loss of sodium lauryl sulphate-damaged skin. J Eur Acad Dermatol Venereol. 2000;14:272–9.

    PubMed  Google Scholar 

  81. Kucharekova M, Van De Kerkhof PC, Van Der Valk PG. A randomized comparison of an emollient containing skin-related lipids with a petrolatum-based emollient as adjunct in the treatment of chronic hand dermatitis. Contact Dermatitis. 2003;48(6):293–9.

    CAS  PubMed  Google Scholar 

  82. Miller CC, Tang W, Ziboh VA, Fletcher MP. Dietary supplementation with ethyl ester concentrates of fish oil (n-3) and borage oil (n-6) polyunsaturated fatty acids induces epidermal generation of local putative anti-inflammatory metabolites. J Invest Dermatol. 1991;96:98–103.

    CAS  PubMed  Google Scholar 

  83. Schurer NY. Implementation of fatty acid carriers to skin irritation and the epidermal barrier. Contact Dermatitis. 2002;47(4):199–205.

    CAS  PubMed  Google Scholar 

  84. Sheu MY, Fowler AJ, Kao J, Schmuth M, Schoonjans K, Auwerx J, et al. Topical peroxisome proliferator activated receptor-alpha activators reduce inflammation in irritant and allergic contact dermatitis models. J Invest Dermatol. 2002;118(1):94–101.

    CAS  PubMed  Google Scholar 

  85. Fowler AJ, Sheu MY, Schmuth M, Kao J, Fluhr JW, Rhein L, et al. Liver X receptor activators display anti-inflammatory activity in irritant and allergic contact dermatitis models: liver-X-receptor-specific inhibition of inflammation and primary cytokine production. J Invest Dermatol. 2003;120(2):246–55.

    CAS  PubMed  Google Scholar 

  86. Proksch E, Nissen HP. Dexpanthenol enhances skin barrier repair and reduces inflammation after sodium lauryl sulphate-induced irritation. J Dermatol Treat. 2002;13:173–8.

    CAS  Google Scholar 

  87. Tanno O, Ota Y, Kitamura N, Katsube T, Inoue S. Nicotinamide increases biosynthesis of ceramides as well as other stratum corneum lipids to improve the epidermal permeability barrier. Br J Dermatol. 2000;143(3):524–31.

    CAS  PubMed  Google Scholar 

  88. Summers RS, Summers B, Chandar P, Feinberg C, Gursky R, Rawlings AV. The effect of lipids, with and without humectant, on skin xerosis. J Soc Cosmet Chem. 1996;47:27–39.

    CAS  Google Scholar 

  89. Rattner H. Use of urea in hand creams. Arch Dermatol Syph. 1943;48:47–9.

    Google Scholar 

  90. Fredriksson T, Gip L. Urea creams in the treatment of dry skin and hand dermatitis. Int J Dermatol. 1975;32:442–4.

    Google Scholar 

  91. Baillie ATK, et al. General Practitioner Research Group. Carbamide in hyperkeratosis. Report No 179. The Practitioner. 1973; 294–6.

    Google Scholar 

  92. Halkier-Sorensen L, Thestrup-Pedersen K. The efficacy of a moisturizer (Locobase) among cleaners and kitchen assistants during everyday exposure to water and detergents. Contact Dermatitis. 1993;29(5):266–71.

    CAS  PubMed  Google Scholar 

  93. Goh CL, Gan SL. Efficacies of a barrier cream and an afterwork emollient cream against cutting fluid dermatitis in metalworkers: a prospective study. Contact Dermatitis. 1994;31(3):176–80.

    CAS  PubMed  Google Scholar 

  94. Mygind K, Sell L, Flyvholm MA, Jepsen KF. High-fat petrolatum-based moisturizers and prevention of work-related skin problems in wet-work occupations. Contact Dermatitis. 2006;54(1):35–41.

    PubMed  Google Scholar 

  95. Winker R, Salameh B, Stolkovich S, Nikl M, Barth A, Ponocny E, et al. Effectiveness of skin protection creams in the prevention of occupational dermatitis: results of a randomized, controlled trial. Int Arch Occup Environ Health. 2009;82(5):653–62.

    CAS  PubMed  Google Scholar 

  96. Kutting B, Baumeister T, Weistenhöfer W, Pfahlberg A, Uter W, Drexler H. Effectiveness of skin protection measures in prevention of occupational hand eczema: results of a prospective randomized controlled trial over a follow-up period of 1 year. Br J Dermatol. 2010;162(2):362–70.

    CAS  PubMed  Google Scholar 

  97. Andersson A-C, Lindberg M, Lodén M. The effect of two urea-containing creams on dry, eczematous skin in atopic patients. I. Expert, patient and instrumental evaluation. J Dermatol Treat. 1999;10:165–9.

    CAS  Google Scholar 

  98. Lodén M, Andersson A-C, Lindberg M. Improvement in skin barrier function in patients with atopic dermatitis after treatment with a moisturizing cream (Canoderm®). Br J Dermatol. 1999;140:264–7.

    PubMed  Google Scholar 

  99. Loden M, Wirén K, Smerud K, Meland N, Hønnås H, Mørk G, et al. Treatment with a barrier-strengthening moisturizer prevents relapse of hand-eczema. An open, randomized, prospective, parallel group study. Acta Derm Venereol. 2010;90(6):602–6.

    PubMed  Google Scholar 

  100. Wirén K, Nohlgård C, Nyberg F, Holm L, Svensson M, Johannesson A, et al. Treatment with a barrier-strengthening moisturizing cream delays relapse of atopic dermatitis: a prospective and randomized controlled clinical trial. J Eur Acad Dermatol Venereol. 2009;23(11):1267–72.

    PubMed  Google Scholar 

  101. Demerjian M, Choi EH, Man MQ, Chang S, Elias PM, Feingold KR. Activators of PPARs and LXR decrease the adverse effects of exogenous glucocorticoids on the epidermis. Exp Dermatol. 2009;18(7):643–9.

    CAS  PubMed Central  PubMed  Google Scholar 

  102. Jensen JM, Pfeiffer S, Witt M, Bräutigam M, Neumann C, Weichenthal M, et al. Different effects of pimecrolimus and betamethasone on the skin barrier in patients with atopic dermatitis. J Allergy Clin Immunol. 2009;124(3 Suppl 2):R19–28.

    CAS  PubMed  Google Scholar 

  103. Kao JS, Fluhr JW, Man MQ, Fowler AJ, Hachem JP, Crumrine D, et al. Short-term glucocorticoid treatment compromises both permeability barrier homeostasis and stratum corneum integrity: inhibition of epidermal lipid synthesis accounts for functional abnormalities. J Invest Dermatol. 2003;120(3):456–64.

    CAS  PubMed  Google Scholar 

  104. Kolbe L, Kligman AM, Schreiner V, Stoudemayer T. Corticosteroid-induced atrophy and barrier impairment measured by non-invasive methods in human skin. Skin Res Technol. 2001;7(2):73–7.

    CAS  PubMed  Google Scholar 

  105. Loden M, Wirén K, Smerud KT, Meland N, Hønnås H, Mørk G, et al. The effect of a corticosteroid cream and a barrier-strengthening moisturizer in hand eczema. A double-blind, randomized, prospective, parallel group clinical trial. J Eur Acad Dermatol Venereol. 2012;26(5):597–601.

    CAS  PubMed  Google Scholar 

  106. Veien NK, Olholm Larsen P, Thestrup-Pedersen K, Schou G. Long-term, intermittent treatment of chronic hand eczema with mometasone furoate. Br J Dermatol. 1999;140(5):882–6.

    CAS  PubMed  Google Scholar 

  107. Held E. So moisturizers may cause trouble! Int J Dermatol. 2001;40(1):12–3.

    CAS  PubMed  Google Scholar 

  108. Blank IH. Factors which influence the water content of the stratum corneum. J Invest Dermatol. 1952;18:433–40.

    CAS  PubMed  Google Scholar 

  109. Tsai TF, Maibach HI. How irritant is water? An overview. Contact Dermatitis. 1999;41(6):311–4.

    CAS  PubMed  Google Scholar 

  110. Aungst BJ. The influence of fatty acids and fatty alcohols on skin permeability. In: Lodén M, Maibach HI, editors. Dry skin and moisturizers: chemistry and function. Boca Raton: CRC Press; 2000. p. 299–325.

    Google Scholar 

  111. Donbrow M, Azaz E, Pillersdorf A. Autoxidation of polysorbates. J Pharm Sci. 1978;67:1676–81.

    CAS  PubMed  Google Scholar 

  112. Travassos AR, Goossens A. Potential allergens in moisturizing creams. In: Lodén M, Maibach HI, editors. Treatment of dry skin syndrome. The art and science of moisturizers. Berlin: Springer; 2012. p. 341–54.

    Google Scholar 

  113. De Groot AC. Sensitizing substances. In: Lodén M, Maibach HI, editors. Dry skin and moisturizers: chemistry and function. Boca Raton: CRC Press; 2000. p. 403–11.

    Google Scholar 

  114. Barany E, Lodén M. Content of fragrance mix ingredients and customer complaints of cosmetic products. Am J Contact Dermat. 2000;11(2):74–9.

    CAS  PubMed  Google Scholar 

  115. Jansson T, Lodén M. Strategy to decrease the risk of adverse effects of fragrance ingredients in cosmetic products. Am J Contact Dermat. 2001;12(3):166–9.

    CAS  PubMed  Google Scholar 

  116. Api AM, Basketter DA, Cadby PA, Cano MF, Ellis G, Gerberick GF, et al. Dermal sensitization quantitative risk assessment (QRA) for fragrance ingredients. Regul Toxicol Pharmacol. 2008;52(1):3–23.

    CAS  PubMed  Google Scholar 

  117. Buckley DA, Rycroft RJ, White IR, McFadden JP. Contact allergy to individual fragrance mix constituents in relation to primary site of dermatitis. Contact Dermatitis. 2000;43(5):304–5.

    CAS  PubMed  Google Scholar 

  118. Lundov MD, Johansen JD, Zachariae C, Moesby L. Creams used by hand eczema patients are often contaminated with Staphylococcus aureus. Acta Derm Venereol. 2012;92(4):441–2.

    PubMed  Google Scholar 

  119. Nilsson EJ, Henning CG, Magnusson J. Topical corticosteroids and Staphylococcus aureus in atopic dermatitis. J Am Acad Dermatol. 1992;27(1):29–34.

    CAS  PubMed  Google Scholar 

  120. Haslund P, Bangsgaard N, Jarløv JO, Skov L, Skov R, Agner T. Staphylococcus aureus and hand eczema severity. Br J Dermatol. 2009;161(4):772–7.

    CAS  PubMed  Google Scholar 

  121. Carr J, et al. Contamination of emollient creams and ointments with Staphylococcus aureus in children with atopic eczema. Br J Dermatol. 2008;159 Suppl 1:114.

    Google Scholar 

  122. Ernst E. Adverse effects of herbal drugs in dermatology. Br J Dermatol. 2000;143(5):923–9.

    CAS  PubMed  Google Scholar 

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Correspondence to Marie Lodén Ms Pharm Sci, Dr Med Sci .

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Lodén, M. (2014). Moisturizers in the Prevention and Treatment of Hand Eczema. In: Alikhan, A., Lachapelle, JM., Maibach, H. (eds) Textbook of Hand Eczema. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-39546-8_27

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