The influence of daily dish-washing with synthetic detergent on human skin

The effects of regular dish-washing on the stratum corneum barrier function, as determined by transepidermal water loss (TEWL), and objective and subjective skin parameters, were investigated in a 'use test' performed by 18 healthy volunteers. Hands were soaked in a 0.05% solution of a commercial dish-washing product (three times/day, for 15 min, at 37 degrees C) over a period of 3 weeks; one hand was unprotected and the other was protected with a commercial rubber glove. TEWL increased in 13/18 volunteers by more than 25% above baseline on exposed hands within the first 2 weeks of the study. Objective skin signs (erythema, scaling, fissures) and subjective symptoms (itching, dryness, smarting) occurred almost exclusively in subjects with substantial TEWL increases and were most prominent 1-2 weeks following peak TEWL values. There was a highly significant correlation between cumulative relative symptom scores and TEWL changes. TEWL increase and symptom scores were not correlated with a history of inhalant allergy and/or elevated serum IgE levels. Three volunteers, who had shown the highest increase of TEWL values and the most intense clinical reactions to the detergent were subjected to a control experiment in which one hand was soaked in warm tap-water following the same experimental protocol. No significant effects on TEWL values or skin symptoms were observed. We conclude that regular exposure to low concentrations of detergents as used for dish-washing is capable of inducing skin lesions in a substantial proportion of individuals.