Immediate irritant reactions to benzoic acid are enhanced in washed skin areas

Factors affecting immediate irritant skin reactions are poorly understood. Our purpose was to study the effect of washing on reactions to benzoic acid, a well-known immediate-type irritant. 12 test subjects washed their left upper arms with a diluted dishwashing liquid 2X daily for 6 days. Benzoic acid in a dilution series was tested on both upper arms on days 0, 3 and 6. The reactions were graded visually, and the blood flow, skin color, transepidermal water loss and electrical capacitance of the test sites were measured. On days 3 and 6, the benzoic acid reactions were stronger on the washed arm than on the control arm. This was clinically visible and was associated with changes in blood flow and skin color measurements. Washing itself did not usually cause visible erythema, but transepidermal water loss increased and electrical capacitance decreased. Low concentrations of irritant substances, such as benzoic acid, may cause clinically relevant reactions in repeatedly washed skin. This should be taken into consideration in assessing product safety in the cosmetic, medical and household chemical industries, and when tests for chemical skin irritancy are designed and the results of such tests interpreted.