The Use of an Over-the-Counter Hand Cream With Sweet Almond Oil for the Treatment of Hand Dermatitis
January 2018 | Volume 17 | Issue 1 | Original Article | 78 | Copyright © 2018
Joshua A. Zeichner MD,a Diane Berson MD,b Kavita Mariwalla MD,c and Angela Donald ND MScd
aMount Sinai Hospital, New York, NY bWeill Medical College of Cornell University, New York, NY cMariwalla Dermatology, West Islip, NY dSkinFix, Halifax, Nova Scotia, Canada
Hand dermatitis is estimated to affect greater than 15% of the general population. Childhood eczema, frequent hand washing, and occupational exposure to chemicals are predisposing factors. Hand dermatitis treatment involves both prevention of outbreaks and treatment of active disease. Moisturizers are essential to protect the skin from the environment, enhance hydration, and repair the skin barrier. They have been shown in large studies to prevent occupational related breakouts. Natural oils are commonly used in moisturizers for their moisturizing and emollient properties. Sweet almond oil is an oil that contains high levels of fatty acids and has been used for centuries to treat skin diseases such as eczema and psoriasis. In this study, a moisturizer with 7% sweet almond oil and 2% colloidal oatmeal was found to be both safe and effective in treating patients with moderate to severe hand dermatitis.
J Drugs Dermatol. 2018;17(1):78-82.
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Hand dermatitis is an umbrella term that encompasses several similarly appearing conditions including endogenous eczema in atopic patients, allergic contact dermatitis, and irritant contact dermatitis. In some cases, they may be indistinguishable, as patients with all of these conditions can experience symptoms of burning, stinging, and itching along with signs of redness, exudation, vesiculation, and lichenification. Disease may be defined as acute or chronic. Acute hand dermatitis is defined as disease present for less than three months and chronic disease when longer than three months or relapse more than twice per year.1The terms hand eczema and hand dermatitis are used interchangeably, and is estimated to affect greater than 15% of the general population, with 5% suffering from chronic disease lasting at least one year. Women account for double the number of sufferers compared to men. Risk factors include eczema in childhood and frequent hand washing.2 Hand eczema is the most commonly reported skin disease in the work place.3,4 Approximately 30% of individuals are affected with high risk occupations such as hair dressers, metal workers, painters, and those in the food, construction, healthcare, and professional cleaning industries.5,6 Occupational exposure to chemicals, use of cleansing agents, excessive exposure to water, and daily household activities have all been shown to be causative factors.7-9 Collectively, these exposures lead to skin barrier disruption, inflammation, and the characteristic clinical features of itching, redness, and inflammation.10Management of hand eczema includes both prevention of outbreaks and treatment of active disease. The use of moisturizers is essential in order to maintain healthy skin barrier function, enhance hydration, and protect the skin from environmental triggers.1,11 In one study, upwards of 60% of patients with hand eczema used moisturizers on a daily basis and having hand eczema increased moisturizer usage in men by a factor of 3.3.2 The efficacy of hand creams as a preventative treatment to minimize the risk of occupational outbreaks has been proven in a large, randomized controlled study.12 Moisturizers should be used regularly, and continued even after clinically apparent disease has improved since subclinical inflammation and barrier defects persist and may increase the risk of future relapse.13 Natural oils are incorporated into skin care products because of their moisturizing and emollient properties. Sweet almond oil is one such oil that has been used on the skin for centuries for medical conditions like eczema and psoriasis, as well as cosmetic concerns such as wrinkling and skin tone.14 Rich in both oleic and linoleic acids, almond oil offers skin protection and hydration.15 Moreover, it exhibits anti-inflammatory and perhaps antioxidant effects. It has been shown to prevent ultraviolet light induced skin damage when applied topically.16 Even though it is derived from a tree nut, almond oil is safe to use in skincare products. There has been only one report of cutaneous sensitization in the literature, which occurred in a newborn in France with known food allergies.17