INTRODUCTION
The skin barrier is important for blocking the ingress of pathogens and restricting access to many irritants and allergens.1 Contact with these substances can lead to the development of inflammatory skin conditions such as contact dermatitis, which can manifest in the form of erythema, vesiculation, dryness, lichenification, and fissuring.2 There is evidence that suggests these conditions are the result of harmful substances penetrating the skin barrier.3 A functional skin barrier could serve as a form of protection against many inflammatory skin conditions, including contact dermatitis. This penetration is made possible by damage caused by mechanical stress, lipid extraction, significant exposure to water, and other potentially harmful chemicals.4 Damage to the epithelial barrier has also been linked to chronic conditions such as asthma, atopic dermatitis, and rhinitis.5 Thus, controlling the permeability of the skin can play a fundamental role in treating the manifestation of these conditions and potentially many others.
There are a number of approaches that may help support and restore the skin barrier. The use of skin protectants has been proposed to facilitate the restoration of the disrupted skin barrier, though their protective value is not entirely clear. These creams consist of occlusives, emollients, and humectants that can achieve the desired result. Occlusives can reduce transepidermal water loss (TEWL) by forming a water-impermeable physical barrier over the stratum corneum, while emollients fill the gaps between rough edges of desquamating corneocytes, resulting in smoother skin. Humectants can hydrate the stratum corneum by drawing water from the epidermis and dermis, ultimately repairing the skin's natural barrier in the process.6
Skin protectant products differ in comparison to traditional barrier repair approaches, as protectants form an additional layer of protection and may also improve the natural skin barrier as well. In doing so, protectants can delay the penetration of substances that can produce harmful effects and lead to the development of serious skin conditions.7
The efficacy of skin protectants in reducing the impact of harmful substances on the skin barrier remains unclear. While these products have demonstrated ameliorative effects in some trials, other studies have indicated the possibility of aggravating effects as well.8 This review aims to highlight the potential for skin protectant products to form a protective layer over the natural skin barrier and defend against conditions such as contact dermatitis, irritant dermatitis, and allergic sensitization.
Narrative Review
The need for further research into the use of skin protectants has been well established since 2003.9 At the time, only 4 intervention studies of barrier cream usage in working populations were documented. These studies generally lacked a large sample size and control group for comparison. Additionally, interventions often involved multiple different components, and outcome measures were not clearly defined in many cases.9 As of
There are a number of approaches that may help support and restore the skin barrier. The use of skin protectants has been proposed to facilitate the restoration of the disrupted skin barrier, though their protective value is not entirely clear. These creams consist of occlusives, emollients, and humectants that can achieve the desired result. Occlusives can reduce transepidermal water loss (TEWL) by forming a water-impermeable physical barrier over the stratum corneum, while emollients fill the gaps between rough edges of desquamating corneocytes, resulting in smoother skin. Humectants can hydrate the stratum corneum by drawing water from the epidermis and dermis, ultimately repairing the skin's natural barrier in the process.6
Skin protectant products differ in comparison to traditional barrier repair approaches, as protectants form an additional layer of protection and may also improve the natural skin barrier as well. In doing so, protectants can delay the penetration of substances that can produce harmful effects and lead to the development of serious skin conditions.7
The efficacy of skin protectants in reducing the impact of harmful substances on the skin barrier remains unclear. While these products have demonstrated ameliorative effects in some trials, other studies have indicated the possibility of aggravating effects as well.8 This review aims to highlight the potential for skin protectant products to form a protective layer over the natural skin barrier and defend against conditions such as contact dermatitis, irritant dermatitis, and allergic sensitization.
Narrative Review
The need for further research into the use of skin protectants has been well established since 2003.9 At the time, only 4 intervention studies of barrier cream usage in working populations were documented. These studies generally lacked a large sample size and control group for comparison. Additionally, interventions often involved multiple different components, and outcome measures were not clearly defined in many cases.9 As of
