A barrier cream is a topical formulation used in industrial
applications and as a cosmetic to place a physical barrier between the
skin and contaminants that may irritate the skin (contact dermatitis
or occupational dermatitis). There are many other terms for creams
designed to protect skin from harmful substances, including skin
protective creams, pre-work creams, antisolvent gels, protective
ointments, and shielding lotions. Three classes of barrier
creams are used: water repellent creams, water-soluble creams, and
creams designed for special applications. Barrier creams may
contain substances such as zinc oxide, talc or kaolin to layer over
the skin. For hand care they are designed to protect against the
harm from detergents and other irritants.
The efficacy of barrier creams is controversial. They have not been
demonstrated to be useful in preventing hand eczema. A 2010
Cochrane review concluded that there was insufficient evidence to
determine whether barrier cream could prevent occupational contact
dermatitis. They are a poor substitute for protective clothing for
workers. Gloves provide a greater protection than barrier
creams. However they are reasonably effective for the protection of
face against some airborne substances.
Some evidence suggests that improper use of barrier cream could cause
a harmful rather than a beneficial effect. Skin that has been
moisturized by barrier cream may be more susceptible to irritation by
sodium lauryl sulfate, which can permeate hydrated skin more easily
because of its hydrophilia. Barrier creams that contain petroleum
jelly or certain oils may cause rubber or latex gloves to
1 Medical uses
1.1 Hand care
1.2 Diaper rash
1.3 Work related
3 Mechanism of action
4 Society and culture
For hand care they are designed to protect against the harm from
detergents and other irritants. To help prevent the spread of
pathogens, health care providers are required to wash their hands
frequently. Frequent hand washing can result in chronic damage
termed irritant contact dermatitis which includes dryness, irritation,
itching, and more seriously, cracking and bleeding. Irritant
contact dermatitis is very common among nurses, ranging from 25% to
55%, with as many as 85% relating a history of having skin
World Health Organization
World Health Organization has considered the use of
barrier creams and has found their efficacy to be "equivocal" and too
expensive to be considered in health-care settings where resources are
Centers for Disease Control and Prevention
Centers for Disease Control and Prevention found "Two recent
randomized, controlled trials that evaluated the skin condition of
caregivers demonstrated that barrier creams did not yield better
results than did the control lotion or vehicle used. As a result,
whether barrier creams are effective in preventing irritant contact
dermatitis among health-care workers remains unknown."
The Great Ormond Street Hospital Manual of Children's Nursing
Practices 2012 book found that "disposable nappies are effective in
drawing fluid away from the skin and can be changed less frequently in
the absence of stools, making regular application of barrier creams
unnecessary in most children."
Barrier creams have been used in industry to protect workers' skin
from the contaminants encountered in occupations such as nurses,
hairdressers, employees in the food processing industry, cleaners,
metal workers, printers, bricklayers etc.
Cochrane review concluded that there was insufficient evidence
to determine whether barrier cream could prevent irritant contact
dermatitis in the workplace. Barrier creams can be applied before
exposure to potential irritants, but are not typically used as the
main protection against hazardous substances. They are a poor
substitute for protective clothing for workers; in particular,
gloves provide greater protection. However barrier creams are
reasonably effective for protection of the face against some airborne
substances. Active barrier creams containing silicone, tartaric
acid, glycerin, and other ingredients are said to be beneficial for
some chromate-sensitive construction workers.
The efficacy of barrier creams is controversial. They have not been
demonstrated to be useful in preventing hand eczema. According to
the National Safety Council, "shielding lotions can keep the skin from
A 2002 review found "some reports indicate that inappropriate BC
application might induce a deleterious rather than a beneficial
effect." Skin that has been moisturized by barrier cream may be
more susceptible to irritation by sodium lauryl sulfate, which can
permeate hydrated skin more easily due to its hydrophilia. When
handling hazardous molecules such as sodium hydroxide, ingredients in
barrier cream could react and induce skin irritation. Barrier
creams that contain petroleum jelly or certain oils may cause rubber
or latex gloves to deteriorate.
Mechanism of action
The mechanism of barrier cream varies by product. Three categories
of barrier creams are used: water repellent creams, water-soluble
creams, and creams designed for special applications. Moisturizing
barrier cream acts as a lubricating film on the skin to prevent
depletion of water (transepidermal water loss) in the skin's outermost
layer, the stratum corneum. This may have a protective effect
against irritant contact dermatitis and allergic contact dermatitis,
which often result from such depletion. These barrier creams can be
classed as occlusives (which prevent loss through a hydrophobic
effect), humectants (which absorb water from the dermis and
environment due to hygroscopy), or hydrating agents (which both
moisturize the skin and maintain its water content). Barrier creams
may contain substances such as zinc oxide, talc or kaolin to layer
over the skin. Other barrier creams are intended to protect the
skin from some external agents, though they are not sufficient to
provide a complete barrier.
Society and culture
In 2005, the Internet marketing agency Expansion Plus began promoting
the term shielding lotion in a highly successful campaign that relied
on planting information in social media so that it would be picked up
and spread virally. The basic principle was to place articles
on the skinmdnatural.com website that appeared to be reviews, and then
distribute links via news sites and press releases, so that the
purported reviews would be replicated elsewhere.
^ a b c d Bauer, Andrea; Schmitt, Jochen; Bennett, Cathy; Coenraads,
Pieter-Jan; Elsner, Peter; English, John; Williams, Hywel C. (June 16,
2010). "Interventions for preventing occupational irritant hand
dermatitis". Cochrane Database of Systematic Reviews (6): CD004414.
doi:10.1002/14651858.CD004414.pub2. PMID 20556758.
^ Wilhelm, Klaus Peter; Zhai, Hongbo; Maibach, Howard I. (2007-11-26).
Dermatotoxicology. CRC Press. p. 299. ISBN 9781420009774. BC
are also called 'skin protective creams' (SPCs) or 'protective creams'
as well as 'protective ointments', 'invisible glove', 'barrier',
'protective', or 'prework' creams and gels (lotions), 'antisolvent'
gels, and so on. Kresken and Klotz (2003) believe that the term
'invisible glove' is incorrect and it might mislead the user. Frosch
et al. (1993a) consider SPC a more appropriate terminology since most
creams do not provide a real barrier, at least not comparable to
stratum corneum. We utilize BC here because this term is in general
usage in industry.
^ a b Safety & Health: SH. 172-173 (Digitized June 1, 2010 ed.).
The Council. 2005.
^ a b Holt, Allan St John (2008-06-09). Principles of Construction
Safety. John Wiley & Sons. p. 177.
^ a b c d e f g h i j k l m n Corazza M, Minghetti S, Bianchi A,
Virgili A, Borghi A (2014). "Barrier creams: facts and controversies".
Dermatitis. 25 (6): 327–33. doi:10.1097/DER.0000000000000078.
PMID 25384222. CS1 maint: Uses authors parameter (link)
^ a b c d Zhai H, Maibach HI (2002). "Barrier creams--skin
protectants: can you protect skin?". Journal of Cosmetic Dermatology.
1 (1): 20–3. doi:10.1046/j.1473-2130.2001.00006.x.
PMID 17134447. CS1 maint: Uses authors parameter (link)
^ a b Robert L. Rietschel; Joseph F. Fowler; Alexander A. Fisher
(2008). Fisher's Contact Dermatitis. PMPH-USA. pp. 333–.
^ a b c d e Richard J. G. Rycroft (January 1, 2001). Textbook of
Contact Dermatitis. Springer Science & Business Media.
pp. 989–. ISBN 978-3-540-66842-8.
^ a b Lebwohl, Mark G.; Heymann, Warren R.; Berth-Jones, John;
Coulson, Ian, eds. (September 19, 2013). Treatment of Skin Disease:
Comprehensive Therapeutic Strategies. Elsevier Health Sciences UK.
pp. 336–. ISBN 978-0-7020-5236-1.
^ a b c d "WHO Guidelines on Hand Hygiene in Health Care: First Global
Patient Safety Challenge Clean Care Is Safer Care". WHO Press. 2009.
Retrieved October 2, 2015.
^ John M. Boyce; Didier Pittet (October 17, 2002). "Guideline for Hand
Hygiene in Health-Care Settings". Morbidity and Mortality Weekly
Report. Centers for Disease Control and Prevention.
^ Susan Macqueen (June 18, 2012). The Great Ormond Street Hospital
Manual of Children's Nursing Practices. John Wiley & Sons.
pp. 181–. ISBN 978-1-4051-0932-1.
^ Schliemann S, Elsner P (2014). "Prevention of Hand Eczema: Barrier
Creams and Emollients". Textbook of Hand Eczema. Springer.
pp. 273–278. doi:10.1007/978-3-642-39546-8_26.
^ Kurpiewska J, Liwkowicz J (2014). "[Barrier creams in prevention of
hand dermatoses]". Medycyna Pracy (in Polish). 65 (2): 297–305.
^ Bansal, I., & Bansal, S. (September 2015). "Social Media
Marketing – An Overview". Sai Om Journal of Commerce &
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^ Lewis, Tanya (July 31, 2006). "Online effort establishes new
category of skin care". PRWeek.
^ "Case Study: SkinMD" (PDF). P