Evaluation of lotion formulations on irritation using the modified forearm-controlled application test method

Specific dermatological benefits associated with quantities of lotion transferred to the skin

BACKGROUND

A growing number of manufacturers are taking advantage of the ability of absorbent consumer products to deliver lotion to the skin. The lotion is included on these products to help protect the skin from adverse skin effects that can occur, including: (1) irritation, (2) over hydration of the stratum corneum, (3) dryness that can occur from extended exposure to highly absorbent consumer products, and (4) changes in pH.

OBJECTIVE

This manuscript presents results of a quantitative lotion transfer study of adult incontinence products. Resulting lotion transfer is compared to the results of several separate experiments in which specific skin benefits have been correlated to lotion concentrations.

METHODS

The behind-the-knee (BTK) lotion transfer protocol was used to quantitate lotion transfer from adult incontinence (AI) test products constructed using 2 lotion formulations and 2 configurations of lotion application. A modified arm patch protocol, in which skin sites of a measured dimension were pre-treated with specific volumes of lotion, was used to evaluate protective effects of lotion against exposure to irritants, and over hydration from wetted absorbent products.

RESULTS

After a 6-hours continuous exposure in the BTK the 5-stripe lotion configuration products transferred (adjusted mean ± SE) 94 ± 11-104 ± 11 μg/cm² lotion. After 24 hours of wear, transfer had increased to 127 ± 22 and 149 ± 24 μg/cm² , respectively. The single-block configuration products transferred 289 ± 10-316 ± 10 μg/cm² (P = .04). Transfer after 24 hours of wear was 328 ± 23 and 472 ± 21 μg/cm² , respectively (P < .0001). Several protocols were used to evaluate the concentration of lotion required to provide four specific skin benefits. In studies evaluating protection against irritants, skin site pre-treated with lotion were patched with 0.5% sodium lauryl sulfate (SLS). Protective effects were assessed by visual assessment of erythema and trans-epidermal water loss (TEWL). In the first experiment, lotion pre-treatment concentrations as low as 165 μg/cm² exhibited significantly (P < .05) lower erythema and TEWL compared to the positive irritant control (ie, no lotion pre-treatment and SLS only). In the second experiment, lotion pre-treatment concentrations of 80 μg/cm² (P = .018) exhibited significantly (P = .018) lower TEWL. In two studies on protection from over hydration, lotion pre-treatment sites were subsequently patched with wetted absorbent consumer products. The change in TEWL was used as a measure of over hydration. Lotion concentrations significantly reduced the increase in TEWL at 80 μg/cm² (P = .007) and 70 μg/cm² (P ≤ .05). A BTK study was used to evaluate the ability of lotion to prevent dryness. After 6 hours of wear, test products transferring lotion concentrations of 110 or 133 μg/cm² produced significantly lower scores for dryness compared to products transferring 48 or 69 μg/cm² . Using collagen sheets to mimic the stratum corneum, an in vitro study was conducted to measure the ability of lotion to prevent passage of high pH buffer solution. Results demonstrated that the lowest concentration of lotion that was tested (110 μg/cm² ) interfered with passage of the high pH buffer through the collagen sheet, delaying the rise in pH.

CONCLUSIONS

We can conclude that pretreatment with 110 μg/cm² lotion acts as a barrier to high pH fluids such as urine. Using the measurement of lotion transfer from the AI products, together with the results of studies conducted to determine the concentration of lotion required to provide specific skin benefits, we conclude that the five-stripe lotion configuration AI test products transferred enough lotion (ie, ≥80 μg/cm² ) to provide skin protection with regard to: (1) irritant effects and (2) excess moisture. The single-block AI test products also transferred enough lotion to provide these skin benefits (ie, ≥165 μg/cm² ), and the additional benefits of skin protection against: (3) dryness, and (4) changes in pH.

A Feminine Care Clinical Research Program Transforms Women's Lives

Feminine hygiene products and menstruation education have transformed the lives of women throughout the world. The P&G Feminine Care Clinical Innovation Research Program has played a key role by expanding scientific knowledge as well as developing technical insights and tools for the development of feminine hygiene products. The aim has been to meet the needs of women throughout their life stages, advancing their urogenital health beyond just menstruation, as well as helping to understand the role of sex hormones in various important health issues that women face. This review article highlights key contributions and research findings in female hygiene products, urogenital health research, and method development. The clinical research team focused on utilizing the results of clinical safety studies to advance the acceptance of feminine hygiene products world-wide. Key findings include that perception of skin sensitivity is not limited to the facial area, but is also relevant to the body and the genital area. Also, they shed light on the role of estrogen in autoimmune diseases as well as premenstrual syndrome. Efforts in the method development area focused on innovative tools that are reliable, predictive of clinical trial results and capable of measuring wear comfort, genital skin health, and the impact of product use on the consumer’s quality of life. A novel method, behind-the-knee (BTK) test, developed to model irritation under normal wear conditions, was the first to account for both chemical and mechanical sources of irritation. The method has been accepted by the FDA as a substitute in clinical trials in some cases, and by American Society for Testing and Materials as a global standard test method. Additional proprietary methods were developed to enhance visual grading of irritation using cross-polarized light, to measure the amount of lotion transferred from sanitary pads, and to evaluate the skin mildness. Finally, the Farage Quality of Life tool was created to measure consumer’s well-being. Based on the results of this extensive clinical research and the newly developed testing methods, the changing needs of women throughout their life stages are better met.

Effect of topical treatments on irritant hand dermatitis in health care workers

BACKGROUND

Irritant contact dermatitis (ICD) from repetitive hand hygiene is the primary reason for compliance failure among health care workers (HCWs). Chronic ICD has implications for infection control because higher bacterial counts are associated with increased skin compromise. Guidelines recommend lotions/creams to lessen irritation. We evaluated the effects of 5 to 10 daily applications of a test cream (A, glove and chlorhexidine gluconate compatible) and current lotions/creams (B) compared with a control of normal skin care.

METHODS

Outcomes were visual skin erythema and dryness, excess erythema (quantitative image analysis), and hydration among 80 HCWs in an intensive care unit.

RESULTS

Knuckle dryness was lower for both treatments than the no treatment control (P < .02) after 2 weeks. Skin treated with A had lower knuckle erythema (P=.03) than B and control. HCWs using A had lower excess erythema (right) than B and control (P < .04). Excess erythema was lower for A and B versus control (P=.003).

CONCLUSION

Reduction in erythema suggests that frequent use of cream A may mitigate the damaging effects of repetitive hand hygiene and allow the skin to recover. Intensive treatment of HCW ICD may be required to counteract the skin compromise and minimize the negative impact on infection control.

Evaluating lotion transfer to skin from feminine protection products

BACKGROUND/PURPOSE

Adding lotions or emollients to the surface of a variety of paper products improves overall consumer comfort. Techniques to measure lotion transfer to skin are needed.

METHODS

Two approaches were compared to assess lotion transfer from impregnated feminine pads: (1) pad application to the popliteal fosssa, an adaptation of the previously described 'behind-the-knee (BTK)' test model, and (2) a clinical in-use study in which pads were worn in the usual manner. In both approaches, dressings attached to the skin were used to absorb lotion transferred from the pad. Lotion transfer was first evaluated after 3 h in both protocols, and then after either 6 h (BTK method) or after and 24 h (clinical use test).

RESULTS

In the BTK model, lotion transfer was a function of both the total amount of lotion contained on the topsheet and the type of absorbent material in the core of the pad. Pads containing absorbent gelling material transferred lotion more effectively than pads containing cellulose absorbent cores. In the in-use clinical study, the results were directionally similar, but statistical significance was not reached.

CONCLUSIONS

An adaptation of the BTK test method provides an effective means of evaluating the transfer of lotion formulations from feminine protection pads.