The Effect of Alcohol-Based Virucidal Hand Sanitizers on Skin Barrier Function-A Randomised Experimental Study.

Abstract

Background: Applying alcohol-based hand rubs (ABHRs) is a proven means of combating hand-borne microorganisms. In addition to their bactericidal activity, some rubs also have virucidal properties (ABVHRs). Frequent use of ABHRs can result in skin irritation.

Objectives: This study investigates the impact of four commercially available ABVHRs on skin function (ABVHR A-D). ABVHR-A and ABVHR-B contained ethanol in higher concentrations, whereas ABVHR-C and ABVHR-D comprised ethanol and 1-propanol at lower concentrations combined with phosphoric acid (PA).

Methods: Using occlusion-modified tandem irritation tests and standard bioengineering methods, we assessed the effects of these ABVHRs and controls (ethanol, isopropanol, PA, water) on 48 healthy Caucasian volunteers' skin.

Results: In general, alcohols and ABVHRs were well tolerated. However, the results revealed significant changes in transepidermal water loss (TEWL), corneometry, and colorimetry between baseline and day 3 for all ABVHRs and controls, particularly for ABVHR-D (TEWL change 6.43 (SD 1.40) to 8.76 (SD 3.87)). Although the differences between the ABVHRs were not statistically significant, ABVHR-A and ABVHR-D significantly increased TEWL compared to water. Most ABVHRs demonstrated a better skin irritation profile than pure ethanol (80%) and isopropanol (70%). PA slightly reduced corneometry values.

Conclusions: This study suggests that the irritative potential of ABVHRs varies, likely due to differences in alcohol type (1-propanol in particular) and concentration. At the tested concentration, PA appears to be well tolerated and may enhance virucidal activity without significantly increasing skin irritation.