ABSTRACT
The frequency of hand hygiene has increased due to the COVID-19 pandemic, but there is little evidence regarding the impact of water exposure and temperature on skin. The aim of this study is to evaluate the effect of water exposure and temperature on skin barrier function in healthy individuals. A prospective observational study was conducted. Temperature, pH, transepidermal water loss (TEWL), erythema and stratum corneum hydration (SCH) were measured objectively before and after hot- and cold-water exposure and TempTest® (Microcaya TempTest, Bilbao, Spain) contact. Fifty healthy volunteers were enrolled. Hot-water exposure increased TEWL (25.75 vs. 58.58 g·h-1·m-2), pH (6.33 vs. 6.65) and erythema (249.45 vs. 286.34 AU). Cold-water immersion increased TEWL (25.75 vs. 34.96 g·h-1·m-2) and pH (6.33 vs. 6.62). TEWL (7.99 vs. 9.98 g·h-1·m-2) and erythema (209.07 vs. 227.79 AU) increased after being in contact with the hot region (44 °C) of the TempTest. No significant differences were found after contact with the cold region (4 °C) of the TempTest. In conclusion, long and continuous water exposure damages skin barrier function, with hot water being even more harmful. It would be advisable to use cold or lukewarm water for handwashing and avoid hot water. Knowing the proper temperature for hand washing might be an important measure to prevent flares in patients with previous inflammatory skin diseases on their hands.
ABSTRACT
Exposome factors, such as sleep deprivation and diet, could affect skin barrier function. The objectives of this study are to compare skin barrier function between patients with Obstructive Sleep Apnea Syndrome (OSAS) and healthy individuals, and to evaluate the effect of other exposome factors on skin. A cross-sectional study was conducted. Patients with OSAS and healthy volunteers matched by age and sex were included. OSAS severity was assessed by the Apnea-Hypopnea Index (AHI). Validated questionnaires were used to assess diet, anxiety, depression, and psychological stress. Skin barrier function parameters including temperature, erythema, melanin, pH, transepidermal water loss (TEWL), and stratum corneum hydration (SCH) were measured on the volar forearm. A total of 86 participants were included, 56 patients with OSAS and 30 healthy volunteers. TEWL was higher in OSAS patients than in healthy individuals (8.01 vs. 8.68 g·m-2·h-1). Regarding disease severity, severe patients had higher TEWL values (9.31 vs. 8.46 vs. 7.08 g·m-2·h-1) compared to moderate and mild patients. Patients with OSAS had significantly lower sleep quality (11.89 vs. 6.47 Pittsburgh Sleep Quality Index score; p < 0.001), poor adherence to the Mediterranean Diet (8.46 vs. 9.77; p = 0.005), and significantly higher anxiety and depression levels than healthy individuals. In conclusion, patients with OSAS may have skin barrier impairment, reflected in higher TEWL values. These patients also have higher levels of anxiety, depression, stress, and a lower adherence to a Mediterranean Diet, all exposome factors that might impact on skin barrier function.
