Contact Dermatitis-Soaps and Detergents
Those whose occupations involve extensive soaping of the skin, such as
dishwashers, housewives, laundresses and surgeons, clinically show
dehydrationor shrivelling of the keratin layers, which leads to
irriation of the "primary irritant" type. Patch tests with 2% soap
solution theoretically can pick up a true allergy, but I am
unconvinced. Perhaps coconut-oil-containing soap are wourse than
others. Neutral soaps, such as Lowila, Basis, Oilatum, Hazeline or
Dermaphyllic are much less drying. Many of the stronger antibacterial
soaps, such as Dial, Zest, Lifebuoy, Safeguard and Palmolive Gold, are
sensitizing as well as drying, and may be photosensitizing.
Contact with clothing washed in strong soaps or detergents (e.g.,
sheets used by bed patients) can lead to dermatitis. This is
especially true if bleach or whitener is used. the great offenders in
this regard are Axion, Bold, Ajax Detergent, cold Power, Salveo Tabs,
Coldwater All, Amway, Arm & Hammer, Era and Dynamo.
Fair-skinned, sensitive or elderly people who bathe a lot in hot
showers or tubs can develop an asteatotic eczema that can be extremely
intractable. Remembering that the skin's pH is acidic, around 5.0, and
all water is slightly alkaline, especially if there are many calcium
and magnesium salts in it, it is easy to see how this happens.
Cessation of bathing and showering for a while is necessary to clear
the skin of these unfortunate patients. An alkaline skin is
increasingly susceptible to the irritant effects of water alone, and
the hyperirritability of the skin can be protracted; it takes 3 months
for a fracture to heal, similarly with the skin. The skin must be put
at rest and allowed lubrication for that length of time before it
recovers.
The usual result of continuous and excessive exposure of the skin to
soaps and detergents is impaired alkaline- neutralization with drying,
fisssuring and defatting of the keratin layer leading ot increased
permeability of comparatively innocuous substances (e.g., vegetable
juices) can lead to senstitization with resultant allergic contact
dermatitis subsequent to the original primary irritant effect. It can
be almost self-sustaining, and many laundry soaps contain chemical
additives which are the actual irritants (e.g., sodium silicate,
sodium phosphate, sodium carbonate). Hand cleaner soaps contain small
harsh particles to assist in grease removal, such as pumice, talc,
borax, corn meal or wood fluor. These are sometimes irritating. Some
yellow laundry soaps contain "rosin" to make the bar more soluble,
which is also a sensitizer.
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