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Extraneous
Causes
Many times contact dermatitis is attributed to gloves when in
fact, the causative agent is from another source. The most notable
is a change in soap or detergents. One of the most common causes
of irritant contact dermatitis is a change in soaps or incomplete
rinsing of the hands after washing. Many times switching to a
mild pH-neutral cleanser eradicates the problem of irritant contact
dermatitis. Skin cleansers designed for and labeled as “heavy-duty
cleansers” or “waterless hand cleaners” can
have more irritating ingredients including solvents and abrasives
such as silica or wood particles. Many times incomplete rinsing
of the cleansers from the skin can cause irritant contact dermatitis.
Occlusion of the hand by wearing a glove on top of the residual
irritants can aggravate the condition.
Exposure
to Chemicals
Thin-gauge disposable gloves are not designed for heavy exposure
to chemicals. There are some chemicals that can be safely handled
while wearing thin-gauge disposable gloves. However, for heavy
exposure to dangerous organic solvents or highly corrosive chemicals,
chemical resistant gloves are recommended. Sometimes the fumes
of a chemical can permeate a disposable glove and be held next
to the skin and cause an irritant contact dermatitis or an allergic
sensitization reaction.
Glove
Reactions
Most allergic reactions to gloves are seen with unsupported gloves.
Most of these reactions are reported in the health care settings
where gloves are worn most of the time and are changed frequently
and hands are washed whenever gloves are changed. There are at
least three causes of contact and allergic contact dermatitis
(Type IV Delayed Contact Urticaria). Natural rubber proteins,
glove powder or rubber accelerators can cause irritant or allergic
contact dermatitis. Common rubber accelerators include: carbamates,
thiurams and mercaptobenzothiazole (MBT). These ingredients are
present in almost every elastomeric glove made. |
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To
determine which ingredient is causing the contact dermatitis,
we recommend the following screening protocol:
Allergy Screening
1. Natural
Rubber Proteins
If you know that you are indeed allergic to natural rubber proteins,
change to a synthetic alternative glove such as nitrile or neoprene
or PVC gloves. For medical gloves, Best® N-DEX® Non- Latex
Gloves are an excellent alternative. None of the synthetic polymer
gloves contain natural rubber proteins. Hypoallergenicity testing
using the modified Draize test for chemical sensitivity resulted
in no test subjects having any kind of reaction.
2.
Glove Powder
Many people believe that they are allergic to glove powder. Most
glove powder used to manufacture gloves is food-grade cornstarch
used in foods and is not an allergy causing material. However,
glove powder has been implicated in cases of latex allergy because
it can serve a carrier of the natural rubber latex protein. The
latex protein laden cornstarch can be inhaled. So, in latex gloves,
a person can react to the latex-containing cornstarch, but in
synthetics such as N-DEX nitrile gloves, the cornstarch does not
contain latex and will not cause allergic reactions. If a person
is still having a rash after changing to Best® N-DEX®
Non-Latex Medical Gloves, they could be experiencing irritant
contact dermatitis from the corn starch powder. This type of reaction
is not considered an allergic response. If so, we recommend changing
to Best® N-DEX® Non-Latex “Powder Free” Medical
Gloves. These styles have the suffix PF in the SKU.
3.
Rubber Accelerators
If a person is still having an allergic reaction even after changing
to the Best® N-DEX® Non-Latex “Powder Free”
Medical Glove, they could be allergic to the rubber accelerator
MBT. The level of MBT in Best® N-DEX® Non-Latex Medical
Gloves is less than half the extractable level determined by Johns
Hopkins, Cleveland Clinic and the FDA to trigger an allergic contact
dermatitis in MBT-sensitized patients. This accelerator is a necessary
ingredient and is the only accelerator used in N-DEX gloves. There
are no carbamates or thiurams used in N-DEX gloves. These other
accelerators are known to cause allergic reactions in more individuals
than MBT. Sometimes a patient is allergic to all of the rubber
accelerators. In that case, they should be advised to try a vinyl
disposable glove or one that is free of accelerators. |
