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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.
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