Clinics in Dermatology (2012) 30, 297300

Effect of soaps and detergents on epidermal

barrier function
Ronni Wolf, MD a,, Lawrence Charles Parish, MD, MD (Hon)b
a
The Dermatology Unit, Kaplan Medical Center, Rehovot 76100, Israel
(affiliated to the Hebrew UniversityHadassah Medical School, Jerusalem, Israel)
b
Department of Dermatology and Cutaneous Biology and Jefferson Center for International Dermatology,
Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA 19101, USA

Abstract The past decade has witnessed an explosion of new impartial information about the complex
interaction of the skin with topically applied substances, including soaps and detergents. Despite of all
these new data, our knowledge on the exact pathomechanism and molecular events leading to detergent-
induced barrier dysfunction remains incomplete and the answers continue to elude us.
The longtime prevailing opinion which contends that the damaging effect of soaps and detergents is
related to their property to extract and remove useful intercellular lipids has mostly been abandoned.
Although this effect might be involved in the damaging effect, it is definitely not the sole mechanism,
nor, indeed, is it even the main one. Skin proteins damage, the interaction with keratins and their
denaturation, swelling of cell membranes and collagen fibers, cytotoxicity expressed with cellular lysis
are other important mechanisms.
One proposed mechanism is that an initial stratum corneum hyper-hydration results from a continuous
disruption of the secondary and tertiary structures of keratin protein by surfactants, exposing new water-
binding sites, thereby increasing the hydration of the membrane. Following evaporation of excess water, the
denatured keratin possesses a decreased water-binding capacity and decreased ability to function as a barrier.
Recent studies have also emphasized the effects of detergents on lipid synthesis, on lipid-metabolizing
enzymes and on keratinocyte differentiation.
2012 Elsevier Inc. All rights reserved.

The attitude toward soap and washing
throughout time
The Phoenicians invented soap some 2300 years ago, and
views toward its actions, benefits, and hazards have changed
greatly over time.
Physicians realized the medicinal value of soap during the
19th century. Perhaps, the best-known protagonist of soap
Portions of this contribution were adapted with permission from the
following: Wolf R, Orion E, Parish LC. A scientific soap opera and winter
itch. Skinmed 2004;3:9-10. Wolf R, Orion E, Davidovici B. Skin care
products and subtle data manipulation. Clin Dermatol 2007;25:222-4.
Corresponding author. Fax: +972 9 9560978.
E-mail address: wolf_r@netvision.net.il (R. Wolf).
was Ignaz Philipp Semmelweis who, in 1847, discovered the
infectious etiology of puerperal fever and required all of his
medical students to wash their hands before examining
patients. His immortal words were, I am not asking
anything world shaking. I am asking you only to wash
For God's sake, wash your hands, and, to the parturients,
Unless everything that touches you is washed with soap and
water and then chlorine solution, you will die and your child
with you! 1
The 19th century German chemist Baron Justus von
Liebig argued that the wealth of a nation and its degree
of civilization could be measured by the quantity of soap
it consumed.
The expression soap opera came from the afternoon
radio serials of the 1930s and 1940s (eg, Ma Perkins,

0738-081X/$ see front matter 2012 Elsevier Inc. All rights reserved.
doi:10.1016/j.clindermatol.2011.08.021
298
Stella Dallas, Helen Trent), sponsored by the purveyors There was only one chapter devoted to tests for evaluating
of soap and detergents (99 and 44/100% pure, Duz does
everything.). Indeed, they convinced our grandmothers and
mothers that they bore the grim responsibility of bringing the
quality of the family's skin as close as possible to the look
and feel of Ivory soap and to the pure whiteness and softness
of Dove.
The enthusiastic support of soap was then followed by a
reactionary swing around the time of World War II. Some
reputable dermatologists considered the product bad for the
skin, even to the point of being hazardous. With the
increasing use of household detergents, it became fashion-
able to blame every case of hand dermatitis on these
cleansers. The uproar eventually calmed down, when leading
dermatologists realized that the damaging and harmful
effects of soaps and detergents had been highly exaggerated.
A profusion of tests for the evaluation of the
effect of soaps on skin and its barrier
The present erathe erstwhile modern agehas wit-
nessed yet another abrupt change in the attitude toward soap,
in terms of its usefulness and harmfulness.
The specific turning point was the publication of a paper
by Frosch and Kligman in 1979, in which they described a
new method for objectively, assessing the irritation
potential of various soaps, called the soap chamber test. 2
Dozens of other tests for evaluating changes in skin barrier
function in reaction to soaps followed, often using
sophisticated instrumentation and methodologies.
What was the evolutionary sequence here? Did the
development of new instrumental techniques for nonin-
vasive investigation of skin physiology result in increas-
ing interest in the harming effect of soaps on the skin
barrier, or did the fear of a toxic effect of soap result in
the search and development of effective tests to evaluate
these characteristics?
There is a third and more insidious possibility: that the
plethora of tests were created primarily in response to the
influence of soap manufacturers, whose interests were to
create conditions in which their product would rank highest
in mildness and lowest in damaging effects to the skin and its
barrier function.
In any case, whatever the motives for creating these tests,
the fortuitous result is that we have gathered a wealth of
knowledge on the effects of soaps on the skin barrier. In an
issue of Clinics in Dermatology published in 1996 on soaps
and detergents, 3 3 sections were devoted to tests involving
tens of different methods (such as transepidermal water loss,
replica technique, electrical properties [capacitance, imped-
ance], laser Doppler flowmetry, skin color measurements,
contact thermography, and skin thickness measurements
with ultrasound) for assessing the irritancy potential of soaps
and their influence on various parameters of the skin barrier.
R. Wolf, L.C. Parish
their efficacy.
All testing methods showed that frequent exposure to
surfactants induces barrier damage and skin dryness
followed by inflammation. Both the quality and the severity
of the skin reaction depend on the surfactant chemistry and
concentration, exposure time, number of and interval
between exposures, and individually related variables, such
as skin hydration, skin type, atopy, age, and anatomic site.
Is there any objectivity out there?
As mentioned previously, the past 2 decades have
witnessed enormous progress in biophysical techniques and
the emergence of numerous devices for quantitative
measurement of various properties of the skin and skin
care products. We have good reason to believe that our
decisions are based on what at least appears to be objective
scientific facts and professionally conducted research rather
than on suspiciously subjective, inaccurate, and inconsis-
tent findings.
The multimillion-dollar question is whether the results of
new, sophisticated bioengineering techniques that are
published in scientific, peer-reviewed journals are really as
clear-cut as they claim to be and to what extent they are
relevant to our patients. In other words, how far can we trust
the data in scientific publications?
One look at the advertisements in dermatologic journals
and those available on the Internet is enough to reveal that
each company presents its preferred method of analysis in
which, to no one's surprise, its product ranks highest in
efficacy and lowest in toxicity and damaging effects. A
simple search in PubMed reveals that there are many
contributions devoted to methods of evaluation of a variety
of skin care products, including surfactants, soaps, and
detergents. Many of them aim to present a new test method
or a new and more effective and real protocol. Some of
them will also reveal data on specific products, as if it
were a by-product (the main issue being the test method). A
closer appraisal of many of these contributions, however,
will expose the authors of the presentation as being
affiliated with the company whose product ranks first in
that survey or that the described research is sponsored by
the respective company.
How does this clever hat trick work? How can
supposedly objective methods, performed by reliable
manufacturers and testing organizations and according to
standards of valid scientific investigation, lead to different
results and conclusions? The answer is simple. Although
the methods and measuring devices are generally objective,
their results can be and often are manipulated to support
the claims of superiority of given products. Specifically,
the study design, protocols, techniques, and end points can
legitimately be adapted to the special characteristics of the
Soap, detergents, and epidermal barrier function
specific product, emphasizing its advantages. The follow-
ing is an example of how they pull the proverbial wool
over our eyes.
Let us make it clear at the outset, there is no consensus
on which methodology best reflects the real-life perfor-
mance, the benefit, and the damage of a given product
there is no single ideal lab test that can supply the answers
we seek. Consequently, an investigator can legitimately
shop around and select the test and all experimental
conditions/designs/settings/devices/protocols that have
what it takes to arrive at the predetermined desired outcome.
If, for example, a soap has a high affinity to proteins, a
characteristic that causes more damage when it is allowed to
come in contact with proteins, the study designers will be
sure to choose a test method that prevents or at least hinders
the contact of their soap with protein structures of the skin.
For such a soap, particularly if it has a large molecule (or
more correctly, if it builds large micelles when in contact
with water) that might not easily penetrate the stratum
corneum, the preferred test is one that emphasizes the
penetration potential of soaps. The choice could be, for
example, the thick skin of the back as the preferred test
area. In vitro tests combining that soap with proteins,
allowing it to enter the eyes of experimental animals, or
testing it on the delicate thin skin of the forearm would yield
less desirable results.
Obtaining the desired scientific results has been a
matter of choosing the test method and the protocol that
yields them. The manufacturers, whose imagination and
resources would appear to be unlimited, have known only
too well how to harness our scientific knowledge to suit
their interest.
Pathomechanisms involved in soap-induced
skin barrier damage/impairment
We wish to emphasize that our critique on the motives
behind the analysis and study of the effect of soaps on skin
barrier does not apply to most of the studies. The past decade
has witnessed an explosion of new impartial information
about the complex interaction of the skin with topically
applied substances, including soaps and detergents, accom-
panied by the emergence of the field of bioengineering and
its many devices for measuring quantitative data on various
properties of the skin. Despite of all these new data, our
knowledge on the exact pathomechanism and molecular
events leading to detergent-induced barrier dysfunction
remains incomplete, and the answers continue to elude us.
The longtime prevailing opinion, which contends that the
damaging effect of soaps and detergents is related to their
property to extract and remove useful intercellular lipids, has
mostly been abandoned. The generally accepted view had
been that because the dirt and grime to be removed is
embedded in the outer fat layer, the cleansing process will
299
always remove useful skin lipids. This was thought to be the
main mechanism for the negative and harmful effect of
detergents on the skin and its barrier. This belief led to the
assumption that there must be a close correlation between a
soap's capacity to clean and its ability to dissolve oils,
removing them from the skin.
The effect of delipidation or degreasing (ie, the ability of
detergents to solubilize and remove stratum corneum lipids)
might be involved in the damaging effect, but it is definitely
not the sole mechanism, nor, indeed, is it even the main one.
Skin proteins are damaged by the interaction with keratins
and their denaturation; the swelling of cell membranes and
collagen fibers, as well as the cytotoxicity expressed with
cellular lysis, are other important mechanisms. 4
A direct interaction between surfactants and keratin
proteins appears to be responsible for the early events in
the damage caused to the skin barrier by the washing process.
This surfactantstratum corneum interaction probably in-
volves a denaturation of -helical keratin by unfolding the
coiled polypeptide protein chain, as suggested by several in
vivo experiments. 5,6 This, initially, reversible conformation-
al change of keratin proteins is most likely also responsible
for the surfactant-induced swelling of various membranes,
eg, isolated stratum corneum, gelatin, and collagen film. The
swelling of these membranes, after contact with surfactants
resulting from increased water absorption, appeared to be
related to the in vivo irritation potential and damaging effects
of detergents. These early subclinical in vivo effects of
surfactants on the stratum corneum had been investigated in
several experiments. In an early experiment, 5 the exposure
of skin to surfactant solutions significantly increased
hydration of the stratum corneum compared with controls.
It increased with the length of application time and was
concentration dependent, saturable with increasing concen-
tration, and rapidly reversible. Induction of hydration was
closely correlated with the irritation potential of the
investigated compounds. It initially increased with increas-
ing carbon chain length. The maximum response was
obtained for the C12 analogue (sodium lauryl sulfate).
It has been suggested that the initial stratum corneum
hyper-hydration results from a continuous disruption of the
secondary and tertiary structures of keratin protein, exposing
new water-binding sites, thereby increasing the hydration of
the membrane. Following evaporation of excess water, the
denatured keratin possesses a decreased water-binding
capacity and decreased ability to function as a barrier.
Recent studies have also emphasized the effects of
detergents on lipid synthesis, on lipid-metabolizing enzymes,
and on keratinocyte differentiation. 7,8
Conclusions
Results of studies that were performed over the past 2
decades challenge earlier assumptions that a surfactant's
300
degreasing of the stratum corneum is the main mechanism
involved in its negative and damaging effect on the
skin barrier.
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assessing the irritancy of soaps. J Am Acad Dermatol 1979;1:35-41.
3. Wolf R. Soaps, shampoos, and detergents: a scientific soap opera. Clin
Dermatol 1996;14:1-132.
R. Wolf, L.C. Parish
4. Corazza M, Lauriola MM, Zappaterra M, et al. Surfactants, skin
cleansing protagonists. J Eur Acad Dermatol Venereol 2010;24:1-6.
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properties induce variable degree of cytotoxicity and mRNA expression
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