lanolin
Place in Therapy
Place in Therapy: Lanolin
Barrier bases, such as lanolin, are considered first-line options for treatment and prevention of diaper dermatitis.<1-2> Lanolin is a sheep wool fat product and an oil-phase absorption base.<2> Although comparative studies of barrier bases are lacking, lanolin proves to be an effective option.<1,-4> A review of the literature suggests lanolin is an effective barrier against skin breakdown.<2,4> It has been shown to prevent diaper dermatitis and an effective treatment option versus placebo.5 It has also been shown to have no effect on increasing bacterial skin colonization.<5>
However concerns are raised when assessing its safety. Some references recommend avoiding any product with lanolin in the treatment or prevention of diaper dermatitis. <2> However, it is among the Food and Drug Administration’s diaper dermatitis list of approved ingredients. <1> Yet many clinicians, guidelines and studies refer to its potential as a skin sensitizer.<1,3,5>
Although effective, lanolin has been shown to cause skin sensitizaiton.<3,4,5> It is a contact allergen that the Canadian Pharmacist Association`s Patient Self-Care reference recommends avoiding its use.<2> Patients may also be sensitive to one lanolin product and not another, increasing difficulty in product selection.<3,5> There is variability regarding its skin sensitizing effects but the risk is there , however very minimal.<3,5> With this in mind and the fact other treatment and prevention options exist with a better safety profile and of equal efficacy suggest lanolin should not be considered first-line barrier therapy in the treatment or prevention of diaper dermatitis.
References
1. Hagemeier NE. Diaper Dermatitis and Prickly Heat. In: Berardi, RR, Ferreri, SP, Remington, TL, eds. Handbook of Nonprescription Drugs. 16th ed. Washington, DC;2009:675-688.
2. Sibbald, D. Diaper Dermatitis. In: McLeod PJ, Allen M, Conly J, eds. Patient Self-Care - Helping Your Patients Make Therapeutic Choices. 2nd ed. Ottawa, ON: Canadian Pharmacists Association; 2010: 534-545.
3. Nguyen J, Chesnut G, James W, et al. Allergic contact dermatitis by lanolin (wool) contained in an emollient in three postsurgical patients. J Am Acad Dermatol. 2010;(62)6:1064-65.
4. Kiechl-Hohlendorfer U, Berger C, Inzinger R. The effect of daily treatment with an olive oil/lanolin emollient on skin integrity in preterm infants: a randomized controlled trial. Pediatr Dermatol. 2008Mar-Apr;25(2):174-8.
5. Wakelin S, Smith H, White I, et al. A retrospective analysis of contact allergy to lanolin. Br J Dermatol. 2001 Jul;145(1):28-31.
Barrier bases, such as lanolin, are considered first-line options for treatment and prevention of diaper dermatitis.<1-2> Lanolin is a sheep wool fat product and an oil-phase absorption base.<2> Although comparative studies of barrier bases are lacking, lanolin proves to be an effective option.<1,-4> A review of the literature suggests lanolin is an effective barrier against skin breakdown.<2,4> It has been shown to prevent diaper dermatitis and an effective treatment option versus placebo.5 It has also been shown to have no effect on increasing bacterial skin colonization.<5>
However concerns are raised when assessing its safety. Some references recommend avoiding any product with lanolin in the treatment or prevention of diaper dermatitis. <2> However, it is among the Food and Drug Administration’s diaper dermatitis list of approved ingredients. <1> Yet many clinicians, guidelines and studies refer to its potential as a skin sensitizer.<1,3,5>
Although effective, lanolin has been shown to cause skin sensitizaiton.<3,4,5> It is a contact allergen that the Canadian Pharmacist Association`s Patient Self-Care reference recommends avoiding its use.<2> Patients may also be sensitive to one lanolin product and not another, increasing difficulty in product selection.<3,5> There is variability regarding its skin sensitizing effects but the risk is there , however very minimal.<3,5> With this in mind and the fact other treatment and prevention options exist with a better safety profile and of equal efficacy suggest lanolin should not be considered first-line barrier therapy in the treatment or prevention of diaper dermatitis.
References
1. Hagemeier NE. Diaper Dermatitis and Prickly Heat. In: Berardi, RR, Ferreri, SP, Remington, TL, eds. Handbook of Nonprescription Drugs. 16th ed. Washington, DC;2009:675-688.
2. Sibbald, D. Diaper Dermatitis. In: McLeod PJ, Allen M, Conly J, eds. Patient Self-Care - Helping Your Patients Make Therapeutic Choices. 2nd ed. Ottawa, ON: Canadian Pharmacists Association; 2010: 534-545.
3. Nguyen J, Chesnut G, James W, et al. Allergic contact dermatitis by lanolin (wool) contained in an emollient in three postsurgical patients. J Am Acad Dermatol. 2010;(62)6:1064-65.
4. Kiechl-Hohlendorfer U, Berger C, Inzinger R. The effect of daily treatment with an olive oil/lanolin emollient on skin integrity in preterm infants: a randomized controlled trial. Pediatr Dermatol. 2008Mar-Apr;25(2):174-8.
5. Wakelin S, Smith H, White I, et al. A retrospective analysis of contact allergy to lanolin. Br J Dermatol. 2001 Jul;145(1):28-31.