Do cool water or physiologic saline compresses enhance resolution of experimentally-induced irritant contact dermatitis?

Acute irritant contact dermatitis (ICD) is frequently treated with cool water or saline compresses. While presumed effective, little quantitative evaluation documents the treatment's benefit. This study sought to determine the efficacy of both distilled water and physiologic saline compresses on experimentally-induced ICD. 24-h application of both the lipophilic nonanoic acid (NAA) and the hydrophilic sodium lauryl sulfate (SLS) were used to induce irritant contact dermatitis in 9 healthy volunteers. Following irritation, compresses were applied 0.5 h 2x daily for 4 consecutive days. Transepidermal water loss (TEWL), laser Doppler flowmetry (LDF), chromametry and visual scoring were used to quantify results. Cool compresses of both water and saline significantly reduced TEWL and LDF, with no statistically significant difference between the efficacy of the saline or water compresses. Chromametry and visual scoring did not detect a significant effect with either the water or saline compresses. The results suggest an improvement with 2x-daily application of either water or physiologic saline compresses in the treatment of acute ICD, though true clinical benefit will be elucidated through further experimentation. Certainly, the current recommendation regarding the use of cool compresses for treating ICD should not be discarded.