Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008 Nov 13;3:26.
doi: 10.1186/1745-6673-3-26.

Safety Evaluation of Topical Applications of Ethanol on the Skin and Inside the Oral Cavity

Affiliations
Free PMC article

Safety Evaluation of Topical Applications of Ethanol on the Skin and Inside the Oral Cavity

Dirk W Lachenmeier. J Occup Med Toxicol. .
Free PMC article

Abstract

Ethanol is widely used in all kinds of products with direct exposure to the human skin (e.g. medicinal products like hand disinfectants in occupational settings, cosmetics like hairsprays or mouthwashes, pharmaceutical preparations, and many household products). Contradictory evidence about the safety of such topical applications of the alcohol can be found in the scientific literature, yet an up-to-date risk assessment of ethanol application on the skin and inside the oral cavity is currently lacking.The first and foremost concerns of topical ethanol applications for public health are its carcinogenic effects, as there is unambiguous evidence for the carcinogenicity of ethanol orally consumed in the form of alcoholic beverages. So far there is a lack of evidence to associate topical ethanol use with an increased risk of skin cancer. Limited and conflicting epidemiological evidence is available on the link between the use of ethanol in the oral cavity in the form of mouthwashes or mouthrinses and oral cancer. Some studies pointed to an increased risk of oral cancer due to locally produced acetaldehyde, operating via a similar mechanism to that found after alcoholic beverage ingestion.In addition, topically applied ethanol acts as a skin penetration enhancer and may facilitate the transdermal absorption of xenobiotics (e.g. carcinogenic contaminants in cosmetic formulations). Ethanol use is associated with skin irritation or contact dermatitis, especially in humans with an aldehyde dehydrogenase (ALDH) deficiency.After regular application of ethanol on the skin (e.g. in the form of hand disinfectants) relatively low but measurable blood concentrations of ethanol and its metabolite acetaldehyde may occur, which are, however, below acute toxic levels. Only in children, especially through lacerated skin, can percutaneous toxicity occur.As there might be industry bias in many studies about the safety of topical ethanol applications, as well as a general lack of scientific research on the long-term effects, there is a requirement for independent studies on this topic. The research focus should be set on the chronic toxic effects of ethanol and acetaldehyde at the point of impact, with special regard to children and individuals with genetic deficiencies in ethanol metabolism.

Figures

Figure 1
Figure 1
Simplified model of the mechanism of carcinogenesis in the oral mucosa after using ethanol-containing mouthrinses.
Figure 2
Figure 2
Hypothetical model for mouthwash related carcinogenic risk.

Similar articles

See all similar articles

Cited by 16 articles

See all "Cited by" articles

References

    1. Pendlington RU, Whittle E, Robinson JA, Howes D. Fate of ethanol topically applied to skin. Food Chem Toxicol. 2001;39:169–174. - PubMed
    1. Irvine LF. Relevance of the developmental toxicity of ethanol in the occupational setting: a review. J Appl Toxicol. 2003;23:289–299. - PubMed
    1. Wolf R. Alcohol and the skin. Clin Dermatol. 1999;17:351–352. - PubMed
    1. Kramer A, Below H, Bieber N, Kampf G, Toma CD, Huebner NO, Assadian O. Quantity of ethanol absorption after excessive hand disinfection using three commercially available hand rubs is minimal and below toxic levels for humans. BMC Infect Dis. 2007;7:117. - PMC - PubMed
    1. Kirschner MH, Lang RA, Breuer B, Breuer M, Gronover CS, Zwingers T, Böttrich JG, Arndt A, Brauer U, Hintzpeter M, Burmeister MA, Fauteck JD. Transdermal resorption of an ethanol- and 2-propanol-containing skin disinfectant. Langenbecks Arch Surg. 2007;394:151–157. - PubMed

LinkOut - more resources

Feedback