Context: At least 15 factors of percutaneous penetration exist that should be considered when investigating dermal absorption profiles of chemicals. Rubbing is one variable that has been understudied, but may play an important role in understanding overall exposure rates, chemical toxicity, dermal absorption and skin's barrier abilities.
Objective: This reviews current data related to the role of massage in enhancing percutaneous penetration and skin decontamination as well as highlights the need for further investigation of its role.
Results: An in vivo study in rhesus monkeys and guinea pigs measuring amount of drug excreted after being topically applied showed no effect with massage. However, studies measuring permeation rates directly through human and animal skin ex vivo showed rubbing increased flux, reduced skin impedance and increased drug retention in skin. Rubbing also increased effectiveness of reactive skin decontamination lotion (RSDL).
Conclusion: Massage sometimes influences chemical penetration rates and should be studied thoroughly to clarify the mechanisms and factors involved in the possible enhancing effect. This will also reveal more insight regarding the skin's ability to act as a barrier to exogenous substances and its role in risk assessment. How ex vivo results translate to in vivo behaviors still requires further investigation.
Keywords: Dermatotoxicity; dermal absorption; pressure; rubbing; skin impedance.