Soaps are water-soluble sodium or potassium salts of fatty acids, produced by saponification or basic hydrolysis of a fat or oil with a strong alkali (Fig. 1A) (1). Evidence exists that several ancient civilizations knew of soap making and
used the resulting material as hair styling aids, to treat skin diseases, and for washing (2). However, it is likely that soap was not used routinely for personal cleansing until about the second century A.D. During the time of the Roman Empire, bathing was extremely popular, but its popularity declined with the fall of Rome in 467 A.D. During the Middle Ages, bathing fell out of fashion in Europe until the 17th century. However, there were regions of the medieval world where personal cleanliness remained important throughout the Middle Ages. Daily bathing was a common custom in Japan during the time, and in Iceland, pools warmed with water from hot springs were popular gathering places on Saturday evenings.
Soap making remained largely a household chore until the mid-19th century. At about this time, high-yield methods were developed for making soda ash or sodium carbonate out of common table salt, thereby improving the quality and yield of soap products, lowering the cost, and facilitating a move toward the commercial manufacturing of soap. These discoveries, along with the development of power to operate factories, made soapmaking one of America's fastest-growing industries by 1850 and changed soap from a luxury item to an everyday necessity. Investigation into the use of synthetic detergents began in the early 1900s and, with the end of World War II, synthetics starting replacing soaps for some cleaning chores, such as laundry and household cleaning (Fig. 1B). As surfactant chemistry became more and more sophisticated, these synthetic detergents began to replace soap in many of the bars and liquids used for personal cleansing.
Synthetic detergents are "synthesized" or put together chemically from a variety of raw materials. They have a major advantage over soaps in that they do not combine as readily with mineral salts to form soap curd (bathtub ring) (1). In addition, detergents offer excellent performance over a wide range of temperatures and water hardness, and greater skin mildness (2).
Whether a fatty acid soap or a synthetic detergent, the function of "soaps" is to reduce the surface tension of water and to solubilize materials such as grease and oils that cannot be removed easily by water alone (3). Materials used for personal cleansing, such as bar soaps, body washes, bubble bath, and feminine washes consist of mixtures of surfactants. Many of these products incorporate additional ingredients to provide added consumer benefits, such as fragrances, deodorant protection, antibacterial components, and skin moisturizers or softeners (4,5).
Most large manufacturers of personal cleansing products have rigorous approaches to evaluate the products for adverse skin effects (6,7). A number of test methods have been developed. Many test protocols include exaggerated use testing, or patch testing, on sensitive body sites. Extended use testing by volunteer participants using the products at home is sometimes part of the safety assessment.
The medical community generally assumes that soaps and other personal cleansing agents can contribute to vulvitis (8). However, given the broad use of these products, there are relatively few specific case reports of adverse reactions of the vulva as a result of using personal cleansing products. It is likely that consumers who experience mild irritant reactions that they perceive to be related to the use of a specific product simply switch products.
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