An assessment of the cost benefits of zinc oxide spray vs. tube application

Andrew Marxen, BAN, RN, CWON, CWS MBA1, Sarah Jackson, MPharmSci2 and Christian Stephenson, BSc2, (1)Crawford Healthcare, Doylestown, PA, (2)Research and Development, Crawford Healthcare, Knutsford, United Kingdom

Zinc oxide barriers are widely used to prevent and treat skin irritation due to moisture associated skin damage (MASD). Traditional rub-on zinc oxide applications can be messy and require a thick layer required in order to provide protection to the skin.  In addition, a significant quantity of cream is often wasted in the tube itself and residual product remaining on gloves.


Evaluate the total number of applications and waste between different zinc oxide containing barrier products.  


Three zinc oxide barriers were evaluated including; a 2 oz spray-on micronized zinc oxide spray in a bottle (ZO1) and two rub-on, 4 oz. zinc oxide barrier pastes in tubes (ZO2, ZO3). Five clinicians were instructed to apply the test products as they would in clinical practice and according to themanufacturer’s directions for use.  Total applications were counted and pre and post application glove weights were recorded until perceived empty.  Then, residual product was removed and weighed for residual waste.  Clinicians rated ease of application of each product on a 1-10 scale. (10 being the easiest).

Results: (weights in ounces)

Average number of applications: ZO1=39 (Range 31-46), ZO2=14 (Range 7-21), ZO3=19 (Range 9-35)

Average glove waste: ZO1=0, ZO2=0.31, ZO3=0.66

Residual product waste: ZO1=0.2oz, ZO2=0.9, ZO3=0.44

Total waste: ZO1=0.2, ZO2=1.22, ZO3=1.1

Ease of application rating average: ZO1= 10/10, ZO2=5.3/10, Z03= 3.5/10

Cost-effectiveness vary based on the delivery and application methods.  Spray-on product allowed greater than twice the applications than rub-on products.  There was no glove waste with the spray-on product, whereas the rub-on products produced consistent waste volumes.


Although this study is in a simulated clinical environment, results indicate there are many factors that contribute to the cost-effectiveness of the zinc oxide barrier products.  Total applications, ease of use, waste, effectiveness, and price are some of these factors.