A Sticky Situation

Wearable technologies for pharmaceutical applications have been receiving a lot of attention recently.

The COVID-19 pandemic showed the value of wearable technologies – especially for clinical trial use. When travel was restricted and participants were reluctant to be exposed to COVID, wearable technologies helped clinical researchers continue to gather data. As COVID concerns have waned clinical trial researchers continue to see the value of wearables as a key technology to gather data and make clinical trials easier for participants – a crucial factor to keep trial participants enrolled and engaged.

Of course, wearables are also used for other purposes beyond clinical trials. Wearable continuous glucose monitors (CGMs) have been around for some time – as well as insulin pumps and pods. The latest insulin pumps/pods work seamlessly with CGMs to deliver insulin around the clock in response to changing glucose readings – as close to an artificial pancreas as we have yet come. Wearables for treating other diseases are available, in all shapes and forms, to infuse medications into patients at home – eliminating the need for a trip to see a doctor.

Much of the focus on wearables has been on data collection, security, and quality; interoperability among devices, patient education, and regulatory issues and approvals.

While much attention is given to these topics, a lesser-known issue, at least to those who don’t use these devices, is the problem with adhesives.

A quick query online reveals some interesting findings:

1. Skin issues from wearable device adhesives are described as "pretty much inevitable" for many users, suggesting they are quite common.²
2. Research by dermatologist Sabine Kamann found that possibly more than two-thirds of patients experience skin issues at some point from wearable diabetes devices.² While this refers specifically to diabetes devices, it indicates a high prevalence of skin problems from wearable medical adhesives.
3. Allergic contact dermatitis and irritant contact dermatitis are common reactions to wearable devices like fitness trackers and smartwatches.³ These can cause symptoms such as itchy rashes, redness, and inflammation.
4. The increasing number of reported skin reactions has led to heightened regulatory scrutiny and demands from patients and medical professionals for alternative adhesive options^.4
5. Eczematous rash is described as the most common dermatologic adverse reaction to continuous glucose monitors, and rashes from wearable activity trackers are commonly reported by consumers.¹

As a user of both a CGM and insulin pod, I have experienced this problem firsthand. And for those not familiar with these devices, they have one “fatal” flaw – once removed you can’t put them back on. So, if you are suffering from an excruciatingly itchy reaction, your choices are to suffer, or remove the device and compromise your treatment. Neither one is a good option. It has given me empathy for people with large casts when they resort to unraveling a wire hanger to get at an itch.

Of course, since so many people are reporting this problem, the market (and choices) for under patches has exploded. Each one claims they eliminate allergic reactions to adhesives. I’m on my third one – I hope it’s the charm.

This is not to say that wearables are “bad.” They are not. The wearable devices I am using have made my life a lot easier – just a bit itchier at times.

A sticky situation for sure – but one I’m confident will eventually be solved.

References

1. https://pubmed.ncbi.nlm.nih.gov/32209871/
2. https://www.healthline.com/diabetesmine/diabetes-device-adhesives
3. https://www.allure.com/story/fitness-tracker-rash-irritation
4. https://dm.henkel-dam.com/is/content/henkel/whitepaper_skin-sensitization-in wearable-medical-devices.pdf

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