Parental knowledge regarding the role of moisturizers in restoring the skin barrier, as well as regular and long-term use of moisturizers, is critical in the treatment of infantile eczema and the prevention of relapse. The parents of children with eczema were enrolled in this study. Their knowledge of the role, use, and effect of moisturizers on their children, as well as their concerns regarding moisturizers were surveyed. A total of 350 parents were enrolled in this study. Two hundred fifty-two parents (72%) knew that eczema requires moisturizers to restore the skin barrier. Among these 252 parents, 175 parents (50.0%) knew that moisturizers can restore the skin barrier. Only 27 parents (27/175, 15.4%) of them knew that moisturizers can improve eczema. Overall, 69.4% used moisturizers; of these, 75.3% used only moisturizers on the face, 87.2% on dry areas of face and other body parts, and only 6.6% on the entire body. Furthermore, 13.2% used topical moisturizers in the long-term; 62.6% used moisturizers 1 to 2 times per day, while 5.4% used moisturizers once every few days. A total of 80.7% discontinued moisturizers immediately after improvement in dryness, and 75.3% reported skin dryness despite moisturizer usage. Among parents of children who used moisturizers, 16.5% were worried about the side effects of moisturizers. Despite a fair level of knowledge about moisturizers, parents of children with eczema are using them inadequately. Pediatrician should be more patient to educate parents the information on the importance of moisturizers for the improvement of eczema and prevention of recurrence.

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Background : As a supplement for promoting hair health, Shi-Bi-Man (SBM) is a natural product comprising various traditional Chinese medicines. Though SBM has been reported to promote hair regeneration, its molecular mechanisms remains unclear. Cynomolgus monkeys (Macaca fascicularis) are non-human primates with a gene expression profile similar to that of humans. The purpose of this research is to evaluate the effect of SBM on promoting hair regeneration in cynomolgus monkeys and to reveal the underlying mechanism. Methods : The effect of SBM on hair regeneration was observed by skin administration on 6 cynomolgus monkeys with artificial back shaving. The molecular mechanism of SBM was studied using single-cell RNA sequencing (scRNA-seq) in combination with quantitative polymerase chain reaction (qPCR) detection for gene transcription level, and immunofluorescence staining verification for protein level. Results : SBM significantly promoted hair regeneration on cynomolgus monkeys, increased hair follicle number and facilitated hair follicle development. Single-cell RNA revealed an increase in the number of hair follicle stem cells (HFSCs) with a higher activation state, as evidenced by the higher expression of activation marker LDHA related to metabolism and the proliferation marker MKI67. Immunofluorescence analysis at the protein level and qPCR at the mRNA level have confirmed the sequencing data. Cellchat analysis revealed an enrichment of ligand-receptor pairs involved in intercellular communication in Laminin-related pathways. Conclusion : SBM significantly promoted hair regeneration on cynomolgus monkeys. Mechanically, SBM could promote LDHA expression and drive HFSC activation. The cell level analysis suggested that SBM promoted the proliferation and differentiation of HFSCs by affecting interaction between HFSCs and others on Laminin-related pathways. Keywords : Hair follicle stem cell activation, Shi-Bi-Man, cynomolgus monkey, single-cell RNA sequencing, LDHA, Laminin pathway.

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