A Review of Moisturizing Additives for Atopic Dermatitis

Abstract

Atopic dermatitis, the most common form of eczema, is a chronic, relapsing inflammatory skin condition that occurs with dry skin, persistent itching, and scaly lesions. This debilitating condition significantly compromises the patient’s quality of life due to the intractable itching and other associated factors such as disfigurement, sleeping disturbances, and social stigmatization from the visible lesions. The treatment mainstay of atopic dermatitis involves applying topical glucocorticosteroids and calcineurin inhibitors, combined with regular use of moisturizers. However, conventional treatments possess a certain degree of adverse effects, which raised concerns among the patients resulting in non-adherence to treatment. Hence, the modern use of moisturizers to improve barrier repair and function is of great value. One of the approaches includes incorporating bioactive ingredients with clinically proven therapeutic benefits into dermocosmetics emollient. The current evidence suggests that these dermocosmetics emollients aid in the improvement of the skin barrier and alleviate inflammation, pruritus and xerosis. We carried out a critical and comprehensive narrative review of the literature. Studies and trials focusing on moisturizers that include phytochemicals, natural moisturizing factors, essential fatty acids, endocannabinoids, and antioxidants were identified by searching electronic databases (PubMed and MEDLINE). We introduce the current knowledge on the roles of moisturizers in alleviating symptoms of atopic dermatitis. We then further summarize the science and rationale of the active ingredients in dermocosmetics and medical device emollients for treating atopic dermatitis. Finally, we highlight the limitations of the current evidence and future perspectives of cosmeceutical research on atopic dermatitis.

Skin microbiome dysbiosis and the role of Staphylococcus aureus in atopic dermatitis in adults and children: A narrative review

“…Xerosis and transepidermal water loss can be prevented using topical moisturizers containing varying amounts of emollient, occlusive and/or humectant ingredients 62 . Although emollients are not specifically an anti‐staphylococcal intervention, they generally improve skin hydration and lower the skin pH which could impact microbial diversity and reduce S. aureus 63 …”

“…Newer emollients termed emollient ‘plus’ are topical formulations with vehicle‐type substances and additional active, non‐medicated substances 73 . The role of moisturizers with active ingredients and emollients ‘plus’ in AD has been reviewed recently 63,74 . In Table 1, we present studies with data on both clinical outcomes on AD and the effect on the microbiome, especially S. aureus .…”

“…62 Although emollients are not specifically an anti-staphylococcal intervention, they generally improve skin hydration and lower the skin pH which could impact microbial diversity and reduce S. aureus. 63 Conflicting results have been obtained with use of emollients to prevent AD in newborns at risk of developing AD. A Cochrane systematic review and meta-analysis concluded that they probably do not prevent eczema in newborns and probably increase local skin infections.…”

“…73 The role of moisturizers with active ingredients and emollients 'plus' in AD has been reviewed recently. 63,74 In Table…”

Antibacterial Aloe vera Based Biocompatible Hydrogel for Use in Dermatological Applications

“…Among its many skin care benefits can be mentioned the reduction of skin irritation, anti-inflammatory properties and wound healing properties [ 23 , 24 ]. Numerous clinical studies have shown that allantoin has both a moisturizing effect and a strong stimulation of cell proliferation and tissue regeneration [ 25 , 26 ]. The beneficial characteristics of this bioactive compound justify its utility and applications in numerous compositions formulated for the cosmetic industry, for the treatment of chronic wounds such as ulcers or for the healing of injuries, wounds and burns [ 27 , 28 , 29 , 30 ].…”