A review of the effects of moisturizers on the appearance of scars and striae

Abstract

SynopsisScars are well known to have a stratum corneum (SC) that is malfunctional. Increases in transepidermal water loss and decreases in SC capacitance and conductance have been reported. Occlusion therapy is a well-known route to improving the signs and symptoms of scarring. Until recently that has been assumed to be totally pressure related. However, studies have demonstrated that the direct effects of hydration on keratinocytes and fibroblasts contribute to the reduction in hypertrophic scarring. Now it is well known that occlusion can regulate epidermal cytokine and growth factor production; changes in profibrotic and anti-fibrotic factors have been established. As a result, it is to be expected that moisturizers may improve the signs and symptoms of scars. As striae have been suggested to be anatomically similar to scars and as it is well established that paracrine signalling occurs in skin, it is expected that striae have similar SC issues. While one cannot exclude the effects of some of the ingredients used in the products, several studies are reported in this review that demonstrates that moisturization is a key component to reducing the clinical signs and symptoms of scars and striae. This is a good example of how knowledge of corneobiology leads to corneotherapies for these skin condition problems. The review is being written in memory of Professor Johann Wiechers who, before he died tragically in November 2011, performed two of the reported studies together with colleagues. Ré suméLes cicatrices sont bien connues pour avoir une couche cornée dysfonctionnelle. L'augmentation de la perte insensible en eau et une diminution de la capacité de la couche cornée et de la conductance ont été signalées. La thérapie d'occlusion est une voie bien connue pour l'amélioration des signes et symptômes de la cicatrisation. Jusqu'à une date récente cela a été supposé être totalement lié à la pression. Cependant, des études ont démontré que les effets directs de l'hydratation sur les kératinocytes et des fibroblastes contribuent à la réduction de cicatrices hypertrophiques. Maintenant, il est bien connu que occlusion peut réguler la production de cytokines épidermiques et du facteur de croissance; des changements dans les facteurs profibrotiques et antifibrotiques ont été éta-blis. En conséquence, il faut s'attendre à ce que les hydratants peuvent améliorer les signes et symptômes des cicatrices. Puisque les striae sont considérés être anatomiquement semblables à des cicatrices, et depuis qu'il est bien établi que la signalisation paracrine se produit dans la peau, on peut s'attendre à ce que les striae présentent des caractéristiques similaires au niveau de la couche cornée. Bien que l'on ne puisse pas exclure les effets de quelquesuns des ingrédients utilisés dans les produits, plusieurs études sont rapportés dans cette revue qui démontre que l'hydratation est une composante clé de la réduction des signes et des symptômes cliniques des cicatrices et vergetures. C'est un bon exemple de la façon dont la connaissance d...

Hydric “Costs” of Reproduction: Pregnancy Increases Evaporative Water Loss in the SnakeVipera aspis

“…We also found a close relationship between scale distension and CEWL among pregnant females, thereby supporting a proximate influence of interscale skin exposure on water loss. Increased transepidermal water loss may also be related to the alteration of skin structure and lipid barrier due to stretching, as reported in humans (Henry et al 1997;Rawlings et al 2012).…”

Management of stretch marks (with a focus on striae rubrae)

“…Topical treatment cannot prevent the occurrence of stretch marks under specific circumstances such as pregnancy. [ 16 17 18 19 20 21 22 23 ]…”

“…A randomized, double-blind, placebo-controlled study in pregnant women indicates that the severity of stretch marks can be reduced by topical application of emollient and moisturizer containing hydroxyprolisilane C, rose hip oil, Centella asiatica triterpenes, and vitamin E.[ 22 ] It seems that moisturizers are the critical component of topical preparations for the treatment of stretch marks and it is questionable, if there is an add-on effect of other ingredients. [ 23 ]…”

Preliminary study on the development of an antistretch marks water-in-oil cream: ultrasound assessment, texture analysis, and sensory analysis

“… 29 As striae have been suggested to be anatomically similar to scars, it is expected that the occlusive and moisturizing ingredients reduce the signs and symptoms of striae. 30 …”