Accelerated barrier recovery and enhancement of the barrier integrity and properties by topical application of a pH 4 vs. a pH 5·8 water-in-oil emulsion in aged skin

Angelova-Fischer, Irena; Fischer, Tobias W.; Abels, Christoph; Zillikens, Detlef

doi:10.1111/bjd.16591

Cited by 27 publications

(31 citation statements)

References 36 publications

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“…However, although not significant, the increase in TEWL was higher for the pH 4 emulsion, suggesting that acidification of the SC may also play a role. In line with results of this study, our previous study 46 with the same cosmetic products utilizing two different models (a short-term chemical damage and mechanical damage of epidermal barrier after long-term treatment) could clearly show that pH is important and an independent factor influencing epidermal barrier. 46,47 Finally, it is also important to note that not only aging skin, but also diseased skin (atopic dermatitis, psoriasis or ichthyosis vulgaris) have been linked to increased pH.…”

Section: Discussionsupporting

confidence: 90%

“…In line with results of this study, our previous study 46 with the same cosmetic products utilizing two different models (a short-term chemical damage and mechanical damage of epidermal barrier after long-term treatment) could clearly show that pH is important and an independent factor influencing epidermal barrier. 46,47 Finally, it is also important to note that not only aging skin, but also diseased skin (atopic dermatitis, psoriasis or ichthyosis vulgaris) have been linked to increased pH. 48 Normalization of skin pH following exogenous acidification is improving epidermal permeability barrier homeostasis, SC integrity/cohesion and anti-inflammatory function 12,13 and reduces damage to exogenous stress (SDS) as shown in this study.…”

Section: Discussionsupporting

confidence: 90%

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Skin acidification with a water‐in‐oil emulsion (pH 4) restores disrupted epidermal barrier and improves structure of lipid lamellae in the elderly

Kilić

Masur

Reich

et al. 2019

The Journal of Dermatology

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The pH of the skin surface increases with age and thus reduces epidermal barrier function. Aged skin needs appropriate skin care to counterbalance age‐related pH increase and improve barrier function. This confirmatory randomized study investigated the efficacy of water‐in‐oil (w/o) emulsions with either pH 4 or pH 5.8 in 20 elderly subjects after 4 weeks of treatment. After the treatment, the skin was challenged with a sodium dodecyl sulphate (SDS) solution in order to analyze barrier protection properties of both formulations. The pH 4 w/o emulsion resulted in a significantly lower skin pH compared with the pH 5.8 w/o emulsion and an improved skin hydration after 4‐week treatment. Further, the pH 4 emulsion led to more pronounced improvements in length of intercellular lipid lamellae, lamellar organization as well as lipid levels than the pH 5.8 emulsion. Following SDS‐induced barrier damage to the skin, the pH of all test areas increased, but the area treated with the pH 4 emulsion showed the lowest increase compared with baseline. In addition, even after the SDS challenge the skin area treated with the pH 4 emulsion still maintained a significantly increased length of intercellular lipid lamellae compared with the beginning of the study. This study provides evidence that topical application of a w/o emulsion with pH 4 reacidifies the skin in elderly and has beneficial effects on skin moisturization, regeneration of lipid lamellae and lipid content. Application of a pH 4 emulsion can improve the epidermal barrier as well as the stratum corneum organization in aged skin.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 90%

Skin acidification with a water‐in‐oil emulsion (pH 4) restores disrupted epidermal barrier and improves structure of lipid lamellae in the elderly

Kilić

Masur

Reich

et al. 2019

The Journal of Dermatology

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“…Maintenance of an acid pH of the skin has been widely studied and is known to have multiple benefits to the health of the skin. Acidic pH has been shown to accelerate barrier repair in aged skin [43]. The maintenance of an acid pH of the skin has also been linked to the stability and adherence of the skin microbiome.…”

Section: Phmentioning

confidence: 99%

Innate Antimicrobial Defense of Skin and Oral Mucosa

Wertz

Szalay

2020

Antibiotics

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This special issue intends to review and update our understanding of the antimicrobial defense mechanisms of the skin and oral cavity. These two environments are quite different in terms of water, pH, and nutrient availability, but have some common antimicrobial factors. The skin surface supports the growth of a limited range of microorganisms but provides a hostile environment for others. The growth of most microorganisms is prevented or limited by the low pH, scarcity of some nutrients such as phosphorus and the presence of antimicrobial peptides, including defensins and cathelicidins, and antimicrobial lipids, including certain fatty acids and long-chain bases. On the other hand, the oral cavity is a warm, moist, nutrient rich environment which supports the growth of diverse microflora. Saliva coating the oral soft and hard surfaces determines which microorganisms can adhere to these surfaces. Some salivary proteins bind to bacteria and prevent their attachment to surfaces. Other salivary peptides, including defensins, cathelicidins, and histatins are antimicrobial. Antimicrobial salivary proteins include lysozyme, lactoferrin, and lactoperoxidase. There are also antimicrobial fatty acids derived from salivary triglycerides and long-chain bases derived from oral epithelial sphingolipids. The various antimicrobial factors determine the microbiomes of the skin surface and the oral cavity. Alterations of these factors can result in colonization by opportunistic pathogens, and this may lead to infection. Neutrophils and lymphocytes in the connective tissue of skin and mucosa also contribute to innate immunity.

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“…Even some dermatologists have recently started recommending ACV baths for AD . ACV soaks are theoretically appealing given their antimicrobial activity and potential to acidify the skin . However, little is known about the efficacy or safety of ACV on skin in AD, and reports of positive effects are often anecdotal .…”

Section: Introductionmentioning

confidence: 99%

“…9 ACV soaks are theoretically appealing given their antimicrobial activity and potential to acidify the skin. 11,12 However, little is known about the efficacy or safety of ACV on skin in AD, and reports of positive effects are often anecdotal. 11 The primary objective of this split-arm pilot study was to examine the effects of dilute ACV application to AD and healthy skin on TEWL…”

Section: Introductionmentioning

confidence: 99%

Apple cider vinegar soaks [0.5%] as a treatment for atopic dermatitis do not improve skin barrier integrity

Luu

Flowers

Kellams

et al. 2019

Pediatric Dermatology

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Background/Objectives Atopic dermatitis (AD) is a common chronic inflammatory skin condition associated with high transepidermal water loss, high skin pH, and Staphylococcus aureus skin colonization. The treatment of AD with bath additives remains highly debated. Recent evidence suggests that dilute apple cider vinegar (ACV) may improve skin barrier integrity in AD, but its safety and efficacy are not well studied. This pilot split‐arm study analyzed the effect of dilute apple cider vinegar soaks on skin barrier integrity in patients with atopic dermatitis as measured by skin transepidermal water loss and skin pH. Methods A total of 22 subjects (11 AD and 11 healthy controls) were enrolled. Subjects soaked both of their forearms for 14 days, with one arm in dilute ACV (0.5% acetic acid) and the other in water 10 minutes daily. Transepidermal water loss and pH were measured pre‐ and post‐treatment. Results In both groups, transepidermal water loss increased and pH decreased at 0 minutes post‐ACV treatment, but these effects were not sustained at 60 minutes. In total, 72.7% (16/22) of subjects reported mild side effects from ACV with improvement after discontinuing the soaks. Conclusions Dilute ACV soaks have no significant effect on skin barrier integrity but caused skin irritation in a majority of subjects. Study limitations include analysis of a single brand, dilution, and application of ACV. Future studies are needed to explore whether lower concentrations of ACV soaks or other applications such as a leave‐on acidic ointment could improve skin barrier integrity in a safe, nonirritating way.

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Accelerated barrier recovery and enhancement of the barrier integrity and properties by topical application of a pH 4 vs. a pH 5·8 water-in-oil emulsion in aged skin

Abstract: Exogenous acidification through topical application of a water-in-oil emulsion with pH 4 leads to improvement of the skin barrier function and maintenance of the barrier homeostasis in aged skin.

Cited by 27 publications

References 36 publications

Skin acidification with a water‐in‐oil emulsion (pH 4) restores disrupted epidermal barrier and improves structure of lipid lamellae in the elderly

Skin acidification with a water‐in‐oil emulsion (pH 4) restores disrupted epidermal barrier and improves structure of lipid lamellae in the elderly

Innate Antimicrobial Defense of Skin and Oral Mucosa

Apple cider vinegar soaks [0.5%] as a treatment for atopic dermatitis do not improve skin barrier integrity

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