Age-Related Changes of Stratum Corneum Functions of Skin on the Trunk and the Limbs

Sato, Noriko; Kitahara, Takashi; Fujimura, Tsutomu

doi:10.1159/000353912

Cited by 26 publications

(18 citation statements)

References 20 publications

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“…The measured median fluid intake of approximately 1,700 mL per day may be considered as appropriate for this population [22] and the interquartile range from 1,500 to 1,900 mL/day indicates that variations were small. The measured skin barrier parameters in the sample are similar to previous research in aged individuals [21, 23, 24]. From face to arm to leg there was a decrease in SCH and TEWL, indicating increasing skin dryness which is supported by increasing clinical dryness scores.…”

Section: Discussionsupporting

confidence: 85%

Effect of Fluid Intake on Hydration Status and Skin Barrier Characteristics in Geriatric Patients: An Explorative Study

Akdeniz

Boeing

Müller‐Werdan

et al. 2018

Skin Pharmacol Physiol

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Background/Aim: Inadequate fluid intake is assumed to be a trigger of water-loss dehydration, which is a major health risk in aged and geriatric populations. Thus, there is a need to search for easy to use diagnostic tests to identify dehydration. Our overall aim was to investigate whether skin barrier parameters could be used for predicting fluid intake and/or hydration status in geriatric patients. Methods: An explorative observational comparative study was conducted in a geriatric hospital including patients aged 65 years and older. We measured 3-day fluid intake, skin barrier parameters, Overall Dry Skin Score, serum osmolality, cognitive and functional health, and medications. Results: Forty patients were included (mean age 78.45 years and 65% women) with a mean fluid intake of 1,747 mL/day. 20% of the patients were dehydrated and 22.5% had an impending dehydration according to serum osmolality. Multivariate analysis suggested that skin surface pH and epidermal hydration at the face were associated with fluid intake. Serum osmolality was associated with epidermal hydration at the leg and skin surface pH at the face. Fluid intake was not correlated with serum osmolality. Diuretics were associated with high serum osmolality. Conclusions: Approximately half of the patients were diagnosed as being dehydrated according to osmolality, which is the current reference standard. However, there was no association with fluid intake, questioning the clinical relevance of this measure. Results indicate that single skin barrier parameters are poor markers for fluid intake or osmolality. Epidermal hydration might play a role but most probably in combination with other tests.

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Section: Discussionsupporting

confidence: 85%

Effect of Fluid Intake on Hydration Status and Skin Barrier Characteristics in Geriatric Patients: An Explorative Study

Akdeniz

Boeing

Müller‐Werdan

et al. 2018

Skin Pharmacol Physiol

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“…However, it should be noted that no clear consensus on the influence of age on TEWL exists in the published work. Both unchanged values for TEWL and subnormal values for TEWL in aged skin have been reported. In line with the observation in this study, Blaak et al .…”

Section: Discussionmentioning

confidence: 95%

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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“…Moreover treatment with the test emollient, unlike with the control emollient, elevated lactate levels in the skin for more than 24 h following the last application. Aged skin contains significantly reduced levels of some carboxylates, including lactate and PCA, which may account for the elevated skin surface pH and propensity for xerosis [5,32,33]. It is interesting therefore that the test emollient maintains skin surface pH by replenishing the carboxylate pool.…”

Section: Discussionmentioning

confidence: 99%

The Effect of an Emollient Containing Urea, Ceramide NP, and Lactate on Skin Barrier Structure and Function in Older People with Dry Skin

Danby

Brown

Higgs-Bayliss

et al. 2016

Skin Pharmacol Physiol

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Xerosis affects up to 75% of older people and develops as a result of a skin barrier defect. Emollients are widely used to treat xerosis; however, there is limited understanding of the differences between them and their effects on the skin barrier in older people. This study aimed to compare the effect of a commercially available emollient containing 5% urea, ceramide NP and lactate (test emollient) to an alternative emollient without these additives (control emollient) on the properties of the skin barrier in older people. Two cohorts of 21 volunteers aged >60 years with dry skin were recruited. The first applied the test emollient to one forearm and no treatment to the other for 28 days. The second compared the test emollient to the control emollient observing the same parameters. Effects on the skin barrier were determined by measuring skin barrier function, hydration, skin surface pH and by analysing Fourier transform infrared spectra before and after treatment. A third cohort of 6 young adults was recruited to investigate the effect of a single treatment with the test emollient on the molecular structure of the skin barrier at greater depths by employing the tape-stripping technique. The test emollient hydrated the skin to a significantly greater extent and for a longer period of time compared to the control emollient, an effect associated with a significant elevation of carboxylate groups (a marker of natural moisturizing factor content) within the stratum corneum. Furthermore, the test emollient imparted additional benefits to the structure and function of the skin barrier not exhibited by the control emollient. In conclusion, the test emollient addressed the pathological features of xerotic aged skin, supporting its use as first-line therapy for xerotic skin conditions in this population.

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Age-Related Changes of Stratum Corneum Functions of Skin on the Trunk and the Limbs

Cited by 26 publications

References 20 publications

Effect of Fluid Intake on Hydration Status and Skin Barrier Characteristics in Geriatric Patients: An Explorative Study

Effect of Fluid Intake on Hydration Status and Skin Barrier Characteristics in Geriatric Patients: An Explorative Study

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

The Effect of an Emollient Containing Urea, Ceramide NP, and Lactate on Skin Barrier Structure and Function in Older People with Dry Skin

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