Effects of moisturization on epidermal homeostasis and differentiation

Short, Rebecca W.; Chan, Jennifer; Choi, Joonhee; Egbert, Barbara M.; Rehmus, Wingfield; Kimball, Alexa B.

doi:10.1111/j.1365-2230.2006.02297.x

Cited by 17 publications

(17 citation statements)

References 8 publications

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“…Frequent moisturization alleviates the discomfort associated with xerosis, helps to repair the skin barrier, and reduces the quantity and potency of pharmacologic interventions. 37,38 In a British study evaluating 51 children with AD, parents were educated on the proper use of moisturizers and topical treatments by a nurse specialist. During the study period, the quantity of moisturizer used increased 800% (average use of 426 g per week per patient) while the severity of AD decreased and the percentage of patients having to use moderate or potent topical steroids decreased.…”

Section: Treatment Principlesmentioning

confidence: 99%

Atopic Dermatitis: Skin-Directed Management

Tollefson¹,

Bruckner²,

Dermatology³

2014

Pediatrics

111

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Atopic dermatitis is a common inflammatory skin condition characterized by relapsing eczematous lesions in a typical distribution. It can be frustrating for pediatric patients, parents, and health care providers alike. The pediatrician will treat the majority of children with atopic dermatitis as many patients will not have access to a pediatric medical subspecialist, such as a pediatric dermatologist or pediatric allergist. This report provides up-to-date information regarding the disease and its impact, pathogenesis, treatment options, and potential complications. The goal of this report is to assist pediatricians with accurate and useful information that will improve the care of patients with atopic dermatitis. Pediatrics 2014;134:e1735-e1744Atopic dermatitis (AD), commonly referred to as eczema, is a chronic, relapsing, and often intensely pruritic inflammatory disorder of the skin. A recent epidemiologic study using national data suggested that the pediatric prevalence is at least 10% in most of the United States. 1 AD primarily affects children, and disease onset occurs before the ages of 1 and 5 years in 65% and 85% of affected children, respectively. 1 The number of office visits for children with AD is increasing. 2 Up to 80% of children with AD are diagnosed and managed by primary care providers, often pediatricians. 3 Although medical subspecialists, such as pediatric dermatologists and/or pediatric allergists, may be suited to provide more advanced care for children with AD, lack of a sufficient number of such physicians, particularly pediatric dermatologists, 4 likely means the burden of AD care will continue to fall to primary care providers. Although consensus guidelines and practice parameters regarding the management of AD in children have been published, 5-10 considerable variability persists in clinical practice, particularly regarding the roles that bathing, moisturizing, topical medications, and allergies play in management. Inconsistencies in opinion and treatment approach as well as the chronic and relapsing nature of AD can lead to frustration for the patient, family, and primary care providers when managing AD. STATEMENT OF THE PROBLEMNew data support the theory that AD results from primary abnormalities of the skin barrier, 11 suggesting that skin-directed management of AD is of paramount importance. This clinical report reviews AD and provides an up-to-date approach to skin-directed management that is based on pathogenesis. Effectively using this information to create treatment plans

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Section: Treatment Principlesmentioning

confidence: 99%

Atopic Dermatitis: Skin-Directed Management

Tollefson¹,

Bruckner²,

Dermatology³

2014

Pediatrics

111

View full text Add to dashboard Cite

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“…Silicones are nonirritating ingredients that give formulations a pleasant velvety soft feeling along with cosmetically appreciated emollient properties [5,6,7]. Especially dimethicone is extensively used in cosmetic formulations [8,9]. It is classified under the functional category of antifoaming compounds, emollients and water-repelling agents [10].…”

Section: Introductionmentioning

confidence: 99%

Silicones as Nonocclusive Topical Agents

Paepe

Sieg²,

Meur³

et al. 2014

Skin Pharmacol Physiol

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Background/Aims: Silicone excipients are commonly used ingredients because of their emollient and skin-conditioning effects, and their ability to form uniform, water-resistant, yet permeable films. Based on comparisons with organic materials and conflicting knowledge from silicones used in scar treatment, the misconception still exists that silicone topical excipients are occlusive substances that may block the passive loss of water through the upper skin layers. Therefore, 3 types of common silicone excipients and 3 water-in-(oil-plus-silicone) or W/(O + Si) creams, containing 10% (w/w) of the respective silicones, were investigated as a function of time and compared to petrolatum. Methods: Transepidermal water loss (TEWL) and skin hydration measurements were carried out after a single topical application on forearm skin of 26 healthy young female volunteers. Results: Both petrolatum and silicones significantly decreased TEWL 15 min after application, but the measurements for the silicones were not significantly different from the untreated control values. The tested silicones did not moisturize the skin. Petrolatum formed an occlusive layer, creating an increase in skin hydration for more than 4 h. The results measured for the W/(O + Si) creams indicated that they moisturized the skin, without any effect on TEWL. Conclusion: A clear difference was shown between the skin occlusive properties of petrolatum and the water vapor permeability of the common silicone excipient materials.

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“…It has been demonstrated that lower SC hydration alone can increase epidermal DNA synthesis and amplify epidermal proliferation induced by repeated barrier abrogation [11,57] . Conversely, topical moisturizers reduce epidermal proliferation and decrease epidermal thickness in both photodamaged skin and psoriasis [12,58] . Moreover, decreased SC hydration could increase cytokine release [59,60] , which in turn could exacerbate cutaneous inflammation, thereby complicating rehabilitation in leprosy.…”

Section: Discussionmentioning

confidence: 99%

“…of epidermal permeability barrier function [11][12][13][14][15][16] . The acidic pH of SC serves as a type of functional superregulator, influencing epidermal permeability barrier homeostasis, desquamation, skin infections, initiation of inflammation in the skin, antimicrobial defense production and primary cytokine release [17][18][19][20][21][22] .…”

mentioning

confidence: 99%

Abnormalities in Stratum Corneum Function in Patients Recovered from Leprosy

Shu-min

Feingold

et al. 2009

Skin Pharmacol Physiol

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Background and Objectives: Leprosy involves both the skin and peripheral nervous system. Leprosy patients display an increased incidence of xerosis and altered sensory thresholds, which persist in previously active skin sites. We assessed here whether alterations in stratum corneum (SC) function persist in cured leprosy, and the relationship of epidermal functional abnormalities to each clinical subtype of leprosy. Methods: A total of 43 cured leprosy subjects and 29 normal control subjects were enrolled in this study. Basal skin surface pH, SC hydration, permeability barrier function as well as barrier recovery rates were measured over previously involved skin sites with a skin physiology monitor. One-way ANOVA and two-tailed Student’s t test were used to determine the significance between 2 groups and 3 or more groups, respectively. Results: Competent barrier function was observed in all subtypes of cured leprosy subjects. All cured leprosy subjects except those with the borderline tuberculoid type exhibited a significantly lower SC hydration in comparison with normal subjects. Skin surface pH was significantly elevated in all cured leprosy subjects in comparison with normal subjects. Conclusions: A varied spectrum of alterations in SC function remains in all subjects who have recovered from leprosy, but the spectrum of SC functional abnormalities varies with disease subtype.

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Effects of moisturization on epidermal homeostasis and differentiation

Cited by 17 publications

References 8 publications

Atopic Dermatitis: Skin-Directed Management

Atopic Dermatitis: Skin-Directed Management

Silicones as Nonocclusive Topical Agents

Abnormalities in Stratum Corneum Function in Patients Recovered from Leprosy

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