N-palmitoylethanolamine and N-acetylethanolamine are effective in asteatotic eczema: results of a randomized, double-blind, controlled study in 60 patients

Abstract

BackgroundAsteatotic eczema (AE) is characterized by itchy, dry, rough, and scaling skin. The treatments for AE are mainly emollients, usually containing urea, lactic acid, or a lactate salt. N-palmitoylethanolamine (PEA) and N-acetylethanolamine (AEA) are both endogenous lipids used as novel therapeutic tools in the treatment of many skin diseases. The purpose of this study was to compare a PEA/AEA emollient with a traditional emollient in the treatment of AE.MethodsA monocentric, randomized, double-blind, comparative trial was conducted in 60 AE patients to evaluate and compare the efficacy of the two emollients. The level of skin dryness among the subjects ranged from mild to moderate. The subjects’ skin barrier function and the current perception threshold were tested for 28 days by clinical scoring and bioengineering technology.ResultsThe results showed that, although some aspects were improved in both groups, the group using the emollient containing PEA/AEA presented a better skin surface change in capacitance. However, the most impressive finding was the ability of the PEA/AEA emollient to increase the 5 Hz current perception threshold to a normal level after 7 days, with a significant difference between values at baseline and after 14 days. A current perception threshold of 5 Hz was positively and significantly correlated with skin surface hydration and negatively correlated with transepidermal water loss in the PEA/AEA emollient group.ConclusionCompared with traditional emollients, regular application of a topical PEA/AEA emollient could improve both passive and active skin functions simultaneously.

N ‐Acyl ethanolamide and eicosanoid involvement in irritant dermatitis

“…It has been shown that the NAE pathway can be manipulated using receptor agonists/antagonists, or by applying enzyme inhibitors to alter NAE metabolism, for example inhibitors of fatty acid amide hydrolase may be a useful treatment for dry skin . Further, topical treatments, including PEA, have proven an effective eczema treatment and merit investigation in ICD …”

Skin Barrier Damage and Itch: Review of Mechanisms, Topical Management and Future Directions

“…In the skin, the endocannabinoid system plays a regulatory role in proliferation, differentiation and cytokine release (59). Incorporation of an endocannabinoid-targeting component within a cream, such as N-palmitoylethanolamine, can decrease the sensation of itch by increasing the lipid content in the barrier (18,60,61).…”

Clinical and in vitro evaluation of new anti‐redness cosmetic products in subjects with winter xerosis and sensitive skin

“…We sought to improve SC moisturization using novel semi‐occlusive barrier mimetic lipids together with humectants and to mitigate skin redness using this moisturizer formulation supplemented with the anti‐inflammatory agents panthenol, PEA and NAM. The latter was also added for their likely effects on improving keratinocyte differentiation and also boosting cellular NAD levels with NAM.…”

“…While reducing the negative effects of UV irradiation is key in alleviating sensitive skin symptoms, maintaining adequate moisturization is also important . Formulations that contain lamellar lipid bilayers, mimicking those found within the SC, are known to be more effective clinically than non‐lamellar lipid formulations in treating dry skin and uremic pruritus in addition to improving barrier function and erythema in subjects with sensitive skin and atopic eczema . The non‐physiological lipid, isostearyl isostearate (ISIS), has also been shown to positively influence lipid lamellar phase behaviour in experimental skin barrier and lipid models .…”