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

Abstract

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.

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

“…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 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 . 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 …”

Prevalence, predictors and comorbidity of dry skin in the general population

“…This indicates the need for basic skincare in patients with chronic inflammatoryskin diseases. Clinical effectiveness has been shown both for single skin care measures as well as for a preventive program against dry skin in the elderly . Nevertheless, there still is a lack of robust data on most topical skin care products concerning effectiveness and quality.…”

Moisturizers versus Current and Next-Generation Barrier Repair Therapy for the Management of Atopic Dermatitis

“…Although these ceramides, if provided at sufficient concentrations, can improve epidermal permeability barrier and SC hydration [8], their content in most formulations is usually too low to impart measurable benefits. Ceramides appear to be included in such preparations largely for marketing purposes.…”