Increased Stratum Corneum Hydration Research Articles

Improvement effects of tapinarof on the skin barrier function in Japanese patients with atopic dermatitis

Background: Tapinarof is a nonsteroidal, topical, aryl hydrocarbon receptor agonist. Tapinarof has been shown to be efficacious and have acceptable safety profile in the treatment of atopic dermatitis (AD).Objective: We sought to evaluate the improvement effect of tapinarof on skin barrier function in patients with AD.Methods: This was an open-label, uncontrolled, single-center study. Japanese patients aged ≥20 years with AD (N = 30) were included in this study. Patients applied tapinarof cream 1% once daily to the target areas on the volar forearm for 8 weeks. The primary endpoints were changes from baseline in stratum corneum hydration (SCH) and transepidermal water loss (TEWL) at the target affected area at week 8.Results: The mean SCH value at the target affected area was 13.656 AU at baseline, 16.904 AU at week 4, and 16.423 AU at week 8. The SCH at the target affected area significantly increased from baseline to week 8, with a mean change of 2.826 AU (p = 0.0433). The mean TEWL value at the target affected area was 17.35 g/m2/hr at baseline, 10.01 g/m2/hr at week 4, and 9.52 g/m2/hr at week 8. The TEWL at the target affected area significantly decreased from baseline to week 8, with a mean change of −8.03 g/m2/hr (p < 0.0001). Clinical signs of AD at the target affected area were improved over time. No serious, severe, or treatment-related AEs were reported.Conclusion: Treatment with tapinarof led to an increase in SCH and a decrease in TEWL in patients with AD, indicating the potential improvement effect of tapinarof on skin barrier function.

A Novel Approach for Dermal Application of Pranoprofen-Loaded Lipid Nanoparticles for the Treatment of Post-Tattoo Inflammatory Reactions.

Recently, the number of people acquiring tattoos has increased, with tattoos gaining significant popularity in people between 20 and 40 years old. Inflammation is a common reaction associated with tattooing. The purpose of this study was to evaluate a nanostructured lipid carrier loading pranoprofen (PRA-NLC) as a tattoo aftercare formulation to reduce the inflammation associated with tattooing. In this context, the in vitro drug release and the ex vivo permeation-through-human-skin tests using Franz cells were appraised. The tolerance of our formulation on the skin was evaluated by studying the skin's biomechanical properties. In addition, an in vivo anti-inflammatory study was conducted on mice skin to evaluate the efficacy of the formulation applied topically after tattooing the animals. PRA-NLC showed a sustained release up to 72 h, and the amount of pranoprofen retained in the skin was found to be 33.48 µg/g/cm2. The formulation proved to be well tolerated; it increased stratum corneum hydration, and no signs of skin irritation were observed. Furthermore, it was demonstrated to be non-cytotoxic since the cell viability was greater than 80%. Based on these results, we concluded that PRA-NLC represents a suitable drug delivery carrier for the transdermal delivery of pranoprofen to alleviate the local skin inflammation associated with tattooing.

Therapeutic effect of the combination of fractional laser and recombinant bovine basic fibroblast growth factor in acne scar patients

Purpose: To assess the feasibility and safety of a combination therapy involving fractional laser treatment and recombinant bovine basic fibroblast growth factor (rb-bFGF) in acne scar patients.Methods: 90 patients with acne scar admitted at Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology from September 2020 to December 2022 were enrolled in retrospective study. Patients were divided into control group (n = 41), treated with rb-bFGF alone and study group (n = 49), which underwent fractional laser treatment using Lutronic fractional laser device involving 40 days per session for three sessions, with additional application of rb-bFGF in the affected area at a dose of 300 IU/cm2 , three times daily, for seven consecutive days following the completion of each laser treatment session. Treatment effect, skin physiological indices, lactic acid stinging test (LAST) scores, stratum corneum integrity, and incidence of adverse reactions were determined.Results: Study group demonstrated superior efficacy with a total effectiveness of 97.96 %, significantly outperforming control group at 85.3 % (p < 0.05). Pre-treatment, both groups exhibited comparable values in trans-epidermal water loss (TEWL), pH, stratum corneum hydration, and erythema (a-value) (p> 0.05). Post-treatment, both groups exhibited significant improvements, with reduced TEWL, pH, and a-value, along with increased stratum corneum hydration (p < 0.05). Compared to control group, study group showed significantly lower TEWL, pH, and a-value, coupled with higher stratum corneum hydration (p < 0.05). Post-treatment, study group demonstrated lower total LAST scores, improved stratum corneum integrity, and a significantly lower incidence of adverse reactions.Conclusion: The combination of fractional laser and rb-bFGF in patients with acne scar improves skin barrier function, reduces lactic acid-induced stinging, and enhances stratum corneum integrity. Further research and clinical trials are needed to optimize the treatment protocols.

The efficacy of a novel tomato extracts formulation on skin aging and pigmentation: A randomized, double-blind, parallel-controlled trial

BackgroundOxidative stress is a significant factor in skin aging and pigmentation, which can be precipitated by various circumstances. Antioxidants and tyrosinase inhibitors, such as carotenoids, yeast extract (glutathione), sodium hyaluronate, astaxanthin, and niacin, can individually protect the skin against aging through distinct mechanisms. These mechanisms potentially enhance the skin barrier and improve signs of aging and pigmentation. However, the synergistic effects of these compounds, as found in a golden tomato extract formulation, have been scarcely explored. ObjectiveTo evaluate the effects of an orally administered formulation on the skin aging and pigmentation. Material and MethodsIn this study, a randomized, double-blind, parallel-controlled trial was conducted, utilizing the WONDERLAB® Tomato Niacinamide beverage. Out of all participants, 62 volunteers completed the experiment and were included in the statistical analysis. ResultsThe results indicated that after eight weeks of consuming the research product, there were no significant changes in the skin indicators within the placebo group. In contrast, the treatment group receiving the sample formulation exhibited a 35.63% increase in stratum corneum hydration and a 29.39% reduction in transepidermal water loss (TEWL), suggesting enhanced skin hydration. Visual assessments revealed improvements in skin color and gloss index by 15.03% and 11.41%, respectively, in the treatment group. Furthermore, the skin gloss and individual typology angle (ITA) value increased by 18.59% and 6.36%, respectively, leading to a lighter skin tone. Significant enhancements were also observed in skin pigmentation, color uniformity, and redness. After eight weeks of intervention with the sample, blood levels of superoxide dismutase (SOD) and glutathione peroxidase (GPx) increased, while malondialdehyde (MDA) levels decreased. ConclusionThese findings confirm that continuous intake of the tomato extract formulation over eight weeks effectively improved the volunteers' skin whitening and hydration, and visibly brightened skin tone through an antioxidant mechanism.

Stratum Corneum Hydration As a Potential Marker of Response to Dupilumab in Atopic Dermatitis®: A Prospective Observational Study.

Background: Dupilumab is an effective treatment for atopic Dermatitis® (AD) and it also restores skin barrier function. Nevertheless, early changes in epidermal barrier parameters related to sustained treatment response or treatment failure are not known. So, the objective of this study is to evaluate whether changes in skin barrier function after 16 weeks dupilumab treatment could predict sustained treatment response or treatment failure. Materials and Methods: A prospective observational study was conducted that included patients with AD starting dupilumab. Clinical scores, patient-reported outcome measures (PROMs), and skin barrier function parameters were assessed at baseline and after 16 weeks treatment. Patients were followed until they failed to dupilumab or until the end of the study period. Participants were divided into 2 groups: patients with treatment failure and those with sustained treatment response. Results: In total, 32 patients with AD were included in the study, with a mean age of 28.03 years (standard deviation 10.65), being 20 (60.6%) females. In total, 22 (66.7%) patients sustained dupilumab response during the study period and only 10 (33.3%) failed to treatment. After 16 weeks treatment, clinical scores were improved in both groups. Patients with sustained treatment response increased stratum corneum hydration (SCH) on noninvolved skin (34.25 arbitrary units [AU] vs 44.90AU, P = 0.001) and on eczematous lesions (20.71 AU vs 40.94 AU, P < 0.001) and also decreased transepidermal water loss (TEWL) on eczematous lesions (28.22 g/[m2·h] vs 14.83 g/[m2·h], P = 0.002). Patients with treatment failure did not change TEWL or SCH. SCH after 16 weeks treatment on noninvolved skin (odds ratio [OR] = 0.83, P = 0.018) and SCH after 16 weeks treatment on eczematous lesions (OR = 0.86, P = 0.028) were related to dupilumab failure. Conclusion: SCH could be used as a predictive biomarker of dupilumab response in patients with AD.

The impact of dupilumab on skin barrier function: A systematic review.

Skin barrier dysfunction plays an important role in atopic dermatitis (AD) aetiopathogenesis. Dupilumab, a drug that inhibits IL-4 and IL-13, is an effective treatment for AD but there is scarce evidence about its impact on epidermal barrier. The objective of this systematic review is to evaluate the influence of dupilumab on skin barrier in patients with AD using non-invasive tools. A systematic review was designed following PRISMA guidelines. The literature search identified 73 references and, finally, only 6 were selected, including a total of 233 participants. All the studies were prospective observational studies. Dupilumab improved clinical scores in all the research. Skin barrier function parameters were mainly measured on the volar forearm. Transepidermal water loss (TEWL) was the parameter most frequently measured, evaluated in all the studies. Dupilumab decreased TEWL on eczematous lesions and non-involved skin. About 33.6% (2/6) studies reported that dupilumab also increased stratum corneum hydration (SCH) on eczematous lesions while one study did not report any changes in this parameter. This drug also decreased temperature and improved ceramide composition. In conclusion, dupilumab improved skin barrier function in AD patients, mainly reflected in a decreased in TEWL values.

How do the skin barrier and microbiome adapt to the extra-uterine environment after birth? Implications for the clinical practice.

The multiple protective functions of the skin derive from the interactions between epithelial skin and immune cells as well as the commensal microbiota. Developed in the last trimester of intra-uterine life, the skin barrier adapts dynamically after birth. Specific differences in the structure and physiology have been disclosed between infant and adult skin. The stratum corneum of infants is thinner and structured by thicker corneocytes with a more anisotropic surface in comparison to adult skin. Lower levels of the natural moisturizing factor and its constituents, together with the increased protease activity in the epidermis result in dry baby skin and ongoing adaptation of the desquamation to the extra-uterine environment. Infant epidermis is characterized by an accelerated proliferation rate and clinically competent permeability barrier in term neonates, despite the higher baseline values of transepidermal water loss in infants. The skin surface of newborns is less acidic, which could increase susceptibility to diaper and atopic dermatitis. Immediately after birth, skin is colonized by commensal bacteria-a process dependent on the mode of delivery and of major importance for the maturation of the immune system. Skin bacterial diversity and dysbiosis have been related to different pathology such as atopic and seborrheic dermatitis. This paper focuses on the ongoing structural, functional and biochemical adaptation of the human skin barrier after birth. We discuss the interactions on the 'skin barrier/ microbiota/ immune system' axis and their role in the development of competent functional integrity of the epidermal barrier.

Acidic Skin Care Promotes Cutaneous Microbiome Recovery and Skin Physiology in an Acute Stratum Corneum Stress Model

Introduction: Skin microbiome and skin physiology are important indicators of the epidermal homeostasis status. Stress models can reveal pathological conditions and modulating effects. Here we investigated the cutaneous microbiome in relation to skin physiology after mild tape stripping (TS) without treatment compared to two cosmetic leave-on lotions (pH 5.5 vs. pH 9.3) in 25 healthy volunteers. Methods: The microbiome was analyzed by 16S-rRNA-gene amplicon sequencing and put in relation to the following skin physiology parameter: epidermal barrier function (TEWA-Meter TM300), stratum corneum hydration (Corneometer CM 825), surface pH (pH-Meter), and skin erythema (Mexameter). Results: TS reduced the alpha diversity with a recovery over 7 days without treatment. Both lotions significantly accelerated the recovery of the alpha diversity already after 2 days with a slightly higher rate for the acidic lotion. After TS, the relative abundance of Proteobacteria was increased, whereas Actinobacteria were reduced. The relative abundances of typical skin-associated genera were reduced after TS. Taxa compositions returned to normal levels after 7 days in all treatment groups. An accelerated normalization could be observed with both lotions already after 2 days. A significant difference in skin pH was observed on day 2 and day 7 with an increased pH for the alkaline lotion. Both lotions induced an increase in stratum corneum hydration. Conclusion: The study proved the suitability of an experimental stress model in the assessment of skin surface microbiome in relation to skin physiology. Stratum corneum hydration increased significantly with both lotions already at day 2. Microbiome parameters (alpha diversity, mean relative taxa, abundance of selected genera) normalized over 2–7 days. The following mechanisms could be responsible for the accelerated normalization of the microbiome: (a) optimized hydration during the recovery phase, (b) the composition of the lotion, (c) the induced repair mechanism. Thus, the formulation has a positive effect on the stratum corneum hydration and subsequently on cutaneous microbiome and skin physiology. Furthermore, this eventually has implications on the modulation of exogenous stress-induced epidermal alterations.

Cotton versus medical face mask influence on skin characteristics during COVID‐19 pandemic: A short‐term study

BackgroundIn the still ongoing COVID‐19 pandemic, one of the main prevention strategy remain to be the use of protective face masks. Changes in skin characteristics and dermatological problems related to wearing different types of masks have been observed. The aim of this study was to compare the short‐term effects of cotton versus medical masks on skin biophysical parameters in general population.Materials and methodsTwenty‐eight human volunteers were enrolled and divided in cotton mask and medical mask wearing groups. We measured four skin biophysical parameters: trans‐epidermal water loss (TEWL), stratum corneum hydration (SCH), skin pH, and erythema index (EI) before and 3 h after wearing masks on both uncovered and mask‐wearing face area.ResultsTEWL increased after 3 h on exposed skin in cotton mask group and slightly decreased in medical mask group There was an increase in SCH after 3 h of wearing protective face masks in both groups. pH of the covered skin slightly decreased while EI increased after 3 h in both groups; changes were not statistically significant. Parameters did not change significantly on uncovered skin.ConclusionThere were no differences between the influence of cotton versus medical protective masks on the skin of healthy volunteers in our study. Both types of masks could be recommended for short‐time protection in individuals with healthy skin during COVID‐19 pandemic.

Dupilumab Therapy Improves Stratum Corneum Hydration and Skin Dysbiosis in Patients With Atopic Dermatitis.

PurposeWe aimed to investigate the effects of dupilumab on 1) the permeability and antimicrobial barrier, 2) the composition of the skin microbiome, and 3) the correlation between changes in skin barrier properties and microbiota in atopic dermatitis (AD) patients.MethodsTen patients with severe AD were treated with dupilumab for 12 weeks. Disease severity was assessed using the Eczema Area and Severity Index (EASI). Skin barrier function was evaluated by measuring transepidermal water loss, stratum corneum (SC) hydration, and pH. The following parameters were analyzed in the pre- and post-treatment SC samples; 1) skin microbiota using 16S rRNA gene sequencing, 2) lipid composition using mass spectrometry, and 3) human β-defensin 2 (hBD-2) expression using quantitative reverse transcription polymerase chain reaction.ResultsSC hydration levels in the lesional and non-lesional skin increased after 12-week dupilumab therapy (24.2%, P < 0.001 and 59.9%, P < 0.001, respectively, vs. baseline) and correlated with EASI improvement (r = 0.90, P < 0.001 and r = 0.85, P = 0.003, respectively). Dupilumab increased the long-chain ceramide levels in atopic skin (118.4%, P = 0.028 vs. baseline) that correlated with changes in SC hydration (r = 0.81, P = 0.007) and reduced the elevated hBD-2 messenger RNA levels (−15.4%, P = 0.005 vs. baseline) in the lesional skin. Dupilumab decreased the abundance of Staphylococcus aureus. In contrast, the microbial diversity and the abundance of Cutibacterium and Corynebacterium species increased, which were correlated with an increase in SC hydration levels (Shannon diversity, r = 0.71, P = 0.027; Cutibacterium, r = 0.73, P = 0.017; Corynebacterium, r = 0.75, P = 0.012). Increased abundance of Cutibacterium species was also correlated with EASI improvement (r = 0.68, P = 0.032).ConclusionsTh2 blockade-induced normalization of skin microbiome in AD patients is associated with increased SC hydration.

The Effectivity of pH 4 Emulsion on Skin Barrier Function in The Elderly: A Systematic review and meta-analysis

Background: The pH of the skin surface is elevated in the elderly therefore it may cause impaired barrier function manifest as various cutaneous abnormalities, including xerosis, pruritus, dermatitis, and skin infections. Consequently, skin care products for the elderly should contain moisturizing ingredients which are formulated to normalize the skin surface pH. Application of pH 4 emulsion is potentially beneficial to improve barrier function in the elderly and promoting skin health. We aimed to determine the difference of effectiveness of pH 4 emulsion compared to identical non pH 4 emulsion on decreasing TEWL in the elderly. A systematic review and meta-analysis was performed of randomized clinical trials assessing the effects of pH 4 emulsion on skin barrier function in the elderly. Methods: Medline Pubmed, Scopus, ProQuest, Cochrane library, ClinicalTrials.gov, the reference list, conference proceedings, researchers in the field of eligible studies were searched. Four studies (n=98 subjects) were included in qualitative analysis of which two studies (n=45 subjects) were included in the meta-analysis. The mean age of the participants was 71.1 years old. Interventions use the application of pH 4 water in oil emulsion (n=2) and pH 4 oil in water emulsion (n=2). Duration of intervention (24 hours-7 weeks) and outcomes of interest varied among included studies. Results: Pooling of data using random-effects model found lower TEWL score in the pH 4 emulsion than in non pH 4 emulsion, with no significant difference (overall effect mean difference -0.068, 95% confidence interval -0.485 – 0.348, p = 0.11, I2=60.1, two RCTs). In addition to that, the qualitative analysis found that the application of pH 4 emulsion increased stratum corneum hydration, decreased skin surface roughness and scaliness, decreased DASI, and improved ICLL length and lamellar organization. Conclusion: The meta-analysis result of the mean differences of TEWL scores lowering effect between pH 4 emulsion and non pH 4 emulsion is statistically inconclusive. This is despite the observation that the pH 4 emulsion appears to be more effective comparatively. The qualitative analysis found that the application of pH 4 emulsion had improved skin barrier function in the elderly. Larger scale, well-designed RCTs assessing the effects of pH 4 emulsion on skin barrier function in the elderly, are still needed.

Effects of a pyroglutamyl pentapeptide isolated from fermented barley extract on atopic dermatitis-like skin lesions in hairless mouse.

Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by pruritic and eczematous skin lesions. The skin of AD patients is generally in a dried condition. Therefore, it is important for AD patients to manage skin moisturization. In this study, we examined the effects of orally administered fermented barley extract P (FBEP), which is prepared from a supernatant of barley shochu distillery by-product, on stratum corneum (SC) hydration and transepidermal water loss (TEWL) in AD-like lesions induced in hairless mice using 2,4,6-trinitrochlorobenzene. Oral administration of FBEP increased SC hydration and decreased TEWL in the dorsal skin of this mouse model. Further fractionation of FBEP showed that a pyroglutamyl pentapeptide, pEQPFP comprising all -L-form amino acids, is responsible for these activities. These results suggested that this pyroglutamyl pentapeptide may serve as a modality for the treatment of AD.

The influence of autogenic training on the physical properties of skin and cardiac autonomic activity in postmenopausal women: an exploratory study.

Autogenic training (AT) is a major relaxation training technique whose clinical efficacy has been verified in dermatology. Many reports demonstrate ameliorated skin conditions in AT-treated subjects with reduced psychological stress. However, no studies have examined the effects of AT on the skin of postmenopausal women. We examine the influences of AT on the physical properties of skin and cardiac autonomic activity in postmenopausal women. Postmenopausal women were classed into anAT group and acontrol one. The women in the AT group were mentored by a professional to practice AT twice a day for 7weeks. The women in the control group were instructed to close their eyes for 3minutes instead of AT. Hydration of the stratum corneum (SC), transepidermal water loss (TEWL), skin elasticity and heart-rate variability (HRV) were measured before and after the study period to examine how they changed. SC hydration and skin elasticity of thecheek, increased in both groups, and the increase was significantly higher in the AT group (n=14) than in the control group (n=12) (P<0.05, Cohen's d=1.03; P<0.05, Cohen's d=0.99; respectively). TEWL did not change in either group. LF/HF was lower in the AT group than in the control group (P<0.05, Cohen's d=0.91). AT increased SC hydration and skin elasticity with changes in the balance of autonomic nervous system activity in postmenopausal women, implying that AT may have improvement effects on aged skin by menopause.

A topical heparinoid-containing product improves epidermal permeability barrier homeostasis in mice.

Because of the importance of epidermal functions, including stratum corneum hydration and maintenance of permeability barrier homeostasis, in the pathogenesis of a variety of cutaneous and systemic disorders, a wide range of products has been developed to improve epidermal functions. However, the underlying mechanisms whereby certain products, including heparinoid-containing product, are far little understood. In the present study, we assessed the impact of a heparinoid-containing product, Hirudoid® cream, on epidermal permeability barrier function and expression levels of a panel of epidermal mRNA related to the formation/maintenance of the permeability barrier in mouse skin. Our results showed that while the baseline levels of transepidermal water rates remained unchanged, treatment with Hirudoid® cream twice daily for 7days significantly accelerated permeability barrier recovery and increased stratum corneum hydration. In parallel, expression levels of epidermal mRNA for certain differentiation marker-related proteins, lipid synthetic enzymes, keratinocyte proliferation and antimicrobial peptides also increased significantly. Together, these results provide the underlying mechanisms by which topical Hirudoid® cream improves epidermal permeability barrier and antimicrobial function. Because of its benefits for epidermal functions, heparinoid-containing product could be more useful in the management of skin conditions, characterized by abnormal permeability barrier and antimicrobial function.

Comparison of linoleic acid-containing water-in-oil emulsion with urea-containing water-in-oil emulsion in the treatment of atopic dermatitis: a randomized clinical trial.

BackgroundApplication of topical moisturizers is an essential part of the management of atopic dermatitis (AD). Linoleic acid (LA), the most abundant fatty acid in the epidermis, and its derivatives have an essential role in the structure and function of the epidermal barrier, and their defects are prominent in AD. The aim of this study was to compare the efficacy and safety of two cosmetic products containing either LA or urea in patients with AD.Patients and methodsA total of 20 patients with AD who met the eligibility criteria and provided written informed consents were enrolled in this randomized, intra-individual split-body, single-center trial. Symmetrical lesions of patients were randomized for treatment with LA- or urea-containing water-in-oil (w/o) emulsions applied two to three times daily for 4 weeks. The efficacy of the two products was evaluated by local Scoring Atopic Dermatitis (SCORAD) of both lesions and also patient (or guardian) satisfaction. In addition, trans-epidermal water loss (TEWL), stratum corneum (SC) hydration, pH, sebum, temperature, erythema, melanin content, and ultrasonographic thickness and echo density of epidermis and dermis were measured before, and 2 and 4 weeks after, treatment.ResultsFour weeks of treatment with the LA-containing product resulted in a significant decrease in local SCORAD, TEWL, erythema, and echo density of dermis, as well as an increase in SC hydration compared to baseline. The urea-containing product also reduced the local SCO-RAD and echo density of dermis and increased SC hydration. In contrast to the LA-containing product, changes in TEWL and erythema were not significant. Moreover, the reduction of erythema was significantly higher in the LA-containing product-treated side compared to the urea-containing product-treated side (p = 0.006).ConclusionBoth LA- or urea-containing w/o emulsions can significantly improve barrier dysfunction and clinical severity of AD. In agreement with literature, it was confirmed that an LA-containing w/o emulsion exhibited erythema-reducing effects. Since emollients should be used on a regular basis, patients should choose a product by individual preference following recommendation by their dermatologists.

A randomized controlled trial to evaluate the effect of a new skincare regimen on skin barrier function in those with podoconiosis in Ethiopia

Podoconiosis affects an estimated 3 million people in Ethiopia with a further 19 million at risk. Volcanic soil and pathogens enter skin breaches in the feet causing inflammation, lymphoedema and hyperkeratosis. There is no robust evidence on optimal podoconiosis skincare regimens to improve skin barrier function (SBF). To evaluate the effectiveness of a new, low-cost, evidence-based intervention to improve SBF in the lower limbs of those with podoconiosis. A randomized controlled trial (NCT02839772) was conducted over 3 months in two podoconiosis clinics (n = 193). The intervention comprised 2% (v/v) glycerine added to a reduced volume of soaking water. The control group received the current skincare regimen. Primary outcome measures were transepidermal water loss (TEWL) and stratum corneum hydration (SCH) at four specific sites on the lower limbs. Improvement in SBF was observed in both groups across all measurement sites and time points, although this was significantly greater in the experimental group. TEWL reduced in both groups at all sites. For example, on top of the foot the estimated group difference in TEWL at visit 4 was 1·751 [standard error (SE) = 0·0390] in favour of the experimental group [t = 3·15, degrees of freedom (df) = 189·58, P = 0·002, 95% confidence interval (CI) 0·066-2·85], indicating a greater reduction in TEWL in the experimental group. Similarly, at the same site the estimated group difference in SCH at visit 4 was -2·041 (SE = 0·572) in favour of the experimental group (t = -3·56, df = 186·74, P < 0·001, 95% CI -3·16 to -0·91), indicating a greater increase in SCH in the experimental group. There were also significantly greater reductions in odour, number of wounds and largest foot circumference in the experimental vs. the control group. The addition of 2% (v/v) glycerol to a reduced volume (83% reduction) of soaking water significantly improved SBF.

Coffee polyphenols extracted from green coffee beans improve skin properties and microcirculatory function

Coffee polyphenols (CPPs), including chlorogenic acid, exert various physiological activities. The purpose of this study was to investigate the effects of CPPs on skin properties and microcirculatory function in humans. In this double-blind, placebo-controlled study, 49 female subjects with mildly xerotic skin received either a test beverage containing CPPs (270mg/100mL/day) or a placebo beverage for 8weeks. The ingestion of CPPs significantly lowered the clinical scores for skin dryness, decreased transepidermal water loss, skin surface pH, and increased stratum corneum hydration and the responsiveness of skin blood flow during local warming. Moreover, the amounts of free fatty acids and lactic acid in the stratum corneum significantly increased after the ingestion of CPPs. These results suggest that an 8-week intake of CPPs improve skin permeability barrier function and hydration, with a concomitant improvement in microcirculatory function, leading to efficacy in the alleviation of mildly xerotic skin.

Effects of a Skin Barrier Cream on Management of Incontinence-Associated Dermatitis in Older Women: A Cluster Randomized Controlled Trial.

The purpose of this study was to examine the effects of a skin barrier cream with moisturization and skin-protectant characteristics for improving the severity of incontinence-associated dermatitis (IAD) pertaining to the skin physiology and appearance. We measured the following outcomes: (1) skin physiological characteristics indicating skin protection and enhancement of the skin's moisture barrier (stratum corneum hydration, dermis hydration level, transepidermal water loss, and skin pH); and (2) changes in skin appearance (the degree of erythema and pigmentation, and the sulcus cutis condition). Single-blind, cluster randomized controlled trial. The study was conducted in a long-term care facility in Japan between November 7, 2011, and May 6, 2012. We used block randomization to obtain a random sample of 6 (4 experimental and 2 control) out of 10 available wards. All subjects were elderly women with IAD of the buttock or inner thigh. We assessed 295 patients, but only 33 met inclusion criteria; 18 were allocated to the experimental group and 15 were allocated to the control group. All participants were managed with cleansing with a skin cleanser and application of a moisturizer daily. In addition, a skin barrier cream designed to enhance the skin's moisture barrier and act as a protective barrier was applied to the skin of patients in the experimental group 3 times a day when absorptive briefs were changed. Skin physiological and appearance characteristics were scored only at the buttock or thigh area. All data were collected on days 1 and 14 of the study. Univariate analysis found that the erythema index was lower in the intervention group than in the control group at day 14 (P = .004). Multivariate analysis found significant associations between use of the skin barrier cream and increased stratum corneum hydration (β= .443, P = .031), decreased skin pH (β=-.439, P = .020), and magnitude of erythema (β=-.451, P = .018). Study findings suggest that a barrier cream designed to enhance the skin's moisture barrier and act as a skin protectant increased stratum corneum hydration, reduced cutaneous pH, and reduced erythema.

Application of Topical Acids Improves Atopic Dermatitis in Murine Model by Enhancement of Skin Barrier Functions Regardless of the Origin of Acids.

BackgroundThe acidic pH of the stratum corneum (SC) is important for epidermal permeability barrier homeostasis. Acidification of the skin surface has been suggested as a therapeutic strategy for skin disorders such as atopic dermatitis (AD).ObjectiveWe performed an animal study to evaluate the usefulness of acidification of SC for inhibition of AD lesions and to find out if the therapeutic effect of vinegar is attributable to its herbal contents, rather than its acidity.MethodsFive groups of six oxazolone-treated (Ox)-AD mice were treated for three weeks with creams of different acidity: vehicle cream alone (pH 5.5), neutralized vinegar cream (pH 7.4), pH 5.0 vinegar cream, pH 3.5 vinegar cream, and pH 3.5 hydrogen chloride (HCl) cream. Also, we have compared two groups of Ox-AD mice treated with pH 5.5 vehicle cream or pH 5.5 vinegar cream.ResultsOx-AD mice treated with acidic creams exhibited fewer AD-like lesions, had significantly lower eczema scores, decreased basal by transepidermal water loss (TEWL), and increased SC hydration compared to the groups given only vehicle and neutral cream. There was no significant difference between the acidic vinegar and HCl groups. Between the groups treated with vehicle and pH 5.5 vinegar cream, there was no difference in eczema score, basal TEWL and SC hydration.ConclusionApplication of topical acids, regardless of their source materials, inhibits the development of AD lesions by maintenance of skin surface pH and skin barrier function in murine model.

Detection of fiber effects on skin health of the human foot

The objective of this investigation was to better understand the effects of foot coverings differing in fiber content on the health of the skin on the foot. A longitudinal controlled parallel design wear trial was carried out over 8 weeks: four sock types differing in fiber/yarn closely matched for fiber diameter (100% acrylic, 100% wool (24.5 µm), 100% cotton, 100% wool (20.5 µm)), manufactured such that only fiber type differed, were worn by 16 men. The effects on transepidermal water loss, stratum corneum hydration, pH, skin temperature were examined. Variability in effects among the participants was evident. Each person was his own control, with change expressed as a percentage from baseline. Fabric structural properties and selected performance properties were measured on fabrics of the same fiber/structure as of the socks. Improvement in skin health at the heel, in particular, was evident. Wool socks were associated with more cases of improved skin health (e.g. reduced percentage changes in transepidermal water loss and increased stratum corneum hydration). Results from two indicators of skin health considered together provided stronger evidence of effects than one alone.