Skin Surface pH Research Articles

Comparing skin characteristics and molecular markers of xerotic foot skin between diabetic and non-diabetic subjects: An exploratory study

BackgroundXerosis cutis of the feet is one of the most common skin conditions among type 2 diabetics. Whether skin dryness among diabetic patients is different from ‘general’ skin dryness is unclear. The overall aim was to compare the structure, function and molecular markers of dry and cracked foot skin between diabetics and non-diabetics. MethodsThe foot skin of 40 diabetics and 20 non-diabetics was evaluated. A clinical assessment of skin dryness was performed and transepidermal water loss, stratum corneum hydration, skin surface pH, epidermal thickness, skin roughness, elasticity and structural stiffness were measured. Ceramides, natural moisturizing factors, histamines, proteins and molecular markers of oxidative stress were analyzed based on a non-invasive sampling method for collection of surface biomarkers. ResultsThe mean number of superficial fissures in the diabetic group was nearly three times higher than in the non-diabetic group (11.0 (SD 6.2) vs. 3.9 (SD 4.2)). The skin stiffness was higher in the diabetic group and the values of almost all molecular markers showed considerably higher values compared to non-diabetics. Malondialdehyde and glutathione were lower in the diabetic sample. ConclusionsThe high number of superficial fissures may be based on an increased stiffness of dry diabetic foot skin combined with different concentrations of molecular markers in the stratum corneum compared to dry foot skin of non-diabetics.

237 Skin barrier integrity is enhanced after topical application of emulsions with an acidic pH

The pH of the stratum corneum is slightly acidic (mean 4.9) and tightly regulated. This is important for antimicrobial defense and the formation of the physical barrier. The acidic pH inhibits the growth of pathogenic Staphylococcus aureus and enables optimal activity of enzymes for lipid synthesis, epidermal differentiation and desquamation. Here we asked whether topical application of an oil-in-water emulsions adjusted to pH 4 or pH 5.8 and the untreated control influence biophysical markers and mechanical stability of the skin barrier, Stratum corneum morphology and inflammation. Twenty-four healthy volunteers aged 18 to 75 years were treated in a randomized way on the lower arms for 28 days; pH, TEWL, SC hydration, mechanical stability, corneocyte size and inflammation were recorded. After 28 days, skin surface pH was significantly more reduced by the pH 4 compared to the pH 5.8 emulsion. TEWL as a marker of skin barrier function was slightly reduced by both emulsions. SC hydration was significantly increased to the same level by both emulsions. The number of D-Squame® tape-strips to disrupt the skin barrier to a threefold increase in TEWL as a marker for skin integrity was significantly increased by both emulsions compared to untreated control, but slightly more by the pH 4 emulsion. Inflammation after tape-stripping as determined by clinical grading of erythema was considerable reduced by the pH 4 emulsion, and IL-1α protein expression was significantly reduced by both emulsions, but the reduction was higher with the pH 4 preparation. The size of corneocytes attached to the tape-strips as a marker for epidermal differentiation and desquamation was significantly increased after treatment with the pH 4 compared to the pH 5.8 emulsion and the control. In summary, treatment with a pH 4 emulsion positively influenced SC pH, TEWL, SC hydration, epidermal differentiation/desquamation resulting in increased mechanically stability and reduced inflammation against tape-stripping induced irritation.

Facial skin mapping: from single point bio-instrumental evaluation to continuous visualization of skin hydration, barrier function, skin surface pH, and sebum in different ethnic skin types.

Dry skin is one of the most important concerns of consumers worldwide. Despite huge efforts over several decades, the personal care industry still does not offer a perfect solution to satisfy the unmet needs of consumers for moisturising treatments in different ethnic groups. The paucity of data for the underlying cellular and biochemical problems in, and the effects of moisturisers on photodamaged facial skin may partly explain this. Mainly, single point measurements are used to understand the effects of products on skin physiology even on surrogate skin sites such as the non‐photodamaged volar forearm. Some groups have developed discontinuous facial maps of skin biophysical properties, however, in 2014 a continuous facial analysis of bio‐instrumental evaluations was developed using a heat map approach. These maps enabled a continuous visualization of features that not only revealed an unexpected complexity of facial skin but also indicated that use of surrogate skin sites for facial skin is inappropriate. We have demonstrated that remarkable gradients of skin hydration, TEWL, skin surface pH and sebum exist within short distances across the face and the gradients are distinctive among different ethnic groups. In addition, these studies have demonstrated that darkly‐pigmented individuals do not necessarily have a better skin barrier function than their less‐pigmented counterparts and that Caucasians have a lower facial skin surface pH compared with more pigmented subjects. Overall, there are no correlations between capacitance, TEWL and skin surface pH including individual topology angle values. Novel 3D camera approaches have also been used to facilitate a more precise assignment of measurement sites and visualisation. The 3D facial colour mappings illustrated precisely the local moisturising effects of a moisturising cream. There were subtle ethnic differences in efficacy that may be related to underlying skin biochemistry and/or ethnic differences in product application. A placebo‐controlled study using conductance measurements in Chinese subjects is also reported. Finally, a new whole face statistical approach has been taken to prove differences in skin parameters but also of moisturiser treatment that adds further to our understanding of the ethnic differences in skin physiology and product application. This paper reviews the background of the development and application of this methodology.

Measurement of transepidermal water loss, stratum corneum hydration and skin surface pH in occupational settings: A review.

The skin provides a permeable barrier which may be impaired in occupational settings. Transepidermal water loss (TEWL), stratum corneum hydration (SCH) and skin surface pH (SSpH) have been used in occupational settings to predict early onset of occupational skin diseases, to measure the effectiveness of prevention strategies for occupational skin diseases, and to assess skin condition during exposure. The aim was to compare the findings, identify shortcomings in the methodology and data reporting and furthermore, to make recommendations for future studies. A literature study was conducted on studies published before December 2018 to provide a review on the measurement of TEWL, SCH and SSpH in occupational settings. TEWL, SCH and SSpH were previously measured in a wide variety of industries. Results between studies were highly variable, due to different study designs and different anatomical positions measured. Not all of the measurement conditions were reported and variations in study objectives led to data being reported and interpreted differently for most studies. Incomplete reporting of methodology hinders comparison of bioengineering measurements. No bioengineering method has been proven useful as a predictive tool for occupational skin diseases, however, it is useful in the acute assessment of skin condition. It is recommended that future studies on TEWL, SCH and SSpH adhere to guidelines for occupational settings as far as possible to enable comparison between studies.

A 10% Lactobionic acid-containing moisturizer reduces skin surface pH without irritation-An in vivo/in vitro study.

Stratum corneum acidification is a newer strategy in management of inflammatory dermatoses; acidifying emollients are normally used for that purpose. However, a decrease in pH of the skin is commonly connected to an increase in irritation. The aim of this study was to investigate whether lactobionic acid (LA), cosmeceutical active and "superacid" belonging to the class of alpha-hydroxy acids (AHAs), could decrease pH of skin surface without irritation. Safety profile of emulsion based on alkyl polyglucosides (APGs) sugar emulsifiers with 10% LA was evaluated in vitro (acute skin irritation test using cytotoxicity assay), and in vivo in safety study employing measurements of the relevant biophysical human skin parameters upon cessation of 24hours occlusive treatment: transepidermal water loss (TEWL), stratum corneum hydration (SCH), and skin erythema index (EI). The effect on the pH of human skin surface was investigated by pH measurements prior and 1hour after application of the emulsion with 10% LA. The pH of the skin was significantly reduced after application of LA-containing emulsion. The results for in vitro skin irritation potential assessment were in line with the in vivo safety study, indicating a satisfactory safety profile of both APG-based emulsion vehicle per se and emulsion with 10% LA. Lactobionic acid (10%) in emulsion based on APGs reduces skin surface pH without irritation and skin barrier impairment; it could be proposed as an alternative to low-molecular AHAs in acidifying emollients.

Facial application of high-concentration carbon dioxide prevents epidermal impairment associated with environmental changes.

PurposeThe transdermal application of carbon dioxide (CO2) gas dissolved in a solution and bathing in carbonated springs have been known to improve circulatory disorders. We aimed to elucidate and profile the effects of CO2 application on local skin function.Patients and methodsA liquid formulation that included high-concentration CO2 or a control formulation was applied to the face of healthy men for 8 weeks. Quantitative analysis was performed during the dry winter months.ResultsAt the site where the control formulation was applied, transepidermal water loss (TEWL) increased while the moisturizing function (conductance) of facial skin decreased during the study period. However, at the CO2-treated site, increases in TEWL and decreases in conductance were significantly suppressed. In addition, the deterioration in scaliness and wrinkles parameters were suppressed by ≥40% at the CO2-treated site. There were no significant differences in skin surface pH or color properties between the control and test sites.ConclusionThis study suggests that the continuous application of a high-concentration CO2 formulation can affect skin physiology and has the potential to suppress reductions in the barrier and moisturizing functions of the stratum corneum accompanied by desquamation, which occurs during the winter.

Nanoencapsulation of betamethasone valerate using high pressure homogenization–solvent evaporation technique: optimization of formulation and process parameters for efficient dermal targeting

Betamethsone valerate (BMV), a medium potency topical corticosteroid, is one of the most commonly employed pharmacological agents for the management of atopic dermatitis in both adults and children. Despite having remarkable pharmacological efficacy, these agents have limited clinical implication due to poor penetration across the startum cornum (SC). To mitigate issues related to targeted delivery, stability, and solubility as well as to potentiate therapeutic and clinical implication, the nanodelivery systems have gained remarkable recognition. Therefore, this study was aimed to encapsulate BMV into the chitosan nanoparticles (CS-NPs) for optimum dermal targeting and improved penetration across the SC. The prepared NPs were characterized for particle size, zeta potential, polydispersity index, entrapment efficiency, loading capacity, crystallinity, thermal behavior, morphology, in vitro release kinetics, drug permeation across the SC, and percentage of drug retained into various skin layers. Results showed that optimized BMV-CS-NPs exhibited optimum physicochemical characteristics including small particle size (< 250 ± 28 nm), higher zeta potential (+58 ± 8 mV), and high entrapment efficiency (86 ± 5.6%) and loading capacity (34 ± 7.2%). The in vitro release study revealed that BMV-CS-NPs displayed Fickian-diffusion type mechanism of release in simulated skin surface (pH 5.5). Drug permeation efficiency and the amount of BMV retained into the epidermis and the dermis were comparatively higher in case of BMV-CS-NPs compared to BMV solution. Conclusively, we anticipated that BMV-CS-NPs could be a promising nanodelivery system for efficient dermal targeting of BMV and improved anti-AD efficacy.

清拭方法の違いによる皮膚表面pH,汚れの除去,主観への影響

清拭方法の違いによる皮膚表面pH,汚れの除去,主観への影響

Infant Skin Barrier, Structure, and Enzymatic Activity Differ from Those of Adult in an East Asian Cohort.

Skin physiology is dynamically changing over the first years of postnatal life; however, ethnic variations are still unclear. The aim of this study was to characterize infant skin barrier function, epidermal structure, and desquamation-related enzymatic activity as compared to that of adult skin in an East Asian population. The skin properties of 52 infants (3-24 months) and 27 adults (20-40 years) were assessed by noninvasive methods at the dorsal forearm and upper inner arm. Transepidermal water loss and skin surface conductance values were higher and more dispersed for infants compared to adults. Infant skin surface pH was slightly lower than adult on the dorsal forearm. The infant SC and viable epidermis were thinner compared to adults with differences that were site-specific. Although the chymotrypsin-like activity for infant skin was comparable to adult level, the caseinolytic specific activity was significantly higher for the infant cohort. These observations indicate a differently controlled pattern of corneocyte desquamation in infants. In conclusion, structural and functional differences exist between infant and adult skin in the East Asian population pointing to dynamic maturation of the epidermal barrier early in life.

Accelerated barrier recovery and enhancement of the barrier integrity and properties by topical application of a pH 4 vs. a pH 5·8 water-in-oil emulsion in aged skin.

Increased skin-surface pH is an important host-related factor for deteriorated barrier function in aged skin. We investigated whether restoration of skin pH through topical application of a water-in-oil emulsion with pH 4 improved the barrier homeostasis in aged skin, and compared the effects with an identical galenic formulation with pH 5·8. The effects of the test formulations on barrier recovery were investigated by repeated measurements of transepidermal water loss (TEWL) and skin pH 3 h, 6 h and 24 h after acetone-induced impairment of barrier function in aged skin. The long-term effects of the pH 4 and pH 5·8 emulsions were analysed by investigation of the barrier integrity and cohesion, the skin-surface pH and the skin roughness and scaliness before and after a 4-week, controlled application of the formulations. The application of the pH 4 emulsion accelerated barrier recovery in aged skin: 3 h and 6 h after acetone-induced barrier disruption the differences in the TEWL recovery between the pH 4 treated and acetone control fields were significant. Furthermore, long-term application of the pH 4 formulation resulted in significantly decreased skin pH, enhanced barrier integrity and reduced skin-surface roughness and scaliness. At the same time points, the pH 5·8 formulation exerted only minor effects on the barrier function parameters. Exogenous acidification through topical application of a water-in-oil emulsion with pH 4 leads to improvement of the skin barrier function and maintenance of the barrier homeostasis in aged skin.

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

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.

Hyaluronic acid-modified betamethasone encapsulated polymeric nanoparticles: fabrication, characterisation, in vitro release kinetics, and dermal targeting.

Atopic dermatitis (AD) is a chronically relapsing eczematous skin disease characterised by frequent episodes of rashes, severe flares, and inflammation. Till date, there is no absolute therapy for the treatment of AD; however, topical corticosteroids (TCs) are the majorly prescribed class of drugs for the management of AD in both adults and children. Though, topical route is most preferable; however, limited penetration of therapeutics across the startum cornum (SC) is one of the major challenges for scientists. Therefore, the present study was attempted to fabricate a moderate-potency TC, betamethasone valerate (BMV), in the form of chitosan nanoparticles (CS-NPs) for optimum dermal targeting and improved penetration across the SC. To further improve the targeting efficiency of BMV and to potentiate its therapeutic efficacy, the fabricated BMV-CS-NPs were coated with hyaluronic acid (HA). The prepared NPs were characterised for particle size, zeta potential, polydispersity index (PDI), entrapment efficiency, loading capacity, crystallinity, thermal behaviour, morphology, in vitro release kinetics, drug permeation across the SC, and percentage of drug retained into various skin layers. Results showed that optimised HA-BMV-CS-NPs exhibited optimum physicochemical characteristics including finest particle size (< 300 ± 28nm), higher zeta potential (+ 58 ± 8mV), and high entrapment efficiency (86 ± 5.6%) and loading capacity (34 ± 7.2%). The in vitro release study revealed that HA-BMV-CS-NPs displayed Fickian diffusion-type mechanism of release in simulated skin surface (pH 5.5). Drug permeation efficiency of BMV was comparatively higher in case of BMV-CS-NPs; however, the amount of drug retained into the epidermis and the dermis was comparatively higher in case of HA-BMV-CS-NPs, compared to BMV-CS-NPs. Conclusively, we anticipate that HA-BMV-CS-NPs could be a promising nanodelivery system for efficient dermal targeting of BMV and improved anti-AD efficacy.

Przydatność sztucznych błon o właściwościach lipofilowych i hydrofilowych do oceny przenikania in vitro p-hydroksybenzoesanu metylu

ABSTRAKTWstęp: Parabeny są obecnie jednymi z częściej stosowanych konserwantów w produktach kosmetycznych i leczniczych. Pod względem chemicznym są to estry kwasu p-hydroksybenzoesowego. Swoją popularność zawdzięczają dużemu spektrum działania przeciwko drobnoustrojom, możliwości zastosowania w szerokim zakresie pH, jak również niskim kosztom produkcji. Pomimo kontrowersji związanych z bezpieczeństwem stosowania parabeny uznawane są za nietoksyczne i o słabym działaniu alergizującym.Celem pracy była ocena przenikania parabenu M (p-hydroksybenzoesanu metylu) przez sztuczne błony o charakterze hydrofilowym i lipofilowym.Materiały i metody: Oceniano przenikanie parabenu M do płynu akceptorowego o pH 5,4 zbliżonego do pH powierzchni skóry ludzkiej oraz o pH 7,4 odpowiadającym jej głębszym warstwom. Badanie wykonano przy użyciu komory dyfuzyjnej Franza. Próbki płynu z komory akceptorowej pobierano po 0,5, 1, 2 oraz 4 godz. Oznaczeń stężeń parabenu M dokonywano metodą wysokosprawnej chromatografii cieczowej.Wyniki: Stwierdzono, iż paraben M wykazywał zdolność przenikania przez sztuczne błony. W wyższym stopniu związek ten przenikał do płynu akceptorowego z dodatkiem 0,5% kremu niż z żelu. Wykazano wyższy stopień penetracji do płynu akceptorowego o pH = 7,4 w porównaniu z pH = 5,4.Wnioski: Charakter membrany, zarówno hydrofilowy, jak i lipofilowy, nie miały wpływu na przenikanie parabenu M. Wpływ na przenikanie miało jednak podłoże, wykazano bowiem większe przenikanie z kremu niż z żelu. Niższa penetracja dopłynu akceptorowego o pH 5,4 może wskazywać na efektywność działania bariery naskórkowej.

Noninvasive monitoring of plant-based formulations on skin barrier properties in infants with dry skin and risk for atopic dermatitis.

BackgroundDry skin and the associated impaired epidermal barrier function are postulated to constitute a major element in the development of atopic dermatitis.ObjectiveThe aim of this study was to evaluate the effect of two plant-based formulations on the epidermal barrier function in a defined cohort of infants with a predisposition for atopic dermatitis.MethodsOver a period of 16 weeks, 25 infants who were ages 3 to 12 months and had an atopic predisposition and dry skin received two emollients that contained pressed juice of the ice plant. The infants received both cream and lotion on the forearm, only cream on the face, and only lotion on the leg. Stratum corneum hydration (SCH), transepidermal water loss (TEWL), skin surface pH, and sebum were assessed on the infants’ forehead, leg, and forearm. The Scoring Atopic Dermatitis (SCORAD) index was used for the clinical assessment.ResultsSCH significantly increased in all body regions that were assessed. The forearm and leg revealed stable levels of pH and TEWL, but a decline in pH (week 16) and TEWL (week 4) was noted on the forehead. At week 16, sebum levels were lower on the forehead compared with those at baseline. SCORAD scores improved significantly during the study.ConclusionA daily application of both emollients was associated with increased SCH levels and a stable course of TEWL, pH, and sebum on the forehead except for the forehead when compared with the forearm and leg. Clinically, improved SCORAD scores were noted.

Measurement of Skin Surface pH.

The acidic nature of the skin surface was recognised more than a century ago and has been measured since 1928. Several non-invasive methods for measuring skin surface pH have been developed ever since and have contributed to our understanding of healthy and diseased skin. This chapter summarises the endogenous physiological, exogenous and environmental factors that influence skin surface pH and its measurement as well as the different measurement methods for skin surface pH, with specific emphasis on the classic planar glass electrode method. Also, practical guidance for measurement of skin surface pH using the planar glass electrode method is provided. Adherence to practical skin surface pH measurement (method) guidelines with due consideration and practicable control of all factors that may affect skin surface pH will ensure credible pH measurement results in our continuous pursuit of understanding especially diseased skin.

PH and Acne.

Acne is based on a complex, multifactorial pathophysiology beginning with a microcomedo. Comedogenesis involves follicular hyperproliferation and disturbed keratinization, hyperseborrhea and hyperplasia of sebaceous glands as well as disturbances in skin microbiome. Acne is treated with antibiotics, retinoids, keratolytics, hormonal and anti-inflammatory agents. Efficacy and side effects of given medications are well known. The uppermost layer of the stratum corneum is acidic. The low pH provides protection by slowing down the growth of some bacteria. Increase of skin surface pH leads to impaired barrier function, disturbances in skin microbiome and inflammation. Acne-predisposed skin is in a constant state of subclinical inflammation. Subclinical inflammation may be linked to changes in skin surface pH and disturbances of the stratum corneum, allowing microorganisms to stimulate the production of pro-inflammatory cytokines. Here, based on the current literature, the possible link between the skin surface pH, epidermal barrier function and acne is reviewed.

Skin Surface pH in Newborns: Origin and Consequences.

The act of birth and the growth of an infant in consecutive months are critical for the baby's adaptation from intrauterine life to the relatively dry and gaseous environment. These adaptive changes have not only effects on structural components but also subsequent functional consequences. The formation of acid mantel is important for the integrity and cohesion of the stratum corneum, a key component of an intact epidermal barrier, as well as for multiple defensive functions of the skin. In this chapter, we review the mechanisms in pH development after birth. Furthermore, we focus on different factors affecting skin surface acidity formation such as the pre- and postnatal age and weight, gender and anatomical site.

The Relation of pH and Skin Cleansing.

Several epidermal barrier functions, like skin barrier regeneration and antimicrobial response, are related to the acidic nature of the skin surface pH (ss-pH). However, the epidermal acidification is known to be fragile and it is commonly accepted that cosmetic products, especially soaps and skin cleansing products, can induce significant changes in ss-pH. As a consequence, epidermal barrier function and skin microflora are affected negatively. ss-pH even increases after a single washing procedure or after rinsing the skin with water alone. The skin pH recovery needs time up to several hours before it can reach the physiological level. For cosmetic-relevant skin conditions, skin disorders and specific consumer groups, maintaining of the acidic ss-pH is beneficial for epidermal physiology and cutaneous microflora. In this context, cleansing and skin care products with a pH level of 4.0-5.0 may be helpful. In addition, combining the acidic product pH level with the ideal mix of surfactants, thereby enhancing product compatibility and minimizing skin irritation and intolerance, is a major challenge for the future. Beyond innovative cleansing technology, further multifaceted cosmetic research is a prerequisite to get deeper knowledge on the interrelation of product pH level, surfactant composition and corneobiology.

Gender, Age, and Ethnicity as Factors That Can Influence Skin pH.

Several studies have generally described the existence of differences of skin surface pH according to gender, age, and ethnicity, but these studies have reported inconsistent results, depending on anatomical sites, methods, and time of measurement. Overall, it could be summarized that female sex, younger age, and black skin have a lower skin pH compared to male sex, older age, and white skin.

Associations between skin barrier characteristics, skin conditions and health of aged nursing home residents: a multi-center prevalence and correlational study

BackgroundGeriatric patients are affected by a range of skin conditions and dermatological diseases, functional limitations and chronic diseases. Skin problems are highly prevalent in elderly populations. Aim of this study was to investigate possible associations between health, functional and cutaneous variables in aged long-term care residents.MethodsThis observational, cross-sectional, descriptive prevalence study was conducted in a random sample of 10 institutional long-term care facilities in Berlin. In total, n = 223 residents were included. Demographic and functional characteristics, xerosis cutis, incontinence associated dermatitis, pressure ulcers and skin tears were assessed. Stratum corneum hydration, transepidermal water loss, skin surface pH and skin temperature were measured. Data analysis was descriptive and explorative. To explore possible bivariate associations, a correlation matrix was created. The correlation matrix was also used to detect possible collinearity in the subsequent regression analyses.ResultsMean age (n = 223) was 83.6 years, 67.7% were female. Most residents were affected by xerosis cutis (99.1%; 95% CI: 97.7% - 100.0%). The prevalence of pressure ulcers was 9.0% (95% CI: 5.0% - 13.0%), of incontinence associated dermatitis 35.4% (95% CI: 29.9% - 42.2%) and of skin tears 6.3% (95% CI: 3.2% - 9.5%). Biophysical skin parameters were not associated with overall care dependency, but with age and skin dryness. In general, skin dryness and measured skin barrier parameters were associated between arms and legs indicating similar overall skin characteristics of the residents.ConclusionPrevalence of xerosis cutis, pressure ulcers and skin tears were high, indicating the load of these adverse skin conditions in this population. Only few associations of demographic characteristics, skin barrier impairments and the occurrence of dry skin, pressure ulcers, skin tears and incontinence-associated dermatitis have been detected, that might limit the diagnostic value of skin barrier parameters in this population. Overall, the measured skin barrier parameters seem to have limited diagnostic value for the reported skin conditions except xerosis cutis.Trial registrationThis study is registered at https://clinicaltrials.gov/ct2/show/NCT02216526. Registration date: 8th November 2014.