Skin Transepidermal Water Loss Research Articles

Evaluating the Irritant Factors of Silicone and Hydrocolloid Skin Contact Adhesives Using Trans-Epidermal Water Loss, Protein Stripping, Erythema, and Ease of Removal.

A composite silicone skin adhesive material was designed to improve its water vapor permeability to offer advantages to wearer comfort compared to existing skin adhesive dressings available (including perforated silicone and hydrocolloid products). The chemical and mechanical properties of this novel dressing were analyzed to show that it has a high creep compliance, offering anisotropic elasticity that is likely to place less stress on the skin. A participant study was carried out in which 31 participants wore a novel silicone skin adhesive (Sil2) and a hydrocolloid competitor and were monitored for physiological response to the dressings. Trans-epidermal water loss (TEWL) was measured pre- and postwear to determine impairment of skin barrier function. Sil2 exhibited a higher vapor permeability than the hydrocolloid dressings during wear. Peel strength measurements and dye counter staining of the removed dressings showed that the hydrocolloid had a higher adhesion to the participants' skin, resulting in a greater removal of proteins from the stratum corneum and a higher pain rating from participants on removal. Once the dressings were removed, TEWL of the participants skin beneath the Sil2 was close to normal in comparison to the hydrocolloid dressings that showed an increase in skin TEWL, indicating that the skin had been highly occluded. Analysis of the skin immediately after removal showed a higher incidence of erythema following application of hydrocolloid dressings (>60%) compared to Sil2, (<30%). In summary, this modified silicone formulation demonstrates superior skin protection properties compared to hydrocolloid dressings and is more suitable for use as a skin adhesive.

Effect of Eriobotrya japonica Leaf Supplements on Allergic Rhinitis Symptoms and Skin Conditions in Healthy Adults: A Randomized, Double-Blind, Placebo-Controlled Study

Eriobotrya japonica (E. japonica) leaves have been used as an herbal traditional medicine in China and Japan owing to their anti-inflammatory and protective effects against skin conditions and allergy symptoms. These beneficial effects are likely mediated by the various triterpenoids present in E. japonica leaves. However, the efficacy of E. japonica leaves in the treatment of allergic rhinitis has not been evaluated in humans. Therefore, in the present study, a randomized, controlled, double-blind trial was performed on healthy adults of age &gt;20 (n = 27) who were randomly assigned to receive either 2.5 g of placebo or E. japonica leaf supplements once daily for 4 weeks. The Japanese Allergic Rhinitis Quality of Life Standard Questionnaire (JRQLQ), dermatological allergy symptoms, Dermatology Life Quality Index, and skin condition parameters were assessed at baseline and after 4 weeks. Significant differences were observed in the variability of the itchy nose, itchy eyes, and eye symptoms between the E. japonica supplementation and placebo groups after 4 weeks. Arm skin transepidermal water loss was improved only in the E. japonica supplementation group. This study suggests that E. japonica leaves can be used as a functional food ingredient to relieve allergic symptoms.

Effects of mesotherapy introduction of compound glycyrrhizin injection on the treatment of moderate to severe acne.

Compound glycyrrhizin has achieved outstanding results in the treatment of various skin diseases. However, the use of mesotherapy to inject compound glycyrrhizin into the skin to treat acne is still understudied. This paper aims to explore the effects of mesotherapy introduction of compound glycyrrhizin injection on the acne. A total of 108 patients were included in this study and divided into the control group (n=54) and the observation group (n=54). The control group was treated with topical clindamycin gel, while the study group was treated with topical clindamycin gel + mesotherapy and compound glycyrrhizin injection. Skin transepidermal water loss (TEWL), cuticle water content, acne severity, adverse reactions, and inflammatory reactions were documented before and after treatment in the two groups. The usage of mesotherapy to inject compound glycyrrhizin into the skin of acne patients more effectively treat acne than traditional clindamycin gel. The mesotherapy compound glycyrrhizin can more effectively protect the skin barrier of patients and reduce the loss of skin moisture. Compared with the traditional clindamycin gel, the combination of mesotherapy and compound glycyrrhizin more effectively inhibit the inflammatory reaction in acne patients and reduce skin damage in acne patients. Mesoderm introduction of compound glycyrrhizin injection has better effects on the treatment of moderate to severe acne than clindamycin gel.

Kinkéliba (Combretum micranthum) Leaf Extract Alleviates Skin Inflammation: In Vitro and In Vivo Study.

Kinkéliba (Combretum micranthum, Seh-Haw in Wolof) is a popular bush tea in West African countries. Although the kinkéliba plant's leaves have been widely consumed for its nutritional and medicinal properties, its benefits on skin health potential have been practically untouched. In human epidermal primary keratinocytes, vitexin and isovitexin-rich kinkéliba extract treatment significantly (p < 0.001) enhanced up to 39.6% of the cell survival rate decreased by UV radiation irritation. The treatment of kinkéliba leaf extracts also reduced the production of UV-induced pro-inflammatory cytokines IL-6 and IL-8 by 57.6% and 42.5%, respectively (p < 0.001), which cause skin redness and skin barrier dysfunction, as well as wrinkles and collagen degradation. The anti-inflammation efficacy of kinkéliba leaf extracts might involve significant inhibition on the levels of cellular reactive oxygen species (ROS) (-70.8%, p < 0.001) and nitrotyrosine (-56.9%, p < 0.05). Further topical applications of kinkéliba leaf extract gel were found to reduce sodium lauryl sulfate (SLS)-induced skin inflammation: at D7, the skin trans-epidermal water loss (TEWL) and skin redness (a* value) were both reduced by 59.81% (p < 0.001) and 22.4% (p < 0.001), compared with D0. In vitro and in vivo data support a new topical application of the kinkéliba leaf as an effective active ingredient for the treatment of skin inflammation, as well as subsequent barrier dysfunction and inflammaging.

Analysis of clinical presentations, lip transepidermal water loss and associated dermatological conditions in patients with chronic cheilitis

Chronic cheilitis (CC) is a spectrum of inflammatory changes of unknown etiology that affect the vermilion of the lips. This study aimed to describe the epidemiology, clinical presentations and risk factors of CC. Patients with CC were recruited from the National Clinical Research Center for Oral Disease of China. A convenience sample of inhabitants who live in the same geographical region were recruited as the control group. The lip skin transepidermal water loss (TEWL) and capacitance of CC patients were compared with that of age- and gender-matched controls. Our results demonstrated that of the 109 patients with CC, 72 (66.1%; 95% CI: 57.0–75.1%) were female. The common clinical presentations of CC consisted of desquamation (n = 99; 90.8%), and/or chapping (n = 81; 74.3%), and/or pruritus (n = 64; 58.7%). Multivariable analysis showed that allergic dermatologic diseases (P < 0.001; OR: 4.5; 95% CI: 2.4–8.4), anemia (P = 0.001; OR: 3.3; 95% CI: 1.5–7.5), and indoor/outdoor alternate working environment (P < 0.001; OR: 2.1; 95% CI: 1.5–2.8) were the significant risk factors for CC. The mean lip skin TEWL was found to be significantly higher, while the capacitance was lower in CC patients compared to that of control individuals. This study provides insights into the etiopathogenesis of CC and may help clinicians to identify the most effective management strategies.

The Effect of Sun Tan Lotion on Skin by Using Skin TEWL and Skin Water Content Measurements.

Stratum corneum (SC) is the outermost skin layer. SC hydration is important for its cosmetic properties and barrier function. SC trans-epidermal water loss (TEWL) measurements and skin water content measurements are two key indexes used for SC characterisation. The instrument stability and accuracy are vitally important when measuring small changes. In this paper, we present our latest study on the effect of sun tan lotion on skin by using skin TEWL and skin water content measurements. We developed techniques to improve the measurement stability and to visualise small changes, as well as developed machine learning algorithms for processing the skin capacitive images. The overall results show that TEWL and skin water content measurements are capable of measuring the subtle changes of skin conditions due to the application of sun tan lotions. The results show that the TEWL values decreased after the sun tan lotion application. The sun tan lotion with SPF 20 had the lowest decrease, whilst the sun tan lotion with SPF 50+ had the highest decrease. The results also show that the skin water content increased after the sun tan lotion application, with SPF 20 having the highest increase, whilst SPF 50+ had the lowest increase.

Did human evolution in skin of color enhance the TEWL barrier?

United States will soon be a nation of color; however, much of our knowledge of normal skin disease, and treatment thereof is based on white skin. We and others have attempted to elucidate any potential differences and advantages/disadvantages in skin function that have emerged during homo sapiens evolution post major migration from Eastern Africa. We investigated differences in one stratum corneum function by examining transepidermal water loss (TEWL) measurements in skin of color compared to Caucasian skin. TEWL, a measure of insensible water loss through stratum corneum, plays a major role in human survival. A comprehensive literature search was conducted to procure relevant papers that measured baseline TEWL in skin of color and Caucasian skin. The data show wide contradiction in results for all skin of color groups and white skin and, therefore, no conclusion can be made based on this question. We suggest this variation may be due to experimental confounding variables that impact TEWL quantification, such as anatomic site and sample size subject to further analysis and focus.

Will Repeated Low-Energy 1064-nm Q-Switched Nd:YAG Laser Treatment Sessions Affect Facial Skin Sensitivity? Results of a 12-Month, Prospective, Randomized Split-Face Study.

To compare changes in skin sensitivity before and after treatment with a 1064-nm Q-switched Nd:YAG laser in healthy individuals, and to provide a reference for clinicians to use this laser reasonably. Nineteen healthy female volunteers underwent 10 random unilateral 1064-nm Q-switched Nd:YAG laser treatments. The skin transepidermal water loss rate (TEWL), skin glossiness, epidermal and dermal thickness and density, current perception threshold (CPT) value, facial blood perfusion were determined before and after treatment at different time points. Moreover, the changes in skin barrier function, blood vessels, and sensory nerve reaction in the treated and untreated sides of the face were recorded before and after treatment. Seventeen volunteers completed the 12-month follow-up study after 1064-nm Q-switched Nd:YAG laser treatment. At D3, M3, and M6, skin TEWL was decreased on the treated side of the face. Skin glossiness was significantly improved in the early post-treatment period (D1-D7) and M3, M6, and M12 compared with the untreated side of the face. There was no significant change in dermal and epidermal thickness or density at all time points before and after treatment. There were no significant differences in sensory nerve CPT values and local blood flow volume or velocity between the treated side of the face and the untreated side before and after treatment. Multiple low-energy 1064-nm Q-switched Nd:YAG laser treatments will not affect the barrier function of facial skin, skin nerve sensitivity, or local microcirculation of healthy skin over the long term. Therefore, 1064-nm Q-switched Nd:YAG laser treatment is safe, and does not alter skin sensitivity. Lasers Surg. Med. © 2021 Wiley Periodicals LLC.

In vitro skin model for the evaluation of burn healing drug delivery systems

This study aims to develop an in vitro burnt skin model to be used in permeation experiments during the research and development of topical formulations for wound healing. For this, a hot plate at 85 ± 1 °C was placed in direct contact with porcine skin for 4, 7, or 10 s. Injury level was evaluated according to skin transepidermal water loss (TEWL) and histological profile, and compared to tape-stripped skin (10, 20, or 30 tapes), a well-known technique for damaging the skin barrier. Also, the permeation of three model drugs with different lipophilicities (catechin, Log P = 1.8; clindamycin phosphate, Log P = 0.9; and ketoconazole, Log P = 4.3) in all injured samples was assessed. TEWL evaluations showed that the skin burnt for only 4 s already reached a critical dehydration condition (30.9 ± 1.0 g/h/m2), while the tape-stripped skin only reached such a critical TEWL state after the removal of 30 tapes (38.5 ± 3.6 g/h/m2). Histological evaluation showed the tape-stripping procedure causes damage equivalent to a first-degree burn. In contrast, progressive skin burn can reproducibly simulate first and superficial or deep second-degree burn conditions, just by adjusting the hot plate's contact time. Noticeably, there were significant increases in drug permeation to the epidermis in situations of second-degree burns regardless of drug lipophilicities. In conclusion, a reliable, inexpensive, and easy-to-handle in vitro burnt skin model can be obtained by applying a hot plate on porcine skin. Such a model might be extremely useful to study drug penetration through burnt skin.

Apple Cider Vinegar Soaks [0.5%] as a Treatment of Atopic Dermatitis Do Not Improve Skin Barrier Integrity

LA Luu, RH Flowers, AL Kellams. Pediatr Dermatol. 2019;36(5):634–639 To study the effect of dilute apple cider vinegar (ACV) soaks on skin barrier integrity by measuring skin transepidermal water loss (TEWL) and skin pH in subjects with atopic dermatitis (AD). The study included a total of 22 subjects recruited at the University of Virginia. Eleven of the subjects with AD and eleven healthy controls, age ≥12 years, enrolled between June 2017 and October 2017. A split-arm pilot study recruiting subjects older than 12 years of age with AD and healthy controls was performed. Exclusion criteria included the use of topical or systemic antimicrobial agents in the past month. However, other treatment methods such as, …

Skin barrier damaging and repairing process: A new application field of dermoscopy.

Although more and more noninvasive detection technologies have been used in assessing skin barrier integrity and functions, more accurate, intuitive, and convenient detective methods still needed to be explored and developed. To investigate the characteristic image changes under the dermoscopy and to explore the relationship with skin physiological indexes in skin barrier damaging and repairing process. 25 healthy subjects with normal skin in forearm were included and divided into different groups according to the operated strips numbers (30, 35, and 40 times). Before tape stripping, and immediately, 3, 7, 14, and 21 days after tape stripping, dermoscopic examination and skin transepidermal water loss (TEWL), surface hydration, and L*a*b* value were simultaneously tested in the same region. Immediately after different times tape stripping, the amount of cuticle cells residues and the microvascular images were different. In skin barrier repairing process, the scab forming time observed under dermoscopy was day 14, day 7, and day 3 on 30 times, 35 times, and 40 times stripped skin, respectively. A small amount of cuticle cells and blurry vessels could be identified in hydration value <40 group, while there was no cuticle cell residue, and the branching vessels were obvious in hydration value >40 group. Unique manifestations could be observed under dermoscopy in different time points of skin barrier with various degree of injury and in skin barrier repairing process. By combining dermoscopy and skin indexes assessing technologies, the skin barrier integrity and function could be observed and evaluated more accurately and precisely.

Skin tape sampling technique identifies proinflammatory cytokines in atopic dermatitis skin

BackgroundMonitoring the effects of biologic therapies in skin diseases will benefit from alternative noninvasive skin sampling techniques to evaluate immune pathways in diseased tissue early and longitudinally. ObjectiveTo establish a minimally invasive profiling of skin cytokines for diagnosis, therapeutic response monitoring, and clinical research in atopic dermatitis (AD) and other skin diseases, particularly in pediatric cohorts. MethodsWe developed a novel method for cytokine profiling in the epidermis using skin tape strips (STSs) in a setting designed to maximize the efficiency of protein extraction from STSs. This method was applied to analyze STS protein extracts from the lesional skin of children having AD (n = 41) and normal, healthy controls (n = 22). A total of 20 cytokines were probed with the ultrasensitive Mesoscale multiplex cytokine assay. ResultsA significant increase in interleukin (IL)-1b (P < .01), IL-18 (P < .001), and IL-8 (P < .001) with a decrease in IL-1a (P < .001) in the stratum corneum of AD lesional skin was found. Concurrently, an increase in markers associated with type 2 inflammatory response was readily detectable in AD lesional skin, including C-C motif chemokine ligand (CCL) 22, CCL 17, and thymic stromal lymphopoietin (TSLP). The levels of IL-1b, IL-18, and TSLP exhibited positive correlations with the AD severity index (Scoring AD index) and skin transepidermal water loss (TEWL), whereas an inverse correlation between IL-1a and Scoring AD index and IL-1a and TEWL was found. The levels of CCL17, CCL22, TSLP, IL-22, and IL-17a correlated with skin TEWL measurements. ConclusionUsing minimally invasive STS analysis, we identified cytokine profiles easily sampled in AD lesional skin. The expression of these markers correlated with disease severity and reflected changes in TEWL in lesional skin. These markers suggest new response assessment targets for AD skin. Trial RegistrationClinicalTrials.gov Identifier: NCT03168113.

Can a handheld device accurately measure barrier function in ichthyoses?

Transepidermal water loss (TEWL) is a surrogate measure of skin barrier dysfunction. Historically, devices that measure TEWL are expensive, complex, and require connection to a computer and energy source. Consequently, measurement of skin's TEWL has been limited to the research setting. Evaluate the accuracy of the handheld device gpskin Barrier Light® in comparison with a standardly used device, AquaFlux AF200® , for measuring TEWL. Transepidermal water loss measurements by gpskin Barrier Light® and AquaFlux AF200® in ichthyotic and healthy skin were compared. AquaFlux AF200® TEWL readings were consistently higher than those from gpskin Barrier Light® . In the pooled cohort, TEWL values were strongly correlated and both devices had excellent reliability. When subjects and controls were examined separately, there was moderate correlation between devices, with stronger agreement at higher TEWL values. Transepidermal water loss was determined at one time point. There is no formally established industry standard TEWL-assessing device. Although gpskin Barrier Light® and AquaFlux AF200® devices cannot be used interchangeably, correlation in measuring TEWL was strong in patients with skin disease. This finding suggests that the low-cost, handheld device can accurately capture change in TEWL to track disease improvement.

Effects of low-dose Aloe sterol supplementation on skin moisture, collagen score and objective or subjective symptoms: 12-week, double-blind, randomized controlled trial.

Daily oral intake of 40 μg Aloe sterol was shown in a double‐blind clinical trial to significantly increase skin barrier function, moisture and elasticity. Ultrasonographic results also suggested that the intake of Aloe sterol increases collagen content in the dermis. Here, we evaluate the effects of a much smaller dose of Aloe sterol, approximately half that used previously, on skin functions in more detail. This is a monocentric, double‐blind, randomized, placebo‐controlled, supplementation study of the effects of low‐dose Aloe sterol on skin transepidermal water loss, hydration, collagen score, evaluation of objective or subjective symptoms, and safety after 12 weeks of daily intake. We randomly administrated either Aloe sterol or placebo to 122 healthy volunteers. Transepidermal water loss was significantly reduced and collagen score was increased in the Aloe sterol group compared with the placebo group at week 12. In the Aloe sterol group, there was significant improvement of objective skin condition (face erythema and pruritus of inner and outer arms) at week 12 compared with week 0, but not in the placebo group. Subjectively, there was significant improvement of visual analog scale of skin acne, fingernail brittleness and constipation in the Aloe sterol group. According to subgroup analysis, although not planned before the study initiation, subjects with dry skin in the Aloe sterol group had significantly increased skin hydration values at week 12 compared with the placebo group. Our results confirmed that even low‐dose Aloe sterol ingestion improves skin moisture by promoting skin barrier function and dermal collagen production, which contributes to maintenance of healthy skin.

Skin tape proteomics identifies pathways associated with transepidermal water loss and allergen polysensitization in atopic dermatitis

Atopic dermatitis (AD) and food allergy (FA) are associated with skin barrier dysfunction. Skin biomarkers are needed for skin barrier interventions studies. In this study, skin tape strip (STS) samples were collected from nonlesional skin of 62 children in AD FA+, AD FA-, and nonatopic groups for mass spectrometry proteomic analysis. transepidermal water loss and allergic sensitization were assessed. STS proteomic analysis results were validated in an independent cohort of 41 adults with AD with and without FA versus nonatopic controls. A group of 45 proteins was identified as a principal component 1 (PC1) with the highest expression in AD FA+ STSs. This novel set of STS proteins was highly correlative to skin transepidermal water loss and allergic sensitization. PC1 proteins included keratin intermediate filaments; proteins associated with inflammatory responses (S100 proteins, alarmins, protease inhibitors); and glycolysis and antioxidant defense enzymes. Analysis of PC1 proteins expression in an independent adult AD cohort validated differential expression of STS PC1 proteins in the skin of adult patients with AD with the history of clinical reactions to peanut. STS analysis of nonlesional skin of AD children identified a cluster of proteins with the highest expression in AD FA+ children. The differential expression of STS PC1 proteins was confirmed in a replicate cohort of adult AD patients with FA to peanut, suggesting a unique STS proteomic endotype for AD FA+ that persists into adulthood. Collectively, PC1 proteins are associated with abnormalities in skin barrier integrity and may increase the risk of epicutaneous sensitization to food allergens.

Events in Normal Skin Promote Early-Life Atopic Dermatitis—The MPAACH Cohort

Nonlesional skin in atopic dermatitis (AD) is abnormal, but the pathobiology of lesional and nonlesional skin and the definition of endotypes are poorly understood. To define lesional and nonlesional endotypes of AD by building the first US-based early-life prospective cohort of children with AD, the Mechanisms of Progression from AD to Asthma in Children cohort. We assessed lesional and nonlesional skin transepidermal water loss, filaggrin (FLG) and alarmin (S100A8, S100A9) expression, staphylococcal colonization, and patterns of aeroallergen and food sensitization to define nonlesional and lesional phenotypes and endotypes. Pathophysiologic changes were present in lesional and nonlesional skin and were associated with SCORing for Atopic Dermatitis. Nonlesional skin had features characteristic of diseased skin including low FLG and high alarmin expression, and increased colonization with Staphylococcus aureus. In a multivariate model, nonlesional, but not lesional, FLG expression was associated with the development of cosensitization and moderate to severe AD. Lesional skin was characterized by further deficits in FLG expression (P < .001), but alarmin expression was the same as observed in nonlesional skin. This study reveals that events in the nonlesional, not the lesional, skin promote the subsequent development of AD severity and cosensitization, which is a key risk factor for allergic comorbidities. Collectively, these data suggest the presence of a subclinical eczema endotype that may predispose to the development of allergic disease in the absence of overt eczema. This may represent a new definition of the atopic march that starts with skin barrier dysfunction rather than eczema.

Study on the Repairing Effect of Cosmetics Containing &amp;lt;i&amp;gt;Artemisia annua&amp;lt;/i&amp;gt; on Sensitive Skin

In view of the increasing sensitivity of consumer skin in recent years, cosmetics containing Artemisia annua extract was tested to evaluate its effectiveness in repairing sensitive skin. Through the experiment of xylene-induced ear swelling in mice, it was found that the inhibition rates of ear swelling in mice induced by xylene in three groups of cosmetics containing Artemisia annua extract reached 60.40%, 73.36% and 74.01%, respectively, close to the positive drug group. Twenty-five sensitive skin volunteers were selected for human clinical trial, and the skin TEWL value, cuticle hydration degree and skin heme (ultra-high concentration) were tested. The results showed that using cosmetics containing Artemisia annua extract for four weeks could effectively increase the hydration degree of cheek cuticle by 63.90% and reduce transepidermal waterloss (TEWL) by 21.51%. The skin heme (ultra-high concentration) decreased by 69.14% and the affected area decreased by 77.47%. The results show that the cosmetics containing Artemisia annua extract can inhibit inflammation, repair skin barrier, improve damaged skin, and reduce redness and other sensitive skin symptoms.

Skin sensitivity evaluation: What could impact the assessment results?

For the evaluation results of skin sensitivity, such as clinical parameters, stinging test records and biophysical assessments dates might be impacted by many factors, the influence factors need to be further explored, and the skin sensitivity evaluation process and methodology needed distinction and normalization. In this study, we investigated the changes of sensitive skin indexes and lactic acid stinging test results in different seasons, facial regions, skin photo-type, and living habits. Twenty-four healthy subjects had completed this study. Lactic acid stinging test was performed in different seasons. Transepidermal water loss (TEWL), skin hydration, sebum secretion, and pH were measured in an environment-controlled room. Correlations between stinging responses, skin biophysical parameters, and sensitive skin inducements in different seasons were statistically analyzed. Skin TEWL, hydration, sebum secretion, and pH values on different facial parts were various. Two-way correlation analysis between the results of lactic acid stinging test in different seasons and the sensitivity factors showed differences between summer, autumn, and winter. The mean scores of lactic acid stinging test increased in autumn. Linear regression analysis of skin sensitivity factors in type III and type IV photobiology skin found that the frequency of sleeping time and eating spicy food in the past of week could infect the sensitive skin evaluation dates statistically (P<.05). Skin sensitivity assessment results were impacted by seasonal transformation, living habits and customs, and facial regions. These indicted that we should consider above interfering factors when evaluated the skin sensitivity for getting more precise dates.

Dosage of Bioactive Molecules in the Nutricosmeceutical Helix aspersa Muller Mucus and Formulation of New Cosmetic Cream with Moisturizing Effect

The present study was carried out to provide the allantoin and glycolic acid contents in the Helix aspersa Muller mucus of common Campania land (Italy) by using chromatographic method. The study continued with the formulation of a snail mucus cosmetic cream, whose ability to hydrate the skin was evaluated comparing the skin hydration and trans-epidermal water loss (TEWL) effects of a stable cosmetic preparation. The skin TEWL and skin hydration effects were measured by TEWAMETER and corneometer probe, respectively, at the beginning, after 1 hour, and 24 hours.

Apple cider vinegar soaks [0.5%] as a treatment for atopic dermatitis do not improve skin barrier integrity

Atopic dermatitis (AD) is a common chronic inflammatory skin condition associated with high transepidermal water loss, high skin pH, and Staphylococcus aureus skin colonization. The treatment of AD with bath additives remains highly debated. Recent evidence suggests that dilute apple cider vinegar (ACV) may improve skin barrier integrity in AD, but its safety and efficacy are not well studied. This pilot split-arm study analyzed the effect of dilute apple cider vinegar soaks on skin barrier integrity in patients with atopic dermatitis as measured by skin transepidermal water loss and skin pH. A total of 22 subjects (11 AD and 11 healthy controls) were enrolled. Subjects soaked both of their forearms for 14days, with one arm in dilute ACV (0.5% acetic acid) and the other in water 10minutes daily. Transepidermal water loss and pH were measured pre- and post-treatment. In both groups, transepidermal water loss increased and pH decreased at 0minutes post-ACV treatment, but these effects were not sustained at 60minutes. In total, 72.7% (16/22) of subjects reported mild side effects from ACV with improvement after discontinuing the soaks. Dilute ACV soaks have no significant effect on skin barrier integrity but caused skin irritation in a majority of subjects. Study limitations include analysis of a single brand, dilution, and application of ACV. Future studies are needed to explore whether lower concentrations of ACV soaks or other applications such as a leave-on acidic ointment could improve skin barrier integrity in a safe, nonirritating way.