Transepidermal Water Loss Research Articles

Skin health promoting effects of a proprietary nutraceutical ingredient (SesZen-BioTM): a placebo controlled, double-blind, and randomized clinical study

Background: This study evaluated the skin health benefits of SesZen-BioTM, a 0.5% natural biotin supplement derived from Sesbania grandiflora, previously linked to hair growth, in healthy adults aged 30-55 with mild skin ageing. Methods: In a single-center, double-blind, placebo-controlled trial, participants between ages 30-55 years with mild skin ageing received either SesZen-BioTM or a placebo, with assessments conducted on days 0, 28, and 56. Parameters measured included facial wrinkles, fine lines, skin elasticity, hydration, skin barrier function and overall skin health. Results: Significant reduction (p<0.01) in crow’s feet area by 27.11% (day 28) and 48.14% (day 56) and 17.95% and 51.17% reduction in fines lines were observed in the treatment group as compared to 12.1% reduction for placebo group at day 56. Physician global assessment (PGA) scores showed improvement in skin condition by 14.07% (day 28) and 20.58% (day 56) for SesZen-BioTM treatment group. The facial skin tone assessment described by individual typology angle (ITA) showed lighter skin tone by 30.55% (day 28) and 58.23% (day 56) (p<0.01). Treatment group showed decrease in retraction time for skin elasticity on day 56, decreased skin roughness and increased skin hydration. Both groups showed decreased transepidermal water loss (TEWL) on both visits (days 28 and 56) as compared to baselines (p<0.01). The placebo group showed no improvement in PGA score, skin tone lightness (L*) and ITA score, skin hydration, or skin elasticity. Conclusions: SesZen-BioTM appears to effectively promote skin health, reducing fine lines and improving skin tone, elasticity, and hydration, suggesting a viable strategy for combating skin aging and enhancing overall skin appearance.

Increasing the effectiveness of total-skin electron beam therapy by reducing the manifestations of radiation dermatitis in patients with primary lymphomas. A comparative randomized prospective study

Background. One of the main adverse events that significantly reduce the quality of life of patients and limit the total focal dose is radiation-induced skin reactions (RISR). Their timely diagnosis, prevention, and treatment remain urgent tasks of modern radiotherapy. Aim. To improve the effectiveness of total skin irradiation (TSI) in patients with primary skin lymphomas by reducing the clinical manifestations of RISR by using additional therapy with a hydrogel containing active components with vasoprotective and anti-inflammatory action. Materials and methods. A comparative randomized prospective study was conducted, including data from 52 patients who received electron TSI by conventional fractionation at a total focal dose of 14 to 30 Gy for primary cutaneous lymphomas at the Granov Russian Research Center of Radiology and Surgical Technologies from September 2021 to January 2024. Before the first TSI session, during treatment and 2 weeks after the end of radiation therapy, all patients underwent assessment for RISR, quantitative assessment of various degrees of severity of radiodermatitis using instrumental methods and assessment scales; for the observation group, a therapeutic regimen for the prevention and treatment of RISR was used, including a hydrogel with troxerutin (2%) and trolamine (0.07%), and in the control group, basic skin care using moisturizers. Results. Analysis of the physiological parameters of the skin showed statistically significant differences between the study groups: patients of the study group (group I; 30 subjects receiving the above-mentioned therapeutic regimen) compared with the control group (group II; 28 subjects who did not receive specific treatment for radiodermatitis) reported significantly lower rates of erythema (386±12.3 and 572±14.4; p=0.005), transepidermal water loss (25±0.3 and 38±0.4 g/m2/h; p0.001) and a decrease in peak endothelial-dependent vasodilation of microvasculature and blood flow in the skin. A lower proportion of severe radiodermatitis (86.3 and 73.3%; p0.05) and a statistically significant difference in the subjective quality of life scores by the 29-point Skindex-29 scale by an average of 22.2% were also found. Conclusion. A comparative analysis of the quantitative indicators of radiodermatitis in the study group and the control group showed that the topical application of the hydrocolloid gel containing troxerutin and trolamine reduces the clinical manifestations of RISR concerning objectively measured physiological parameters of the skin and blood flow parameters of the microvasculature measured by high-frequency ultrasound, thus improving the quality of life of patients during and after the course of radiation therapy.

Retention of nickel, cobalt and chromium in skin at conditions mimicking intense hand hygiene practices using water, soap, and hand-disinfectant in vitro

BackgroundDuring the COVID-19 pandemic, increased hand hygiene practices using water, soap and hand disinfectants, became prevalent, particularly among frontline workers. This study investigates the impact of these practices on the skin’s ability to retain the allergenic metals nickel, cobalt, and chromium. The study constitutes three parts: (I) creating an impaired skin barrier, (II) exposing treated and untreated skin to nickel alone, and (III) in co-exposure with cobalt and chromium.MethodsUsing full-thickness skin from stillborn piglets, in vitro experiments were conducted to assess retention of metals in skin at conditions mimicking intense hand hygiene practices. Treatment of skin with varying concentrations of sodium lauryl sulphate (SLS), to impair its barrier integrity was assessed. This was followed by exposure of treated and untreated skin to the metals, that were dissolved in Milli-Q water, 0.5% SLS, and ethanol respectively.ResultsResults showed that pre-treatment with 5% SLS impaired the skin barrier with regards to the measure of trans epidermal water loss (TEWL). Metal amounts retained in the skin were generally higher in treated than untreated skin. The highest amounts of metal retained in skin were observed for exposure to nickel in ethanol. Co-exposure to nickel, cobalt, and chromium in 0.5% SLS resulted in the highest amounts of total metal retention.ConclusionsThe in vitro findings highlight the increased risk of metal retention in skin due to an impaired barrier. The SLS concentration used in the current study corresponds to those used in many hand hygiene products. Hence, occupational settings with frequent exposure to water, soap and disinfectants need to consider protective measures not only for the irritant exposures themselves but also simultaneous exposure to allergenic metals.

Efficacy of a Video Education Program Regarding Basic Skin Care in Pediatric Atopic Dermatitis: A Randomized Controlled Trial.

Basic skin care education holds the potential to improve clinical outcomes in pediatric atopic dermatitis (AD). However, evidence is lacking on the efficacy of video education for patient guardians in Thailand to reduce AD disease severity. To compare the efficacy of a video education program for guardians of pediatric AD patients versus a control group by assessing the severity score of AD (SCORAD), transepidermal water loss (TEWL), and skin hydration (SH). A single-blinded, randomized controlled trial was conducted at a tertiary hospital from June 2023 to February 2024, involving AD patients aged < 18 years and their guardians. Both groups received standard treatment, and the educational group received an additional video education program. SCORAD, TEWL, SH, pruritus, sleeplessness, and parental/guardian confidence and knowledge accuracy were assessed at enrollment and a 4-week follow-up. Seventy patients (educational:control group, 34:36) with a median age of 3.1 years were enrolled. The groups exhibited no significant demographic or disease severity differences between them. At follow-up, the educational group showed significant SCORAD improvement compared to the control group (mean difference -10.93 [95% CI -16.92--4.95]; p < 0.001). SH (mean difference 3.82 [95% CI -2.7-10.33]; p = 0.25) and TEWL (mean difference -1.24 [95% CI -5.72-3.24]; p = 0.58) did not differ significantly. Video education demonstrated efficacy in significantly reducing SCORAD. While there were improvements in SH and TEWL in patients in the education group, these improvements were not statistically significant. Further investigation with a larger sample size is warranted. Thai Clinical Trials Registry (TCTR): TCTR20230524001.

Efficacy of Pseudo-Ceramide Absorption Into the Stratum Corneum and Effects on Transepidermal Water Loss and the Ceramide Profile: A Randomized Controlled Trial.

Changes in the level or profile of ceramides are associated with decreased stratum corneum (SC) barrier function. Topical application of a pseudo-ceramide (pCer)-containing moisturizer can improve barrier function. Additionally, pCer that absorbs into the SC may improve ceramide profiles. We investigated the relationship between pCer absorption into the SC and SC properties and determined the efficacyof a pCer-containing spray compared with that of a commercial spray without pCer. Patients with self-perceived dry and sensitive skin and decreased barrier function (transepidermal water loss [TEWL] > 10 g/m2h) were randomized into two groups to topically apply a pCer-containing spray (test group; N = 33) or commercial spray without pCer (control group; N = 19) twice daily as a single-blind study. SC function and ceramide properties were investigated before and after 4 weeks of application. In the test group, the ceramide (NP)/(NS) ratio proportionally increased with the pCer application level after 4 weeks of pCer-containing spray application. In the control group, there were no changes in SC function after topical application of the commercially available spray without pCer; however, the SC water content, TEWL, SC cell area, and scaling score improved in the test group. Furthermore, the changes in TEWL in the test group were significantly negatively correlated with the pCer application level. The efficacy of pCer-containing sprays for those who have sensitive skin with impaired barrier function was demonstrated. Furthermore, the improvement in SC barrier function induced by pCer may contribute to normalizing the SC ceramide profile.

A prospective, double‐blinded, randomized head‐to‐head clinical trial of topical adapinoid (oleyl adapalenate) versus retinol

AbstractBackgroundRetinoids, such as retinol, are widely investigated and utilized in skin care products as a treatment for photoaging but their use is limited by tolerability. Adapinoid (oleyl adapalenate, OA) is a novel third generation retinoid that is a pro‐drug of adapalene, but there is little research on its effects on photoaging or its tolerability.ObjectivesThe purpose of this study is to compare the effects and tolerability of OA 0.5% to retinol 0.5% cream regarding visible signs of facial photoaging including facial wrinkles, fine lines and pigmentation.MethodsIn this 12‐week, double‐blind, randomized clinical trial, 48 eligible participants were recruited and enroled from the Greater Sacramento region. The study consisted of a baseline and follow‐up visits at weeks 4, 8 and 12. Participants were randomized to receive either topical OA 0.5% or retinol 0.5% for 12 weeks. The primary outcome was changes in the appearance of wrinkle severity at 12 weeks. Secondary outcome measures include changes in erythema, skin pigmentation, skin hydration and transepidermal water loss (TEWL).ResultsOA improved wrinkle severity by 9.45% (p &lt; 0.0001) at week 12, whereas retinol improved wrinkle severity by 4.11% (p &lt; 0.001) compared to baseline. When comparing the two treatment groups at week 12, the OA group improved significantly more than the retinol group (p = 0.001). OA decreased pigment intensity at week 12 by 3.88% (p &lt; 0.0001), whereas retinol decreased pigment intensity by 3.15% (p &lt; 0.03) compared to baseline. OA‐based improvement in pigment intensity at week 12 was not significantly different from retinol (p = 0.62). OA reduced facial erythema by 13.39% (p &lt; 0.05) at week 12, whereas the retinol group did not have a significant change. OA use led to a 14.92% decrease in TEWL by week 12 (p = 0.07), whereas the retinol group had no significant change. OA was better tolerated than retinol when assessed at all follow‐up visits.ConclusionsOA 0.5% is superior to retinol 0.5% in improving wrinkle severity and similar in improvement of pigment intensity. OA is better tolerated than retinol. Overall, the use of OA as a precursor to adapalene may be an effective method to improving the tolerability of retinoids while maintaining efficacy.Trial RegistrationThis study was registered on www.clinicaltrials.gov (NCT05778760).

Comprehensive Assessment of Intradermal Responses to Hyaluronic Acid-Based Skin Injection Fillers through Multi-Pathway Dynamic Synergies

Skin injection filling products must undergo a rigorous evaluation before entering the market, and intradermal reactions are crucial for biocompatibility. However, current evaluation methods for skin injection fillers often lack precision. This study aims to explore a comprehensive evaluation method by incorporating additional indicators: dermoscopy, transepidermal water loss, moisture content, ultrasound, and histological observation. Experimental findings show sodium hyaluronate gel groups exhibited no noticeable erythema or abnormalities, except for skin swelling. The dynamic and quantitative assessment of water content and transdermal water loss provided insights into the injection site skin's edema status. Ultrasound imaging observed subcutaneous material occupation and measured skin protrusion height. Histopathological observations revealed edema and inflammation in positive groups but no significant reactions in any gel samples. The comprehensive use of these methods confirms that the intradermal response of injection fillers in this study is within an acceptable range. However, if solely evaluated based on existing standards, it may exceed the qualified range. Consequently, the study suggests that for sodium hyaluronate gel, a macromolecular injection filler for long-term subcutaneous space occupancy, the traditional intradermal reaction scoring method may be inadequate. The proposed comprehensive evaluation scheme in this study is considered a more objective approach.

Incontinence-Associated Dermatitis-Like Skin Changes Induced by the Application of Absorbent Pads Containing Bacteria and Artificial Urine in Rats.

Incontinence-associated dermatitis (IAD) is one of the most serious complications in older people with incontinence. Controlling urine property in absorbent pads could be effective for preventing IAD caused by bacterial urine. However, no animal model has been established to evaluate their effectiveness. This study aimed to induce IAD-like skin changes using absorbent pads containing bacterial urine and to confirm their pathophysiology in rats. Hairless Wistar Yagi rats were divided into the bacteria-containing urine (BU) and the bacteria-free urine (U) groups. A 10-h-attachment of absorbent pads containing artificial urine with/without bacteria to the skin pretreated with sodium lauryl sulfate was performed repeatedly for 5 days. Macroscopic findings and skin barrier function were examined every day, and histological changes, inflammatory responses and bacterial quantification in tissue samples were examined on Day 5. The BU group exhibited significant skin redness from Day 3, significant elevation of transepidermal water loss from Day 1, and histological changes, including significantly thickened epidermis, abnormal keratinocyte differentiation and erythrocyte leakage. Inflammation, confirmed by higher myeloperoxidase-positive cells, elevated tumour necrosis factor-α expression, and vascular endothelial damage, indicated by CD31 and pentraxin 3-positive cells, were observed in the BU group. The bacterial quantification showed no significant difference between the groups. IAD-like skin changes including histological changes and inflammation were suggested to be caused by urine properties altered by bacteria. This study proposed a new animal model for evaluating the effectiveness of absorbent pads in controlling the urine properties of bacterial urine on preventing IAD.

Differential Diagnosis of Irritant Versus Allergic Contact Dermatitis Based on Noninvasive Methods

Introduction: Irritant contact dermatitis (ICD) is characterized by direct injury to the epidermal cells, activating the innate immune response. Allergic contact dermatitis (ACD), in contrast, is delineated by a delayed hypersensitivity reaction of type IV. Despite the distinct etiopathogenic mechanisms underpinning each condition, the differentiation between them presents a significant diagnostic challenge. Objective: This study aims to determine whether a combination of clinical evaluation and noninvasive measurements—encompassing oxidative stress, erythema, hydration, melanin content, transepidermal water loss (TEWL), hemoglobin concentration, and skin texture and volume—can distinguish ICD from ACD. Methods: Two cohorts, each comprising 21 patients, were evaluated: one diagnosed with ICD and the other with ACD. All participants underwent biophysical and clinical assessments, along with Antera® 3D evaluations. Tape strips were utilized for skin sampling, and oxidative stress levels were measured via fluorescence assessments. Results: ICD prompts an almost immediate inflammatory reaction (peaking at 24 hours), whereas ACD incites a delayed response (72 hours). Noninvasive evaluated parameters as hemoglobin concentration, skin texture and volume, melanin content, erythema, and TEWL showed significant differences between the ICD and ACD cohorts (p &lt; 0.05). The allergens amcinonide, nickel sulphate, cobalt chloride, budesonide, PPD, and thiuram mix were found to induce elevated levels of oxidative stress. Conclusions: The evaluation of patients with noninvasive parameters, including transepidermal water loss (TEWL), hemoglobin concentration, and skin texture and volume, could markedly aid in distinguishing irritant contact dermatitis from allergic contact dermatitis (ACD). Nevertheless, the study is constrained by a limited sample size.

SSA-ZP on Scalp Seborrheic Dermatitis: Regulating Sebum Levels and Scalp Barrier.

The occurrence of scalp seborrheic dermatitis (SD) is closely related to the production of sebum and scalp barrier function. Supramolecular salicylic acid has the keratolytic and anti-inflammatory properties, and zinc pyrithione is an antifungal drug delivered as a microparticle to skin epithelia. This study aimed to assess the efficacy and safety of 2% supramolecular salicylic acid (SSA) combined with 0.8% zinc pyrithione conditioner (SSA-ZP) in treating scalp SD focusing on key outcome measures including sebum levels and scalp barrier function. Five patients with mild to moderate scalp SD were included in the 2-week self-controlled prospective study, receiving daily SSA-ZP treatment. Evaluation on days 0, 7, and 14 included dermoscopy, the adherent scalp flaking scale (ASFS), sebum level, transepidermal water loss (TEWL), pH, and stratum corneum hydration. We also performed the fungal count across specific scalp regions, such as the left and right sides of the forehead, the top of the head, and the occiput. Five patients with mild to moderate scalp SD participated in this study. After 2 weeks of SSA-ZP treatment, significant reductions in ASFS scores, sebum levels, and fungal count were observed, alongside improvements in TEWL and pH values across multiple scalp regions. Moreover, there was no difference in the hydration of stratum corneum. SSA-ZP demonstrated efficacy in treating scalp SD without adverse effects, suggesting its potential as a first-line treatment option. Further research with larger sample sizes and longer follow-up periods is warranted to validate these findings.

Identification of Key Genes Related to Immune-Lipid Metabolism in Skin Barrier Damage and Analysis of Immune Infiltration.

Several physical and chemical factors regulate skin barrier function. Skin barrier dysfunction causes many inflammatory skin diseases, such as atopic dermatitis and psoriasis. Activation of the immune response may lead to damage to the epidermal barrier. Abnormal lipid metabolism is defined as abnormally high or low values of plasma lipid components such as plasma cholesterol and triglycerides. The mouse skin barrier damage model was used for RNA sequencing. Bioinformatics analysis and validation were performed. Differently expressed genes (DEGs) related to immune and lipid metabolism were screened by differentially expressed gene analysis, and the enriched biological processes and pathways of these genes were identified by GO-KEGG. The interactions between DEGs were confirmed by constructing a PPI network. GSEA, transcription factor regulatory network, and immune infiltration analyses were performed for the 10 genes. Expression validation was performed by public datasets. The expression of key genes in mouse skin tissue was detected by qPCR. The expression of differentially expressed immune cell markers in the skin was detected by immunofluorescence. Based on the trans epidermal water loss (TEWL) score, the expression of key genes was detected by qPCR before skin barrier injury, at 4h and 7d, and at recovery from injury. Il17a, Il6, Tnf, Itgam, and Cxcl1 were immune-related key genes. Pla2g2f, Ptgs2, Plb1, Pla2g3, and Pla2g2d were key genes for lipid metabolism. Database validation and experimental results revealed that the expression trends of these genes were consistent with our analyses. The research value of these genes has been demonstrated through mouse datasets and experimental validation, and future therapeutic approaches may be able to mitigate the disease by targeting these genes to modulate the function of the skin barrier.

The influence of air pollution on skin microbiome: a link to skin barrier dysfunction.

An equilibrium of skin microbiome is crucial for maintaining skin barrier function. However, external factors such as air pollution have the potential to disrupt this equilibrium. Hence, further investigation into the influence of air pollution on the skin microbiome emerges as a critical imperative. Healthy women matched for age from two different ambient air cities in Thailand: Bangkok, characterized by highly polluted air (HPA) (n = 33), and Songkhla, characterized by less polluted air (LPA) (n = 33) were recruited. Skin barrier physiological parameters were measured on the forehead skin. Microbiome samples were collected via the scraping and swabbing technique from the forehead skin and analyzed for microbiome profiles using amplicon sequencing. We found that the abundant microbiome at the phylum level was comparable between HPA- and LPA-exposed skin. However, microbiome diversity was decreased at genus level of fungus and species level of bacteria on HPA-exposed skin. Interestingly, some relatively higher enriched microbiome correlated with skin barrier physiological parameters. Specifically, a higher enrichment of Streptococcus parasanguinis on LPA-exposed skin correlated with both lower skin pH and higher stratum corneum (SC) hydration. Conversely, a higher enrichment of Malassezia spp. and Aureobasidum spp. on HPA-exposed skin was correlated with increased transepidermal water loss and decreased SC hydration, respectively. In conclusion, air pollution potentially affects the skin microbiome by reducing its diversity, disrupting its beneficial correlations with barrier physiology, and promoting the overgrowth of pathogenic microbiome, resulting in decreased hydration and increased pH levels. These factors could ultimately lead to skin barrier dysfunction.

Effectiveness of Delayed First Baths on Transepidermal Water Loss in Late Preterm Infants: A Randomized Controlled Trial.

This study evaluates whether delaying the first bath affects late preterm infants' skin barriers, body temperatures, and comfort. Late preterm infants' skin is drier and has a limited water retention capacity compared to term infants and adults. It is important to determine timing of care for this population with limited competencies. A two-arm, three-center, and single- and evaluator-blind randomized controlled trial was conducted. The study is based on the CONSORT guidelines. The participants were recruited from September 2020 to September 2021. The first baths of participants in the intervention group were postponed until 48hours after birth. Outcomes were measured before bathing and 1, 10, and 30minutes after bathing. There was a statistically significant interaction between the groups and times for transepidermal water loss, body temperature, and comfort. The intervention group had a lower transepidermal water loss value at follow-up than the control group in the forearm and sternum. The control group had lower mean body temperatures and comfort levels. When the first bathing of a late preterm infant is postponed by a minimum of 48hours, it reduces damage to the skin barrier, body temperature is maintained, and the experience is more comfortable. Therefore, the first bath should be delayed for at least 48hours after birth. The study can guide nurses to eliminate the uncertainty of the first bath applied for late preterm infants with a fragile structure in the neonatal intensive care setting and to eliminate the differences between clinics.

Statistical analysis of predictors of effectiveness of complex physiotherapeutic treatment in patients with involutional skin changes

BACKGROUND: Analysis of predictors of the effectiveness of various treatment regimens for diseases, as well as the correction of involutionary processes in the human body, is increasingly becoming a standard in scientific medical research. The technology for identifying them traditionally includes the use of correlation and regression analysis, as well as the principles of correlation adaptometry, which makes it possible to approach the solution of this problem from the position of system analysis. AIM: Analysis of predictors of the effectiveness of correction of involutive skin changes in middle-aged and older women with metabolic syndrome using various therapeutic regimens, including hyaluronic acid laser phoresis and the use of transcranial magnetic therapy in combination with oxygen barotherapy. MATERIALS AND METHODS: The study was carried out with the participation of 60 patients from middle and older age with involutional changes in the skin against the background of metabolic syndrome. All patients were divided into 2 groups using simple fixed randomization. The first group (comparison, 30 patients) received laser phoresis of hyaluronic acid in the form of a 1.5% sodium hyaluronate gel using a laser and laser-vacuum therapy device LAZMIK. Patients of the second group (main group, 30 patients) were prescribed combined physiotherapy. For transcranial magnetic therapy, the Amo-Atos device with the Headband attachment was used, and oxygen barotherapy was carried out in single pressure chambers of the Oka-MT or Irtysh-Shch1 type under a pressure of 2 atm for 1 hour. RESULTS: It was found that in the initial state, the quality of life of patients with involutional changes in the skin against the background of metabolic skin syndrome was largely determined by the presence of pathological correlation galaxies that integrate changes in the condition of the skin, metabolic disorders, indicators of oxidative stress and microhemodynamics, and the activity of proinflammatory cytokines. At the same time, the leading role in the deterioration of the quality of life belonged to the age of the patients, the insulin resistance index, transepidermal water loss and microcirculation indicator. However, predictors of effectiveness varied across different treatment regimens. With laser phoresis of hyaluronic acid, its effectiveness increases in younger women with minimal involutional manifestations of skin aging, tested for the condition of the skin, while combined physiotherapy is also most effective in women with a low average age limit, with minimal manifestations of metabolic syndrome and inflammatory processes, as well as against the background of high activity values of one of the enzymes of antioxidant protection ― superoxide dismutase. CONCLUSION: The results obtained convincingly prove the effectiveness of combination therapy in correcting involutive skin changes in middle-aged and older women due to metabolic syndrome, which is comparable in a number of parameters to the effectiveness of hyaluronic acid laser phoresis. At the same time, predictors of effectiveness depend on the characteristics of the mechanisms of therapeutic action of the treatment regimens used, which allows for a more correct approach to the choice of personalized treatment methods.

Changes in Skin Barrier Function in Neonates: Daily Variation and Impact of Bathing.

The skin barrier function is an important predictor of neonatal barrier defects. This study aimed to investigate the daily changes in skin barrier function and the impact of bathing on skin barrier function in neonates. We assessed the transepidermal water loss (TEWL) and stratum corneum hydration (SCH) on the forehead, cheek, volar forearm, and chest from days 2 to 7 and at 1 month after birth. Additionally, we measured the values after bathing and compared them with the pre-bathing values. Sixty-six neonates were involved in the assessment, and each value at the four sites showed significant correlations. TEWL remained stable between days 2 and 7, but SCH significantly increased at most sites. Both significantly increased by 1.5-2 times in 1 month. After bathing, TEWL increased by more than 20% but decreased again after 3 h. TEWL did not change significantly with age during the first week of life. To minimize the effects of bathing, TEWL should be measured at least 3 h after bathing.

Mask wearing impacts skin barrier function and microbiome profile in sensitive skin

Mask-wearing behavior, common in the post-COVID-19 era, raises concerns for sensitive skin. This split-face study investigated mask-related changes in skin barrier function and microbiome composition among 30 female volunteers with sensitive skin and assessed the mitigating effects of a moisturizer containing biological lipids and probiotics. Skin physiological indicators (transepidermal water loss, erythema index, stratum corneum hydration, pH, temperature) of masked and unmasked areas were collected at baseline, after three hours of mask-wearing, post-tape stripping, and after 24 h, respectively. Microbiome samples collected from the masked areas before and after wearing a medical mask were analyzed with bioinformatics methods. Mask-wearing significantly weakened barrier function in both masked and adjacent unmasked areas, while reducing bacterial diversity. It was also associated with an increase in Cutibacterium (P = 0.110) and decreases in Streptococcus (P = 0.032) and Prevotella (P = 0.026) abundance. Moisturizer application prior to mask-wearing significantly reduced transepidermal water loss and erythema (both P < 0.001) and further improved erythema after 24 h (P = 0.048). These findings demonstrate that mask-wearing can disrupt the skin barrier and microbiome in individuals with sensitive skin and applying a moisturizer beforehand can mitigate mask-related discomforts by aiding barrier repair and reducing sensitivity.

Antibiotic biocompatibility assay and anti-biofilm strategies for Pseudomonas aeruginosa infection in bioengineered artificial skin substitutes.

Bioengineered artificial skin substitutes (BASS) are an advanced therapy for treating extensively burned patients. Pseudomonas aeruginosa (P. aeruginosa) infections represent a major challenge in these patients as formation of biofilms impede wound healing and perpetuate a chronic inflammatory state. Here we assessed antibiotics (alone or in combination) with respect to cytotoxicity, as well as antimicrobial efficacy in P. aeruginosa biofilm formed on infection of BASS. Cell viability, structure and functionality were evaluated using microscopy and trans-epidermal water loss analyses, respectively. BASS were established and infected for 24 h to allow P. aeruginosa biofilm formation, after which two antimicrobial approaches, treatment and prevention, were tested. In the latter, antibiotics were added to BASS before infection. The antimicrobial effect was determined using real-time calorimetry. In dose-response experiments, 1.25 mg/mL amikacin, 0.02 mg/mL ciprofloxacin, 0.051 mg/mL colistin, 1 mg/mL meropenem and colistin in combination with either amikacin, ciprofloxacin and meropenem did not affect BASS' viability, structure and functionality. All antibiotics, except colistin, showed effective antimicrobial activity at these non-cytotoxic concentrations. For concentrations below the highest non-cytotoxic ones, successive treatments resulted in higher bacterial metabolic rates. Only the combinations managed to eradicate the infection with repeated treatments. With respect to prevention of infection, all antibiotics at the highest non-cytotoxic concentrations and the combinations were effective. This preventive capacity was maintained for at least 5 days. The findings highlight the potential for developing BASS with antimicrobial properties that can prevent infections during wound healing in burn patients.

Unveiling the Metabolomic Profile of Oily Sensitive Skin: A Non-Invasive Approach

Skin barrier impairment is becoming increasingly common due to changes in lifestyle and modern living environments. Oily sensitive skin (OSS) is a condition that is characterized by an impaired skin barrier. Thus, examining the differences between OSS and healthy skin will enable a more objective evaluation of the characteristics of OSS and facilitate investigations of potential treatments. Initially, a self-assessment questionnaire was used to identify patients with OSS. Biophysical measurements and LAST scores were used to determine whether skin barrier function was impaired. Epidermal biophysical properties, including skin hydration, transepidermal water loss (TEWL), sebum content, erythema index (EI), and a* value, were measured with noninvasive instruments. We subsequently devised a noninvasive D-square sampling technique to identify changes in the skin metabolome in conjunction with an untargeted metabolomics analysis with an Orbitrap Q ExactiveTM series mass spectrometer. In the stratum corneum of 47 subjects, 516 skin metabolites were identified. In subjects with OSS, there was an increase in the abundance of 15 metabolites and a decrease in the abundance of 48 metabolites. The participants with OSS were found to have the greatest disruptions in sphingolipid and amino acid metabolism. The results revealed that an impaired skin barrier is present in patients with OSS and offers a molecular target for screening for skin barrier damage.

Deficient functional wound closure as measured by elevated trans-epidermal water loss predicts chronic wound recurrence: An exploratory observational study

A single-center, prospective, observational pilot study was performed to evaluate wound healing endpoint and recurrence by measuring transepidermal water loss (TEWL) post-closure at the site of wound repair. Patients with clinically-defined chronic wounds (such as pressure ulcers, diabetic ulcers, and trauma wounds) who visited the Plastic Surgery outpatient department or were in-patients at the All India Institute of Medical Sciences, Rishikesh, India, and were referred for chronic wound management, were enrolled. Non-invasive point-of-care TEWL measurements were obtained, from closed wound-site and contralateral healthy skin site, starting from confirmation of closure (post-closure, V0) continuing every 2 weeks for a maximum of five visits or until the wound recurred. Statistical analyses of the data involved logistic regression and likelihood ratio chi-square tests to assess differences in TEWL at visit 0 (V0) between the closed wound site and reference skin, with the TEWL score as the sole predictor of recurrence. Of the 72 subjects that completed the study, 44 (61%) showed no recurrence and 28 (39%) had wounds that recurred over a period of 12 weeks. A significant association was found between the V0 (post-closure) TEWL score and the odds of wound recurrence, both in univariate analysis (OR [95%CI] = 1.26[1.14,1.42] (p < 0.001) and after adjusting for covariates in multivariable analysis (OR [95%CI] = 1.34[1.19,1.61] (p < 0.001). The likelihood ratio chi-square analysis demonstrated that the V0 TEWL score is a significant universal predictor of recurrence across all wound types studied. Cases of closed wounds with subsequent recurrence showed an overall higher post-closure V0 TEWL score, compared to those who did not have a wound recurrence, across visits. The TEWL score cut-off value predictive of recurrence was 24.1 g.m–2.h–1 (AUC = 0.967). The outcome of this pilot study on a wide range of chronic wounds leads to the hypothesis that post-closure TEWL at the site of wound healing is a reliable biomarker of wound recurrence. It also raises the question whether the clinical endpoint of wound closure should include re-establishment of skin barrier function as additional criterion. The current standard of care wound closure endpoint calls for re-epithelialization of the wound with no discharge for two consecutive weeks disregarding the functional parameter of restoration of skin barrier function at the wound-site.

A Highly Efficient and User-Friendly Sensitive Skin Model on the Forearm.

Sensitive skin is a worldwide skin problem, and its assessment of therapeutic efficacy traditionally relies on the facial stinging test. However, this test possesses certain limitations due to its restrictive application site, intense pain sensation, and adverse effects on physical appearance. This study aimed to develop and evaluate a highly efficient and user-friendly sensitive skin simulation model, which combines tape stripping and capsaicin testing on the forearm (FA-TS-CAT), as an alternative to the facial stinging test. A randomized, double-blind, placebo-controlled clinical trial was conducted involving 74 subjects. Skin redness (a* value), transepidermal water loss (TEWL), and self-assessment questionnaires were collected at different time points for analysis. Tape stripping 5 times and 10 min application of capsaicin test were identified as the optimal conditions for the FA-TS-CAT model. Consistent stimulation and natural recovery trends of a* value and TEWL were observed on both the FA-TS-CAT and facial capsaicin test (F-CAT) models within 50 min. After the 4-t-butylcyclohexanol complex emulsion was applied, the a* value in the FA-TS-CAT model exhibited a soothing trend similar to the F-CAT model, with a significantly reduced by 3.99-fold and 3.28-fold at T3 and T4 (p < 0.001), compared to the placebo. Notably, the test efficiency of the FA-TS-CAT model was threefold higher than that of the F-CAT model, and subjects showed more willingness to participate in the FA-TS-CAT test (95.95% vs. 4.05%). These results indicated the FA-TS-CAT is a highly efficient and user-friendly model for sensitive skin, providing a reliable and valid method for clinical research in sensitive skin treatment.