The Effect of Absorbent Pad Design on Skin Wetness, Skin/Pad Microclimate, and Skin Barrier Function: A Quasi-experimental Open Cohort Study.

Conflicting evidence exists on how skin barrier function compares between Africans and Caucasians. This study measured skin barrier function of South African first year nursing students before their practical training started to compare skin barrier function between the racial groups. Transepidermal water loss (TEWL), stratum corneum (SC) hydration, and skin surface (SS) pH was measured on female first year nursing students (19 African and 31 Caucasian; age range 18-40years). Geometric means and ranges were calculated and the influence of anatomical areas and racial differences were evaluated respectively. No significant difference in TEWL was established between the racial groups. SC hydration was significantly lower (P≤0.05) and SS-pH was significantly higher (P≤0.0001) in African nursing students when compared to Caucasians. African nursing students had significantly lower (P≤0.05) SC hydration on their palms when compared to the other anatomical areas. Stratum corneum hydration and SS-pH differed significantly between African and Caucasian skin, while no difference was found for TEWL, the primary parameter used to evaluate skin barrier function. Low SC hydration and high SS-pH of African nursing students prior to their practical training, may suggest a higher risk for developing occupational skin diseases.

Measurements of transepidermal water loss (TEWL) and stratum corneum (SC) hydration are important for assessing epidermal functions. However, the availability of reliable and user-friendly devices, which can simultaneously measure both TEWL and SC hydration and can allow health providers to remotely access data in time, is limited. GPSkin Barrier® was compared with MPA5 system in the measurements of TEWL and SC hydration on the cheek, the dorsal hand, and the forearm in 200 normal volunteers, including 126 females and 74 males, aged 1-78years with an average age of 45.24±1.04years. Correlation of data measured with MPA5 system and GPSkin Barrier® was determined. Levels of both TEWL and SC hydration measured with the Barrie GPSkin Barrier® were lower than that with MPA5 system on all 3 body sites except for hydration on the cheek. The levels of both TEWL and SC hydration measured with GpSkin Barrier® were correlated well with that measured with MPA5 system on all 3 body sites CONCLUSIONS: GPSkin Barrier® is a reliable, affordable, and versatile device for assessing epidermal permeability barrier function and SC hydration.

To determine any correlation between the stratum corneum barrier function and the phenotypic severity of congenital ichthyosis, we studied stratum corneum hydration, flexibility, thickness and transepidermal water loss (TEWL) in patients with congenital ichthyosis. Seven patients with congenital ichthyosis aged 2-46 years and age-matched controls were included in the present study. We divided seven patients into two groups; patients with non-bullous type (non-bullous congenital ichthyosiform erythroderma patients) and patients with the bullous type of congenital ichthyosis (bullous congenital ichthyosiform erythroderma and ichthyosis bullosa of Siemens). Stratum corneum hydration, thickness and flexibility were measured using a Corneometer ASA-M2. The stratum corneum thickness was also examined using a skin biopsy technique. TEWL was measured using Evaporimeter AS-TW1. The clinical severity of ichthyosis phenotype was evaluated using a visual analogue scale (VAS). Stratum corneum hydration and flexibility were significantly reduced in both congenital ichthyosis patient groups. Stratum corneum thickness was significantly increased in both groups. In the patient group with non-bullous congenital ichthyosis, significant negative correlations were confirmed between the VAS score and stratum corneum hydration and between the VAS score and flexibility. A significant, positive correlation was also observed between the VAS score and stratum corneum thickness. There was a positive correlation between the VAS score and TEWL on both the extensor and flexor sides of the forearm and back. We conclude that stratum corneum hydration, flexibility and thickness measured by the corneometer, and TEWL on the arm may be a useful indicator of the severity of ichthyosis phenotype.

IntroductionRecently, there are a few moisturizers showing hydrating effects up to 24 hours after single application. Aquaporin 3 might be associated with the degree of skin hydration. We aimed to assess the effects of two brands of 24‐hour moisturizers on the skin barrier function, as well as the AQP3 gene expression.MethodTwo moisturizers were applied once daily by 20 participants age 36.15 ± 9.55 years. Upper right and left forearms were randomly assigned to application of each product, whereas the right lower forearm served as control site for application of a cream base formulation. Biophysical assessments including trans epidermal water loss (TEWL), skin hydration, pH, surface lipids, and elasticity parameters were performed before intervention, 1, 4, and 24 hours after single application, following 2 weeks daily application and 1 week after termination of use. Also 5‐mm punch biopsies were performed from application sites of product B and cream base formulation in for five participants after 2 weeks of application.ResultsA single treatment with both products led to 24‐hour increase in skin moisture in comparison with the control site (P‐value <.01). Daily application of both products for 14 days also led to significant improvement in skin moisture (P‐value <.01), TEWL (P‐value <.01), and elasticity parameters. The increase in skin hydration was associated with upregulation of AQP3 gene expression in treated area for one of the formulations (P‐value = .04).ConclusionThe tested 24‐hour moisturizers only need to be applied once daily to improve skin barrier function and hydration and up‐regulate AQP3 mRNA expression.

To evaluate the effect of radiant warmers on skin barrier function in preterm infants. Transepidermal water loss (TEWL) and stratum corneum hydration were measured in 30 preterm infants (birth weight 825 to 2220 g) in seven body areas: forehead, upper back, cubital fossa, palms, soles, abdomen, and inguinal region. Measurements were performed under radiant warmer and incubator conditions. Each patient served as his/her control. TEWL was significantly higher in the radiant warmer compared to the incubator condition in only two areas: forehead and back. The overall mean difference in percentage TEWL between the conditions was 15%. Stratum corneum hydration was not affected by the radiant warmer. The use of radiant warmers does not significantly decrease barrier function in the preterm infant.

Background/Objectives: Natural oils are widely promoted and used around the world as part of skincare. Among them, extra virgin olive oil (EVOO) stands out for its broad range of organic compositions and well-known moisturizing properties. This study aimed to evaluate the effects of topically applied EVOO compared to petrolatum on skin barrier function (SBF) and microtopography. Methods: A within-person randomized clinical trial was conducted in healthy adult volunteers. EVOO and petrolatum were applied to defined areas on the volar forearm. Parameters related to the SBF, including stratum corneum hydration (SCH), transepidermal water loss (TEWL), temperature, and erythema, were assessed. The skin microtopography was evaluated through two approaches: (1) topographic parameters-surface roughness, desquamation, smoothness, and wrinkles; and (2) stratum corneum (SC) composition-corneocytes subtypes and the desquamation index (DI). The participants completed a tolerability questionnaire for each product. Results: A total of 54 participants (50% female; mean age: 28.57 ± 11.02 years) completed the study. Both EVOO and petrolatum significantly improved the SBF by increasing SCH and reducing erythema and skin temperature. Petrolatum additionally reduced TEWL. Regarding the skin microtopography, both products decreased the desquamation index and reduced the prevalence of mature corneocyte types (types 2-5). These effects were more pronounced with petrolatum. Notably, EVOO significantly increased the proportion of early-stage corneocytes (type 1). Conclusions: Both EVOO and petrolatum effectively enhanced the SBF and improved the microtopographic features of the skin. While petrolatum exerted a stronger occlusive effect by reducing TEWL and desquamation, EVOO uniquely promoted epidermal renewal by increasing epidermal turnover.

Increased production of natural moisturizing factors and bleomycin hydrolase activity in elderly human skin

It is not known whether distinct anatomical locations will respond with different recovery rates following acute barrier challenges. To investigate whether barrier parameters differ at five body sites during recovery from acute disruption. Acute barrier disruption was achieved by tape stripping and by acetone extraction of stratum corneum lipids. Transepidermal water loss (to assess barrier function), capacitance (for stratum corneum hydration) and skin surface pH were measured at each of five different body sites in 14 human volunteers. Individual measurements were obtained every 24 h for 96 h. Lipid-rich skin areas (e.g. the forehead) were the most vulnerable to barrier disruption by either method. While acetone treatment affected barrier function and decreased stratum corneum hydration, tape stripping similarly altered barrier function but increased capacitance values. Although the effect of barrier disruption on surface pH appeared to vary with location, no significant pattern of variation emerged. Independent of the method used for barrier disruption, the pH normalized within 96 h. Skin at different body sites shows distinct patterns of barrier recovery that are likely to be related to structural and physiological differences. Therefore, 'anatomically specific' regimens appear possible and relevant for the treatment of cutaneous disorders. In addition, adequate statistical analyses are essential to detect real differences in barrier recovery parameters.

BackgroundGentle cleansing of the skin without further compromising its barrier function and moisture content and being simultaneously devoid of adverse effects on the skin microbiome are important features of body cleansers for atopic‐prone skin sufferers. For this population, a new dexpanthenol‐containing liquid cleanser (DCLC) was developed.MethodsTwo prospective 4‐week studies have been conducted. Study 1 investigated the effect of once‐daily DCLC on stratum corneum (SC) hydration, transepidermal water loss (TEWL), skin pH, and skin microbiome (all on the volar forearm) in adult subjects with dry skin (N = 44). Study 2 explored the cutaneous tolerability of DCLC and its effect on the microbiome biodiversity of the volar forearm skin in infants/children with atopic‐prone skin (N = 33, aged 6 months to 6 years). In the latter study, DCLC was applied 2–3 days/week in combination with an emollient applied at least twice daily.ResultsIn Study 1, on Day 29, the mean change in skin surface capacitance from baseline was significantly greater in the forearm test area treated with DCLC than in the contralateral test area (control) treated with water only (5.16 vs. 3.65 a.u.; p = 0.011), suggesting long‐term SC hydration. DCLC use was not associated with changes in TEWL, skin pH, or microbiome biodiversity if compared to control. In Study 2, the 4‐week use of DCLC in combination with an emollient was well tolerated according to pediatrician skin assessment, and no flare‐ups were recorded. The microbiome biodiversity did not shift during the study.ConclusionThese findings support the use of DCLC in subjects with atopic‐prone skin.

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

Orally administered sphingomyelin in bovine milk is incorporated into skin sphingolipids and is involved in the water-holding capacity of hairless mice

Ethnic and racial differences in infant skin have not been well characterized. The purpose of this study was to establish whether there are ethnic differences and similarities in the stratum corneum (SC) functions of Thai and Chinese infants. Healthy infants 6 to 24months of age (N=60; 30 Thai, 30 Chinese) who resided in Bangkok, Thailand, were enrolled. Transepidermal water loss (TEWL) and SC hydration (capacitance) on the thigh, buttock, and upper arm were measured. Ceramide content was determined in the SC on the upper arm. SC hydration was not remarkably different between the two ethnicities at any site measured, but TEWL was significantly higher in Chinese infants than in Thai infants at all sites. Hydration of the SC was not significantly correlated with age in either ethnicity. TEWL had significant but weak correlations with age on the thigh and upper arm in Thai infants. Ceramide content was significantly higher in Chinese SC than in Thai SC. No relationship between ceramide content and TEWL or hydration was observed in either ethnicity. The significant differences in TEWL and ceramide contents between Chinese and Thai infant skin could prove useful in designing skin care and diapering products that are best suited for each ethnicity.

Although there is poor scientific evidence that working with occlusive gloves is as damaging as wet work, prolonged glove occlusion is considered to be a risk factor for developing hand eczema similar to wet work. To assess the effects of wearing occlusive gloves during the whole working day, without exposure to any additional hazardous substances, on skin condition and skin barrier function. We investigated 323 employees of a semiconductor production company in Germany: 177 clean-room workers wearing occlusive gloves during the whole shift (exposed group) and 146 employees working in administration (control group). A standardized interview was performed, the skin condition of both hands was studied using the quantitative skin score HEROS, and transepidermal water loss (TEWL) and stratum corneum hydration were measured. There was no significant difference in skin condition between the two subgroups. Values for TEWL and corneometry were significantly higher in exposed participants (P<0·05). However, the TEWL values were similar to control values if participants took off the occlusive gloves at least 30min before the measurement. Hence, the effect of occlusion on skin barrier function seems to be transient. Prolonged wearing of occlusive gloves with clean hands and without exposure to additional hazardous substances does not seem to affect the skin negatively.

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease whose incidence is increasing. Skin barrier dysfunction plays an important role in this disease. It has been observed that AD patients have higher transepidermal water loss (TEWL) and lower stratum corneum hydration (SCH); however, there is little information about skin microtopography in this pathology. The objective of this study is to evaluate skin barrier dysfunction and structural changes in patients with AD. Methods: A cross-sectional study was conducted including patients with AD. Parameters of skin barrier function were measured (TEWL, temperature, erythema, pH, skin hydration, elasticity) and also other topographical parameters (scaliness, wrinkles, smoothness, surface, contrast, variance) in both healthy skin and flexural eczematous lesions. Results: A total of 32 patients with AD were included in the study. Flexural eczematous lesions had higher erythema (369.12 arbitrary unit (AU) vs. 223.89 AU, p < 0.001), higher TEWL (27.24 g/h/m2 vs. 13.51 g/h/m2, p < 0.001), lower SCH (20.3 AU vs. 31.88 AU, p < 0.001) and lower elasticity (0.56% vs. 0.65%, p = 0.05). Regarding topographic parameters, flexural eczematous lesions presented greater scaliness (5.57 SEsc vs. 0.29 SEsc, p = 0.02), greater smoothness (316.98 SEsm vs. 220.95 SEsm p < 0.001), more wrinkles (73.33 SEw vs. 62.15 SEw p = 0.03), greater surface area (836.14% vs. 696.31%. p < 0.001), greater contrast (2.02 AU vs. 1.31 AU p = 0.01), greater variance (6.22 AU vs. 4.96 AU p < 0.001) and a lower number of cells (105.5 vs. 132.5 p < 0.001) compared to unaffected healthy skin, reflecting a decrease in skin quality in AD patients. Conclusions: Both skin barrier function and skin topography are damaged in patients with AD, with differences between healthy skin and flexural eczema.

Disorders of skin barriers: clinical implications.