Skin barrier in rosacea

Addor, Flávia Alvim Sant’Anna

doi:10.1590/abd1806-4841.20163541

Cited by 39 publications

(59 citation statements)

References 36 publications

(37 reference statements)

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“…The search was based on studies using objective noninvasive imaging and/or biophysical skin measurement techniques for diagnosis, assessing severity or therapy follow‐up of rosacea. Skin measurement tools were extracted by literature search and by exploring their PubMed MeSH‐terms . We defined ‘noninvasive’ as every method that theoretically cannot lead to skin irritation, bleeding or scarring; this excluded biopsies, epilation of eyelashes/hairs, application of tape or glue onto the skin, and collection of skin scrapings or excretions from sebaceous follicles.…”

Section: Methodsmentioning

confidence: 99%

“…Rosacea is a chronic inflammatory skin disease of uncertain pathophysiology; many factors may play a role in disease development. [1][2][3][4][5][6][7][8][9] Initially, four rosacea subtypes were described: erythematotelangiectatic, papulopustular, phymatous and ocular. Recently, the classification system was changed from subtype-based to phenotype-based to increase diagnostic and presentation accuracy, but as many trials predate the updated phenotype approach, the subtype-based system still dominates rosacea literature.…”

Section: What Does This Study Add?mentioning

confidence: 99%

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Noninvasive objective skin measurement methods for rosacea assessment: a systematic review

et al. 2019

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Summary Background Rosacea assessment and therapy monitoring can be challenging to standardize, as most clinical evaluation systems are prone to interobserver variability and not always validated. Therefore, objective, reliable and preferably noninvasive measurement tools are needed. Objectives To give insight into available noninvasive imaging techniques and biophysical methods in rosacea by performing a systematic review. Methods PubMed, Embase, Cochrane and Web of Science databases were searched until 1 September 2018 in accordance with PRISMA guidelines, to identify studies providing original data about objective noninvasive imaging and/or biophysical skin measurement techniques for diagnosis, assessing severity or therapy monitoring of adult patients with cutaneous facial rosacea. Risk of bias of included articles was assessed with the Cochrane Risk of Bias tool, Quality in Prognosis Studies tool, and the Newcastle–Ottawa Scale. Results A total of 78 studies were included, describing 14 imaging and biophysical methods. Widespread information about (sub)surface cutaneous morphology and functionality was obtained. Methodological study quality was relatively low and interstudy outcome variability was large. Several tools show promising value in research settings: for treatment follow‐up Demodex mites are countable with reflectance confocal microscopy, spectrometry can quantify erythema, and rosacea severity could be objectified with skin hydration‐ and transepidermal water loss measurements. Conclusions This systematic review describes the spectrum of noninvasive imaging and biophysical methods in rosacea assessment, giving multifaceted information about structure and properties of rosacea skin, especially useful for research purposes. Larger studies with good methodological quality are needed to create validated protocols for further implementation into research. What's already known about this topic? Rosacea is a chronic inflammatory skin disease with a variety of clinical manifestations. Most clinical evaluation systems are subjective, not always validated, and subsurface skin processes remain unnoticed. Currently, different types of noninvasive measurement tools are available for rosacea assessment and therapy monitoring, but a comprehensive overview is lacking. What does this study add? Seventy‐eight publications were included, describing 14 imaging and biophysical tools, providing a wide range of information about rosacea skin morphology and functionality. Reflectance confocal microscopy and spectrometry are especially promising in therapy monitoring and skin barrier measurements for rosacea severity assessment. Larger studies with better methodological quality are needed to create validated protocols for implementation into research.

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Section: Methodsmentioning

confidence: 99%

Section: What Does This Study Add?mentioning

confidence: 99%

Noninvasive objective skin measurement methods for rosacea assessment: a systematic review

et al. 2019

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“…Subjects with dry skin were used in this study as patients with rosacea often present with a defective skin barrier and therefore an increased TEWL. Accordingly, subjects with dry skin on the forearms were used to replicate the damaged barrier and increased TEWL that is found in such patients …”

Section: Discussionmentioning

confidence: 99%

“…Patients with rosacea often present with a defective skin barrier and therefore an increased transepidermal water loss (TEWL) . Healthy subjects with dry skin were used in order to “mimic” the damaged barrier and increased TEWL that is found in patients with rosacea …”

Section: Methodsmentioning

confidence: 99%

A novel moisturizer with high sun protection factor improves cutaneous barrier function and the visible appearance of rosacea‐prone skin

Baldwin¹,

Santoro

Lachmann

et al. 2019

J of Cosmetic Dermatology

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SummaryBackgroundConsensus guidelines advocate general skincare for rosacea patients.ObjectivesTwo independent studies were performed to assess whether a tinted daily SPF‐30 facial moisturizer (DFM30) improves barrier function of dry skin and the efficacy and tolerability of DFM30 on rosacea‐prone skin.MethodsIn study 1, electrical capacitance (EC) and transepidermal water loss (TEWL) were measured at baseline, 2, 4, 8, and 24 hours after a single application of DFM30 and on a control site in 21 healthy females with dry skin. Study 2 evaluated 33 females with mild to moderate rosacea and nontransient erythema. Efficacy and tolerability after once‐daily DFM30 were assessed using a chromameter, image analysis of photographs, and trained rater and patient evaluations up to day 22.ResultsIn study 1, EC showed statistically significant increases at 2, 4, and 8 hours, and TEWL showed statistically significant decreases 2, 4, 8, and 24 hours after DFM30 application to healthy females compared to baseline. In study 2, covering skin redness improved significantly after DFM30 application on day 1; 33.3% showed improved covering skin redness compared to baseline. Patients reported significantly less redness on day 8 than day 3. Feelings of dryness and tightness/tension were lower 30 minutes after first application. Feeling of dryness was lower than baseline after 3 days, 1 and 3 weeks. Image analysis suggested redness was significantly lower on day 22 compared to baseline. Chromameter readings showed significantly lower erythema on the cheek compared to baseline. All patients stated that DFM30 relieves and neutralizes visible redness who also indicated that they would purchase DFM30, and the product was well tolerated.ConclusionsThese studies show that DFM30 is suitable as part of the skincare regimens advocated by ROSacea COnsensus (ROSCO) for rosacea patients. DFM30 is an effective moisturizer that improves cutaneous barrier function and the appearance of rosacea‐prone skin.

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“…This is followed by persistent erythema due to repeated vasodilation, then telangiectasia and skin inflammation in the form of papules, pustules, lymphoedema and fibrosis. 2,4 Rosacea can seriously affect a patient's quality of life. This should prompt clinicians to diagnose it early and start treatment.…”

Section: Introductionmentioning

confidence: 99%