Barrier-repair prescription moisturizers: Do we really need them? Facts and controversies

Wolf, Ronni; Parish, Lawrence Charles

doi:10.1016/j.clindermatol.2013.05.018

Cited by 11 publications

(9 citation statements)

References 8 publications

(6 reference statements)

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“…Local application of the ointment over 6 days diminished this uptake and prevented increased transepidermal penetration of this allergen. These findings are in line with studies that show clear beneficial effects of ceramide‐containing ointments in improving the clinical symptoms and skin barrier of patients with AD …”

Section: Discussionsupporting

confidence: 91%

Effects of a ceramide‐containing water‐in‐oil ointment on skin barrier function and allergen penetration in an IL‐31 treated 3D model of the disrupted skin barrier

Huth

Schmitt

Marquardt

et al. 2018

Experimental Dermatology

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Atopic dermatitis (AD) is a chronically relapsing, pruritic inflammation of the skin with dryness and disturbed skin barrier function. Recently, we established that IL-31 treatment of human 3D skin models resulted in a disrupted skin barrier phenotype resembling AD. In this model, we found that IL-31 interferes with the differentiation of keratinocytes and inhibits the expression of terminal differentiation markers. In the present study, we investigated the effects of a ceramide-containing water-in-oil skin care ointment on the physical skin barrier structure and function in disrupted skin barrier models, generated either by using primary normal human epidermal keratinocytes (NHEK) or HaCaT cells. We observed that the physical skin barrier of the models recovered after daily topical treatment with the ceramide-containing ointment. Topical application of the ointment prevented downregulation of filaggrin and disorganization of other differentiation markers, such as keratin 10 and β4-integrin, as demonstrated by immunohistological analysis. The expression of Ki67 was also upregulated in response to the ointment. Furthermore, functional studies revealed that local application of the ointment diminished the increased uptake of fluorescently labelled recombinant allergens of timothy grass (phl p1) in our model. In conclusion, our data revealed that topical application of a ceramide-containing skin care ointment reduced IL-31 induced impairments of the physical skin barrier and skin barrier function in an in vitro model of the disrupted skin barrier. This standardized model can be utilized in the future to monitor ex vivo effects of various topical therapies on skin morphology, physiology, and gene expression.

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Section: Discussionsupporting

confidence: 91%

Effects of a ceramide‐containing water‐in‐oil ointment on skin barrier function and allergen penetration in an IL‐31 treated 3D model of the disrupted skin barrier

Huth

Schmitt

Marquardt

et al. 2018

Experimental Dermatology

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“…Compared with other emollients that form a more superficial occlusive barrier ( e.g. , petrolatum), ceramide-dominant physiologic lipid-based products are thought to participate in physiologic lipid replacement therapy by permeating the SC, incorporating into keratinocyte synthesis, becoming processed in the LBs and being secreted back into the SC 93. The ceramide-dominant, triple-physiologic lipid barrier repair therapy for AD (Cer:cholesterol:free fatty acids at a 3:1:1 molar ratio) addresses the problems of both a global reduction in lipids and the further decline in Cer in AD 52,94.…”

Section: Introductionmentioning

confidence: 99%

Epidermal Permeability Barrier Defects and Barrier Repair Therapy in Atopic Dermatitis

Lee

2014

Allergy Asthma Immunol Res

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Atopic dermatitis (AD) is a multifactorial inflammatory skin disease perpetuated by gene-environmental interactions and which is characterized by genetic barrier defects and allergic inflammation. Recent studies demonstrate an important role for the epidermal permeability barrier in AD that is closely related to chronic immune activation in the skin during systemic allergic reactions. Moreover, acquired stressors (e.g., Staphylococcus aureus infection) to the skin barrier may also initiate inflammation in AD. Many studies involving patients with AD revealed that defective skin barriers combined with abnormal immune responses might contribute to the pathophysiology of AD, supporting the outside-inside hypothesis. In this review, we discuss the recent advances in human and animal models, focusing on the defects of the epidermal permeability barrier, its immunologic role and barrier repair therapy in AD.

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“…The barrier is located mainly in the stratum corneum (SC), which is composed of corneocytes surrounded by lipid lamellae composed of ceramides, cholesterol and free fatty acids (13)(14)(15). Although emollients are regarded as basic therapy by the European Task Force on Atopic Dermatitis/European Academy of Dermatology and Venereology (EADV) Eczema Task Force, their efficacy in randomized controlled trials (RCT) has been insufficiently investigated (16)(17)(18)(19)(20). Therefore, the aim of the present double-blinded RCT was to assess the efficacy of an emollient containing ceramides and magnesium (Cer-Mg), compounds involved in the maintenance of the skin barrier (21).…”

mentioning

confidence: 99%

Efficacy of a Cream Containing Ceramides and Magnesium in the Treatment of Mild to Moderate Atopic Dermatitis: A Randomized, Double-blind, Emollient- and Hydrocortisone-controlled Trial

Koppes

Charles²,

Lammers³

et al. 2016

Acta Derm Venerol

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The aim of this randomized controlled trial was to assess the efficacy of a cream containing ceramides and magnesium (Cer-Mg) in the treatment of mild to moderate atopic dermatitis and to compare it with hydrocortisone and a commonly used emollient (unguentum leniens; cold cream). A total of 100 patients, randomized into 2 groups, were treated for 6 weeks simultaneously (left vs. right side of the body) with either Cer-Mg and hydrocortisone (group I) or Cer-Mg and emollient (group II). The primary outcome was a reduction in severity of lesions as assessed by (local) SCORAD (SCORing Atopic Dermatitis). Levels of trans-epidermal water loss (TEWL), skin hydration, and natural moisturizing factors (NMF) were then measured. After 6 weeks, group I showed comparable significant improvement in SCORAD and TEWL, while in group II, the decrease in SCORAD and TEWL was significantly greater after Cer-Mg compared with emollient. Finally, Cer-Mg cream was more effective in improving skin hydration and maintenance of levels of NMF than hydrocortisone and emollient.

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Barrier-repair prescription moisturizers: Do we really need them? Facts and controversies

Cited by 11 publications

References 8 publications

Effects of a ceramide‐containing water‐in‐oil ointment on skin barrier function and allergen penetration in an IL‐31 treated 3D model of the disrupted skin barrier

Effects of a ceramide‐containing water‐in‐oil ointment on skin barrier function and allergen penetration in an IL‐31 treated 3D model of the disrupted skin barrier

Epidermal Permeability Barrier Defects and Barrier Repair Therapy in Atopic Dermatitis

Efficacy of a Cream Containing Ceramides and Magnesium in the Treatment of Mild to Moderate Atopic Dermatitis: A Randomized, Double-blind, Emollient- and Hydrocortisone-controlled Trial

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