Influence of Aqueous Cream BP on corneocyte size, maturity, skin protease activity, protein content and transepidermal water loss

Abstract

SummaryBackground Aqueous Cream BP is frequently prescribed for patients with eczema and is known to induce sensitivity in certain patients and also to decrease the thickness of the stratum corneum (SC). We have previously reported methodology to quantify corneocyte maturity and size, protease activity and protein content within different levels of the SC. Objectives The aim of the present study was to investigate changes in corneocyte size, corneocyte maturity, selected protease activities, protein content and transepidermal water loss (TEWL) in normal skin after a 28-day application of Aqueous Cream BP. Methods The left and right mid volar forearms of six healthy female volunteers were selected as the study sites. Aqueous Cream BP was applied twice daily to treated sites for 28 days. At the end of this period, the site was tape-stripped and corneocyte maturity, corneocyte size and protease activity of the desquamatory kallikrein proteases, KLK5 and KLK7, and the inflammatory proteases tryptase and plasmin were measured. Protein content and TEWL measurements were also recorded. Results Corneocyte maturity and size decreased with increasing number of tape strips, and were significantly lower in treated sites compared with untreated sites. Protease activity and TEWL values were higher (P < 0AE05) for the treated sites compared with untreated sites. The amount of protein removed from deeper layers of treated sites was significantly lower than from untreated sites. Conclusions We report rapid minimally invasive measures of the effects of Aqueous Cream BP at the cellular and molecular level of the skin. Treatment with this formulation is associated with increased desquamatory and inflammatory protease activity. Changes in corneocyte maturity and size are also indicative of accelerated skin turnover induced by chronic application of this emollient. These findings question firmly the routine prescription of this preparation as a moisturizer in patients with atopic dermatitis.

The Effect of an Emollient Containing Urea, Ceramide NP, and Lactate on Skin Barrier Structure and Function in Older People with Dry Skin

“…For example, some optimally designed emollients containing humectants ameliorate skin dryness and reduce the severity of skin inflammation [11,12,13]. In stark contrast, aqueous cream, containing the harsh anionic surfactant sodium lauryl sulphate (SLS) and no humectant, was found to damage the skin barrier [14,15,16,17], an effect linked to high rates of adverse reactions and exacerbation of AD symptoms [18]. In response to growing evidence and improvements in emollient formulation, a recent consensus statement by health care professionals highlighted the need to differentiate emollients based on their mechanism of action [19].…”

The structure and function of the stratum corneum

“…This innate immunity, which further underlies the skin's ability for repairing itself, is crucial for survival. The application of simple emollient formulations has been shown to alter desquamatory and inflammatory enzyme activity in the SC (Mohammed et al, 2011).…”

Dry Skin in Childhood and the Misery of Eczema and Its Treatments

“…It usually contains sodium lauryl sulphate (SLS), a known skin irritant. Recent work has shown that application of aqueous cream reduces Stratum corneum thickness and increases the rate of trans-epidermal water loss (TEWL) during tape stripping [ 31 ] and is associated with reduced maturity and size of corneocytes and increased desquamatory and infl ammatory protease activity [ 32 ] .…”