Moisturizers for Patients with Atopic Dermatitis: An Overview

Sirikudta, Wararat

doi:10.4172/2155-6121.1000143

Cited by 15 publications

(12 citation statements)

References 45 publications

(52 reference statements)

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“…Several reviews and guidelines, a practice statement and a dissertation that evaluated the efficacy and usefulness of moisturizers in eczema treatment were identified . No disagreements were noted, and all confirmed that persistent, repeated and abundant use of moisturizers is needed to repair or maintain epidermal barrier function, which is in agreement with the conclusion of this review.…”

Section: Discussionsupporting

confidence: 71%

Emollients and moisturizers for eczema: abridged Cochrane systematic review includingGRADEassessments

Zuuren

Fedorowicz

Arents³

2017

Br J Dermatol

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Eczema is a chronic inflammatory skin disorder with considerable impact on quality of life. Emollients or moisturizers are widely recommended, but are these effective and safe? We searched for randomized controlled trials (RCTs) in the Cochrane Skin Group Specialised Skin Register, CENTRAL in The Cochrane Library, MEDLINE, Embase, LILACS, the GREAT database and five trial registers to December 2015. We included 77 RCTs with 6603 participants. Seven studies (9%) were at low risk of bias, 34 (44%) had unclear risk and 36 (47%) were at high risk. The quality of the evidence was mainly low or moderate for the prespecified outcomes. The most important comparison, 'moisturizer vs. no moisturizer', showed improved Scoring Atopic Dermatitis values in the moisturizer group compared with no moisturizer [mean difference -2·42, 95% confidence interval (CI) -4·55 to -0·28], but did not meet the minimal important difference of 8·7. Fewer flares were seen (risk ratio 0·40, 95% CI 0·23-0·70) and the rate of flares was reduced (hazard ratio 3·74, 95% CI 1·86-7·50). The groups applying moisturizer used less topical corticosteroids over 6-8 weeks (mean difference -9·30 g, 95% CI 15·3 to -3·27). Glycyrrhetinic acid-, urea- and glycerol-containing creams worked better than their controls (vehicle, placebo or no moisturizer) according to both participants and physicians. More flares were reported with moisturizer alone than when combined with twice-weekly fluticasone propionate (risk ratio 2·17, 95% CI 1·55-3·11). Adding moisturizers to topical anti-inflammatory treatment was more effective than anti-inflammatory treatment alone and resulted in fewer flares.

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Section: Discussionsupporting

confidence: 71%

Emollients and moisturizers for eczema: abridged Cochrane systematic review includingGRADEassessments

Zuuren

Fedorowicz

Arents³

2017

Br J Dermatol

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“…It is comprised of 10-20% moisture, which prevents the skin surface from drying and reduces skin barrier anomalies (32,33). Ceramide is a lipid component that constitutes the stratum corneum and is known to have a skin moisturizing effect, while β-glucosidase is an enzyme that regenerates ceramide from glycosylceramide and acyl glycosylceramide (34,35). Therefore, the moisture content of the stratum corneum is an index used to monitor skin damage.…”

Section: Resultsmentioning

confidence: 99%

Anti‑photoaging effect of fermented agricultural by‑products on ultraviolet B‑irradiated hairless mouse skin

et al. 2019

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Processed products from agricultural produce generate a large number of agricultural by-products that contain a number of functional substances. These are often discarded owing to the lack of suitable processing methods. The present study investigated the anti-photoaging properties of fermented rice bran (FRB), soybean cake (FSB) and sesame seed cake (FSC) on ultraviolet B (UVB)-irradiated hairless mouse skin. Results indicated that the oral administration of FRB, FSB and FSC effectively inhibited the UVB irradiation-induced expression of matrix metalloproteinase (MMP)-2, MMP-9, MMP-3 and MMP-13. Reverse transcription-quantitative polymerase chain reaction results also demonstrated that FRB, FSB and FSC significantly inhibited the UVB-induced expression of the genes encoding tumor necrosis factor-α, inducible nitric oxide synthase, interleukin (IL)-6 and IL-1β when compared with the UVB-vehicle group (P<0.05). Additionally, collagen degradation and mast cell infiltration were reduced in hairless mouse skin. Furthermore, UVB-induced wrinkle formation was also significantly reduced in mouse skin compared with the UVB-vehicle group (P<0.05). These results reveal that fermented agricultural by-products may serve as potential functional materials with anti-photoaging activities.

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“…Urea is normally present in healthy skin as part of the natural moisturizing factor (NMF) in the stratum corneum [ 14 ]. Urea is a humectant with water attracting properties from dermis into epidermis and aids in holding water in the stratum corneum [ 14 , 28 , 29 ]. In atopic skin epidermal barrier function is impaired, TEWL is increased and the ability to retain water in the skin is decreased [ 14 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

Performance and Tolerability of the Moisturizers Cetaphil® and Excipial® in Atopic Dermatitis: What is the Evidence Based on Randomized Trials?

Zuuren

Fedorowicz

Arents³

2017

Dermatol Ther (Heidelb)

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IntroductionMoisturizers play a prominent role in the management of atopic dermatitis by improving the impaired skin barrier function and enhancing skin hydration. Their efficacy was evaluated in a recently published Cochrane Review ‘Emollients and moisturizers for eczema’.ObjectiveIn the present review, we summarize the performance and safety of Cetaphil® and Excipial® moisturizing products.MethodsThis review was carried out in compliance with standard Cochrane methodological procedures, which means independent study selection, data extraction, assessment of risk of bias, and analyses by two review authors. The quality of evidence for the predefined outcomes was rated with the GRADE approach. The prespecified outcomes of the review included participant assessments, satisfaction, adverse events, investigator assessments, prevention of flares, change in use of topical active treatment, skin barrier function and quality of life.ResultsFour randomized controlled studies examining these moisturizers were included in the previously published Cochrane Review. For the performance and tolerability of these moisturizers, there was very low to moderate quality evidence for the prespecified outcomes.ConclusionThe results from these four studies are in line with those of the Cochrane Review that moisturizers themselves have beneficial effects, and that combining moisturizers with active topical treatment produced better results when compared to active topical treatment alone.Electronic supplementary materialThe online version of this article (doi:10.1007/s13555-017-0184-3) contains supplementary material, which is available to authorized users.

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Moisturizers for Patients with Atopic Dermatitis: An Overview

Cited by 15 publications

References 45 publications

Emollients and moisturizers for eczema: abridged Cochrane systematic review includingGRADEassessments

Emollients and moisturizers for eczema: abridged Cochrane systematic review includingGRADEassessments

Anti‑photoaging effect of fermented agricultural by‑products on ultraviolet B‑irradiated hairless mouse skin

Performance and Tolerability of the Moisturizers Cetaphil® and Excipial® in Atopic Dermatitis: What is the Evidence Based on Randomized Trials?

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