Objective and subjective in vivo comparison of two emollient products

Abstract

BackgroundFew studies have directly compared the effectiveness of different emollients in vivo, and the important matter of patient preference is generally overlooked.MethodsWe report the results of an assessor-blinded, bilateral, concurrent comparison of two emollient pharmaceutical presentations, ie, Doublebase gel (DB) and Aqueous cream BP (AC), applied by 20 participants three times daily for 7 consecutive days. The primary efficacy endpoint was cumulative improvement in skin hydration measured by corneometry on days 1, 3, and 5 immediately before the first application and approximately 2 hours after the third application of the day. Secondary endpoints were investigator assessment of skin condition at these time points and participant assessment of product acceptability at the end of the study.ResultsBoth products increased skin hydration, but the effect of AC was relatively modest, with morning values readily returning to pretreatment levels. Hydration levels were higher for DB gel, maintained at all time points, and showed stepwise, cumulative increases over the 7 days of use. Overall patient satisfaction scores were higher for DB gel, and especially for “consistency,” “ease of use,” and “ease of absorption into the skin.” Eighty-five percent of participants expressed a desire to use DB gel again as compared with 40% for AC.

Effectiveness and safety of lotion, cream, gel, and ointment emollients for childhood eczema: a pragmatic, randomised, phase 4, superiority trial

“…However, some research suggests that emollients that are ostensibly identical in their major constituents can still be experienced as different by the user. [19][20][21] Also, it cannot be assumed that the findings apply to non-study emollients. Missing electronic medical record data and the pragmatic nature of our design, in which the prescription was issued via the participant's general practitioner and usual pharmacy, meant that we were unable to confirm for some participants (29 [5%]) which emollients they initially received, and that nine (2%) participants received an emollient of the correct type but that was not study approved.…”

Emollient product design: objective measurements of formulation structure, texture and performance, and subjective assessments of user acceptability

“…Ideally, this deconstruction both reduces the viscosity of the gel and results in separation of the oil and aqueous phases, allowing the emollient (oily) ingredients to be spread easily and form a uniform occlusive barrier over the skin surface . In addition, if the phase separation is irreversible, this also serves to prolong emollient retention on the skin by rendering the oily ingredients more resistant to re‐emulsification when washing/bathing …”

“…10 In addition, if the phase separation is irreversible, this also serves to prolong emollient retention on the skin by rendering the oily ingredients more resistant to re-emulsification when washing/bathing. 11,12 When compared in their normal states, the DBG formulation looked smoother and more homogeneous, and was less firm and sticky compared with ZDG. In addition, after coming into contact with salts, the DBG emulsion broke down more readily and substantially, became less firm and spread more readily than ZDG.…”

A Double-Blind, Randomised Study Comparing the Skin Hydration and Acceptability of Two Emollient Products in Atopic Eczema Patients with Dry Skin

“…The significantly greater hydration performance of DELP over ZBC may be attributed to a higher oil content of DELP compared to ZBC (30% vs. 21% as declared by the manufacturers) and to their differing substantivities on the skin [ 15 ]. In addition, DELP contains high levels of glycerol, which is a humectant and has the ability to bind and retain water within the entire thickness of the stratum corneum [ 16 – 18 ].…”