Optimised emollient mixture for skin barrier repair: Applications to global child health

Elias, Peter M.; Man, Mao‐Qiang

doi:10.7189/jogh.12.03019

Cited by 4 publications

(9 citation statements)

References 27 publications

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“…The most commonly applied emollients used for neonatal skin care were petrolatum-based oils and jellies. These substances are known to have deleterious effects as demonstrated in prior studies, especially in preterm neonates [ 25 – 29 ]. In addition to emollients, talcum powder (often referred to as baby powder) was commonly applied to the neonates.…”

Section: Discussionmentioning

confidence: 99%

Perceptions, beliefs, and current practices regarding neonatal skin care and emollient use in eastern Uganda: a qualitative study

et al. 2023

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Background The skin is a major route of infection in the neonatal period, especially in low birthweight (LBW) infants. Appropriate and safe neonatal skin care practices are required to reduce this risk. The perceptions and beliefs of mothers and other caregivers towards various neonatal skin care practices in our setting have been documented. Data from Asia suggests that the application of emollient to the skin of LBW infants can promote growth, reduce serious neonatal infections, and potentially reduce mortality. This is the first study to explore the acceptability of emollients and massage as part of neonatal skin care in a low-resource setting in sub-Saharan Africa (SSA) that is representative of the majority of government health facilities in Uganda and many in SSA. Objective To explore perceptions, beliefs, and current practices regarding neonatal skin care and emollient use in eastern Uganda. Methods We conducted a qualitative study consisting of three focus group discussions (30 participants), eight in-depth interviews with mothers/caregivers of preterm and term neonates and 12 key informant interviews with midwives, doctors and community health workers involved in neonatal care, to explore the perceptions and practices surrounding neonatal skin care and emollient use. Data collected were transcribed and analyzed using thematic content analysis. Results Mothers perceived that skin care began in utero. Skincare practices depended on the place of delivery; for deliveries in a health facility the skincare practices were mainly based on the health worker’s advice. Vernix caseosa was often washed off due to its perceived undesirability and was attributed to sexual intercourse in the last trimester. Despite their deleterious attributes found in previous studies, petrolatum-based oils, petrolatum-based jellies and talcum baby powders were the most commonly reported items used in neonatal skin care. In our population, there was high acceptability of emollient therapy use; however, neonatal massage was treated with scepticism as mothers feared damaging the vulnerable neonate. Mothers suggested massage and emollient application be undertaken by health workers, if it becomes an intervention. Conclusions In eastern Uganda, the perceptions and beliefs of mothers/caregivers toward neonatal skincare influenced their practices of which some could potentially be beneficial, and others harmful. Emollient use would be easily accepted if adequate sensitisation is conducted and using the gatekeepers such as health workers.

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Section: Discussionmentioning

confidence: 99%

Perceptions, beliefs, and current practices regarding neonatal skin care and emollient use in eastern Uganda: a qualitative study

et al. 2023

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“…The SC lipids that exclusively make up the SC lipid matrix are unique among biological membranes in terms of their composition, structural organization, and functionality. It is a phospholipid-free mixture of polar and non-polar lipids, predominantly composed of three key components in approximately equimolar concentrations [13,14]. The three major physiological lipid types of the healthy SC lipid matrix are ( 1) CERs (about 45-50% by mass), ( 2) CHOL (25% by mass), and (3) FFAs (10-20% by mass).…”

Section: The Composition Of the Stratum Corneum And The Importance Of...mentioning

confidence: 99%

“…Many current management and/or therapeutic approaches known as CER-dominant formulations include a combination of the key CER subclasses, namely phytosphingosinebased CER[EOP], CER[NP], and CER[AP], as well as CHOL and FFAs. For example, double-CER combination containing CER[EOP] and CER[NP], and triple-CER combination containing CER[EOP], CER[NP], and CER[AP]) [36][37][38][39][40] combined with (1) CHOL and/or FFAs [37][38][39][40]; (2) conventional moisturizers (e.g., glycerin) [37][38][39][40]; (3) frequently used CER precursors/promoters/boosters, including niacinamide, lactic acid and phytosphingosine [37][38][39][40]; and (4) sporadically used CER-Mg [41] and ursolic acid [2] can complement the science of CERs and 'prompt' skin into making CERs in order to initiate or more likely to accelerate skin barrier recovery and repair [14]. Topical formulations that contain a complete and equimolar physiological mixture (1:1:1) of triple-lipid CERs:CHOL:FFAs are not harmful to disturbed or compromised skin; however, incomplete or imbalanced mixtures can potentially aggravate underlying barrier defects, presumably by destabilizing the functional properties of the skin's lipid-based barrier [14].…”

Section: The Composition Of the Stratum Corneum And The Importance Of...mentioning

confidence: 99%

“…For example, double-CER combination containing CER[EOP] and CER[NP], and triple-CER combination containing CER[EOP], CER[NP], and CER[AP]) [36][37][38][39][40] combined with (1) CHOL and/or FFAs [37][38][39][40]; (2) conventional moisturizers (e.g., glycerin) [37][38][39][40]; (3) frequently used CER precursors/promoters/boosters, including niacinamide, lactic acid and phytosphingosine [37][38][39][40]; and (4) sporadically used CER-Mg [41] and ursolic acid [2] can complement the science of CERs and 'prompt' skin into making CERs in order to initiate or more likely to accelerate skin barrier recovery and repair [14]. Topical formulations that contain a complete and equimolar physiological mixture (1:1:1) of triple-lipid CERs:CHOL:FFAs are not harmful to disturbed or compromised skin; however, incomplete or imbalanced mixtures can potentially aggravate underlying barrier defects, presumably by destabilizing the functional properties of the skin's lipid-based barrier [14]. Lately, triple-lipid topical formulations that contain a 3:1:1 optimal molar ratio of CERs:CHOL:FFAs (preferably with longer chains) have been extensively used to maintain healthy skin barrier or more often to accelerate disease-affected skin barrier recovery and repair, thus improving skin barrier health in a timely and effective manner [14].…”

Section: The Composition Of the Stratum Corneum And The Importance Of...mentioning

confidence: 99%

“…Topical formulations that contain a complete and equimolar physiological mixture (1:1:1) of triple-lipid CERs:CHOL:FFAs are not harmful to disturbed or compromised skin; however, incomplete or imbalanced mixtures can potentially aggravate underlying barrier defects, presumably by destabilizing the functional properties of the skin's lipid-based barrier [14]. Lately, triple-lipid topical formulations that contain a 3:1:1 optimal molar ratio of CERs:CHOL:FFAs (preferably with longer chains) have been extensively used to maintain healthy skin barrier or more often to accelerate disease-affected skin barrier recovery and repair, thus improving skin barrier health in a timely and effective manner [14].…”

Section: The Composition Of the Stratum Corneum And The Importance Of...mentioning

confidence: 99%

See 2 more Smart Citations

Considering Phytosphingosine-Based Ceramide Formulations for Atopic Skin Care

Mijaljica,

Townley,

Hondros

et al. 2024

Dermato

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This review provides an overview of the structural and functional features of key phytosphingosine-based ceramides (CERs), notably CER[EOP], CER[NP], and CER[AP], and their role in atopic skin health. Herein, we discuss how these indispensable stratum corneum (SC) lipids maintain skin barrier homeostasis and contribute to the skin’s barrier function in terms of its cohesiveness and resilience. We also consider the usefulness of CER[EOP], CER[NP], and CER[AP] in preserving skin hydration and protecting and/or repairing dry, itchy, or sensitive skin. Next, we explore how and to what extent an imbalance or inadequate amounts of CER[EOP], CER[NP], and CER[AP] contribute to the hallmark characteristics of atopic skin diseases like eczema. Furthermore, we discuss the importance of complementary SC resident lipids such as cholesterol (CHOL) and free fatty acids (FFAs), which are crucial for optimal CER function. Studies have shown that delivering topical CERs in balanced and optimal combination with CHOL and FFAs—while supporting and boosting the endogenous biosynthesis of CERs using ingredients such as niacinamide and lactic acid—helps relieve symptoms of atopic diseases to provide some measure of relief. Finally, we look at some emerging ingredients that can complement the science of CERs in healthy and diseased skin.

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The heterogeneity and complexity of skin surface lipids in human skin health and disease

Mijaljica,

Townley,

Spada

et al. 2024

Progress in Lipid Research

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Optimised emollient mixture for skin barrier repair: Applications to global child health

Cited by 4 publications

References 27 publications

Perceptions, beliefs, and current practices regarding neonatal skin care and emollient use in eastern Uganda: a qualitative study

Perceptions, beliefs, and current practices regarding neonatal skin care and emollient use in eastern Uganda: a qualitative study

Considering Phytosphingosine-Based Ceramide Formulations for Atopic Skin Care

The heterogeneity and complexity of skin surface lipids in human skin health and disease

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