The effect of a basic skin care product on the structural strength of the dermo‐epidermal junction: An exploratory, randomised, controlled split‐body trial

Abstract

Skin ageing is associated with various structural alterations including a decreased strength of the dermo‐epidermal adhesion increasing the risk for shear type injuries (skin tears). Topical applications of basic skin care products seem to reduce skin tear incidence. The suction blister method leads to the artificial and controlled separation of dermis and epidermis. Therefore, time to blister formation may be used as outcome measuring the strength of dermo‐epidermal adhesion. We conducted an exploratory, randomised, controlled trial with a split‐body design on forearms in healthy female subjects (n = 12; mean age 70.3 [SD 2.1] years). Forearms assigned to the intervention were treated twice daily with petrolatum for 8 weeks. Suction blisters were induced on forearms after 4 and 8 weeks and time to blister formation was measured. Stratum corneum and epidermal hydration were measured and epidermal thickness was assessed via optical coherence tomography. Time to blistering was longer and stratum corneum as well as epidermal hydration was consistently higher in intervention skin areas. We conclude that topical application of basic skin care products may improve mechanical adhesion of the dermo‐epidermal junction and that the parameter “time to blistering” is a suitable outcome to measure dermo‐epidermal adhesion strength in clinical research.

Epidermal thickness in healthy humans: a systematic review and meta‐analysis

“…4 Prolonged occlusion and/or hydration of the epidermis also leads to changes in the epidermal morphology changing its mechanical properties. 5,6 Several skin diseases, such as psoriasis, contact or atopic dermatitis, lichen planus, or scar tissue, are characterized by alterations in the epidermis, which may result in thickness changes. [7][8][9] To evaluate epidermal thickness (ET) changes in the context of skin diseases or in dermatological research, it is necessary to compare obtained estimates with reference values.…”

“…The stiffer the epidermis, the less it is able to deform (e.g., during walking) and the higher is the risk for fissuring and ulceration 4 . Prolonged occlusion and/or hydration of the epidermis also leads to changes in the epidermal morphology changing its mechanical properties 5,6 …”

Effects of a leave‐on product on the strength of the dermoepidermal junction: An exploratory, intraindividual, randomized controlled trial in older adults with dry skin

“…Products containing 5% urea are considered tolerable on moderately scaly skin 7 . Previously we have shown, that the application of petrolatum in skin healthy older people improved DEJ adhesion 33 . Since dry skin is one prognostic factor for skin tear development, 23 we hypothesized that the effect might be stronger in dry skin; in terms of increased DEJ adhesion and subsequent reduction of the risk of skin tears.…”

“…32 The parameter "time to blistering" was suggested as a clinically relevant outcome, which reflects the resistance and mechanical integrity of DEJ. 20,27,33 Basic leave-on products are helpful in decreasing skin dryness, improving skin barrier function, as well as reducing the risk of skin tear development in the older adults. 34,35 Humectants in combination with basic leave-on products are effective in this regard and any effect on the skin is due to the total composition of the product.…”

The Importance of Mimicking Dermal-Epidermal Junction for Skin Tissue Engineering: A Review

“…Furthermore, through applying mechanical forces, the rete ridges enlarge and trigger a rapid proliferation of basal precursors, resulting in the basal layer’s growth. This mechanism preserves the epidermal organization and enhances the regenerative potential of expanded skin [ 25 , 26 ].…”