Diet and Skin Barrier: The Role of Dietary Interventions on Skin Barrier Function
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Abstract:
Multiple research studies have examined the role of specific dietary interventions and their effects on skin barrier function. The skin barrier is one of the body's first lines of protection against environmental insults, and disruption of this natural line of defense can result in xerosis, irritation, chronic dermatitis, and other cutaneous effects. Multiple laboratory, animal, and human studies have demonstrated that certain dietary interventions have the potential to impact skin barrier function. Measurements of skin barrier function include stratum corneum hydration and transepidermal water loss. In this review, we examine this research and provide an overview of the effects of prebiotics, probiotics, fatty acids, and emerging research on other substances.Keywords:
Transepidermal water loss
Barrier function
Skin Barrier
Skin irritation
Sensitive skin
Dry skin
Background: Moisturizers are topical products designed to improve and maintain the skin barrier function and to help prevent dry skin. Materials and methods: A new moisturizer (Ceramide cream) was formulated containing ingredients which mimic the skin's own natural moisturizing systems. Corneometry was performed at baseline, 2, 4, 6 and 24 hours following a single application of Ceramide cream to healthy skin, and compared to three reference moisturizers available over-the-counter, and placebo. Transepidermal water loss (TEWL) was also measured following a single application of Ceramide cream compared to baseline, and its safety was assessed by repeat insult patch test, ophthalmologist and pediatric testing. Results: A single topical application of either the Ceramide cream or the three reference moisturizers resulted in a significant increase in skin hydration over time ( P <0.001). The placebo cream did not significantly increase skin hydration at any time point. At 24 hours post-application, skin hydration measured for Ceramide cream was significantly greater ( P <0.05) than that measured for all three of the reference moisturizers tested. Ceramide cream was also found to significantly decrease TEWL ( P <0.001) over 24 hours, and was shown to be non-sensitizing to the skin of both adults and children and non-irritating to the skin, eyes and related eye area. Conclusion: Ceramide cream increases skin hydration and improves barrier function which may make it suitable for use on dry skin. Keywords: ceramide, moisturizer, stratum corneum, dry skin, humectant, emollient, occludent, transepidermal water loss, natural moisturizing factor
Transepidermal water loss
Moisturizer
Dry skin
Sensitive skin
Skin Barrier
Corneocyte
Barrier function
Desquamation
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The skin of patients with atopic dermatitis is characterized by abnormal stratum corneum lipid levels. Consequently, the lamellar matrices are disrupted and skin barrier function is diminished, increasing skin sensitivity to irritants and allergens.To determine whether a cream containing ceramides, triglycerides and cholesterol in a multivesicular emulsion can reinforce the skin barrier and protect against skin irritation.A randomized observer-blind intrapatient-controlled study in 34 adults with dry, eczema-prone skin was conducted. Each participant underwent 4 weeks of treatment with the test cream on one forearm and lower leg and a reference emollient cream on the other. Skin properties were determined before and after treatment. Lipid structure was assessed by Fourier-transform infrared spectroscopy using a novel interface.Skin barrier integrity was greater at sites treated with the test cream [effect size for area under the transepidermal water loss curve -162, 95% confidence interval (CI) -206 to -118]. Skin sensitivity to sodium lauryl sulfate was reduced (-0·5 points visual redness, 97·57% CI -1·00 to -0·25), as was transepidermal water loss (-15·3 g m-2 h-1 , 95% CI -20·3 to -10·4) compared with the reference. Sites treated with the test cream displayed enhanced lipid chain ordering, which was significantly associated with skin barrier integrity (r = 0·61). Compared with the reference, treatment with the test cream increased hydration (8·61 capacitance units, 95% CI 6·61-10·6) and decreased signs of dryness.The test cream facilitates skin barrier restoration and protects the skin from dryness and irritation. Compared with a commonly prescribed emollient in the UK, the test cream is highly suited to the management of dry, sensitive skin.
Dry skin
Barrier function
Skin irritation
Skin Barrier
Corneocyte
Sensitive skin
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A new dexpanthenol-containing hand cream (ND-HC) was developed for people with dry, sensitive, and/or environmentally stressed hands. To explore the performance and acceptability of ND-HC, we conducted a randomized, intraindividual comparison study in 40 healthy adult subjects with sensitive and very dry skin on the hands. Instrumental measurements determined the effects on stratum corneum (SC) hydration and transepidermal water loss (TEWL) after single and/or 4 weeks’ use of ND-HC. Single and continued at least four times daily applications of ND-HC to very dry skin of the hand for 4 weeks triggered significant increases in SC hydration. On day 29, the mean change in skin capacitance from baseline was significantly greater when ND-HC was applied to the test area compared with the untreated area on the contralateral hand (12.41 vs. 4.46 a.u.; p < 0.001). Upon use of ND-HC over 4 weeks, mean TEWL decreased significantly (bilateral difference: −1.8 vs. 1.0 g/m2/h; p = 0.003), indicating an improvement in SC barrier function. A reduction in dry hand symptoms was observed over the study course. ND-HC was well tolerated and achieved a high level of acceptance and satisfaction. Our findings suggest that ND-HC complies with the required features of a state-of-the-art hand cream.
Transepidermal water loss
Dry skin
Sensitive skin
Skin Barrier
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Atopic dermatitis (AD) is a common, chronically recurring skin disorder. Dry skin is a common finding in patients with AD, apart from the dermatitis. Although there are obvious clinical signs of an impaired barrier function of the skin, few investigators have studied this aspect of AD. The stratum corneum, where the barrier is located, has been studied with different techniques in patients with AD, and the results are now presented. The water-binding capacity of dry atopic skin was found to be reduced when measured with an in vitro microbalance technique. TEWL (transepidermal water loss) measured with and Evaporimeter Ep1, was increased in dry skin and in clinically normal skin of atopics on predilection areas. Water content was decreased in dry atopic skin, when measured with the Corneometer CM 420. In a quantitative electron microscopic study, the lamellar bodies were found to have an increased relative volume in dry atopic skin. When using chromatographic analysis, preliminary data suggested reduced amounts of extractable stratum corneum lipids in patients with AD. In a clinical study, 80% of the patients with AD regarded their skin as being dry. Fifty percent were found to have areas of dry skin, on clinical examination. By scanning electron microscopy (SEM), the surface pattern of dry atopic skin was found to be coarse and irregular. When using profilometry, quantitative differences in roughness parameters were found in dry atopic vis-à-vis to normal skin.(ABSTRACT TRUNCATED AT 250 WORDS)
Dry skin
Transepidermal water loss
Skin Barrier
Sensitive skin
Atopy
Dry weight
Human skin
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Patients with atopic skin show a defective barrier function both in rough and in clinically normal skin, with an increasing risk of developing contact dermatitis. Moisturizing creams are often used in the treatment of dry skin. The purpose of this study was to investigate the influence of treatment with a urea‐containing moisturizer on the barrier properties of atopic skin. Fifteen patients with atopic dermatitis treated one of their forearms twice daily for 20 days with a moisturizing cream. Skin capacitance and transepidermal water loss (TEWL) were measured at the start of the study and after 10 and 20 days. On day 21 the skin was exposed to sodium lauryl sulphate (SLS) and on day 22 the irritant reaction was measured non‐invasively. Skin capacitance was significantly increased by the treatment, indicating increased skin hydration. The water barrier function, as reflected by TEWL values, tended to improve (P= 0.07), and the skin susceptibility to SLS was significantly reduced, as measured by TEWL and superficial skin blood flow (P< 0.05). Thus, it seems that certain moisturizers could improve skin barrier function in atopics and reduce skin susceptibility to irritants. The mechanism and the clinical relevance need further investigation.
Transepidermal water loss
Moisturizer
Dry skin
Skin Barrier
Sensitive skin
Barrier function
Irritant contact dermatitis
Skin reaction
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Disruption of the skin barrier function caused by epidermal hyper-proliferation, results in the skin becoming dry and showing high transepidermal water loss (TEWL). Gamma linolenic acid (GLA) is reportedly efficacious for treating TEWL and epidermal hyper-proliferation. In this study, to elucidate the effect of GLA-rich oil on skin function, GLA-containing food was given to adults with dry skin or mild atopic dermatitis and skin parameters were evaluated. In the results, we recognized beneficial effects on the TEWL index. The efficacy of GLA was also demonstrated to be statistically significant especially in subjects with pro-inflammatory features. The results suggest that the mechanism of improvement of skin barrier has been associated with possible generation of anti-inflammatory metabolites from GLA. The clinical physician also confirmed that none of the subjects showed any noteworthy side effects. GLA-enriched food appears to be safe and to improve skin barrier function in subjects with dry skin conditions and mild atopic dermatitis.
Transepidermal water loss
Dry skin
gamma-Linolenic acid
Barrier function
Skin Barrier
Sensitive skin
Refractory (planetary science)
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SUMMARY Apparently, the use of mathematical and statistical models to describe the structure and function of the skin barrier is rather limited. The skin barrier protects the body against uncontrolled loss of water and desiccation, and prevents environmental substances from entering the skin. A simple measure of the barrier function is the transepidermal water loss (TEWL), which is easy to measure. Healthy skin has low TEWL values, whereas various skin diseases result in high TEWL values and eventually in the development of dry skin. The use of skin care products can protect and prevent dry skin. In this study several different trial formulations are compared with respect to their abilities as skin care products. The study is performed as a longitudinal study on mice, where the skin barrier is broken by means of acetone and then treated with one of the formulations. We analysed the data by means of a semimechanistic random-effects model with similarities to pharmacokinetic models. In the model each formulation is characterized by two parameters: one that corresponds to the initial barrier restoration effect and one that corresponds to the elimination rate.
Transepidermal water loss
Dry skin
Skin Barrier
Barrier function
Skin Temperature
Skin care
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Two novel body/face wash gels enriched with emollient ingredients (including dexpanthenol) were developed for the daily care of dry skin. Two similarly designed 2-week studies (N = 42 each) were conducted to assess the biophysical and cosmetic performance of each of the new wash gels in healthy adults with dry skin. Instrumental measurements quantified the effects of the wash gels on stratum corneum (SC) hydration and transepidermal water loss (TEWL) (with and without a previous sodium lauryl sulfate (SLS) challenge) after single and repeated usage. Following single and repeated applications of the face wash gel to facial skin, as well as to dry SLS-undamaged and SLS-damaged skin of the forearm, skin hydration significantly increased. Similarly, after single and repeated usage of the body wash gel to dry SLS-undamaged and SLS-damaged skin of the forearm, skin moisturization increased significantly from baseline; comparisons with control areas provided inconsistent results for SLS-undamaged skin. No effects on TEWL were observed for either product. Both wash gels were well tolerated and the cosmetic performances were appreciated by the subjects. The study results suggest that daily use of the new wash gels was associated with significant skin-moisturizing effects without adversely affecting skin barrier function and repair.
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Dry skin
Sensitive skin
Moisturizer
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Skin irritation
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Three studies were conducted with three new dexpanthenol-containing emollients containing increasing lipid contents (Emollients 1–3) to assess their performances in healthy adults with dry skin. All three studies (N = 42 each) followed virtually the same design. A single skin application of the study product was performed followed by once-daily usage. Skin hydration, transepidermal water loss (TEWL), skin biomechanical properties, and lipid content of the stratum corneum (SC) were regularly assessed over the 28-day study period; a subset (N = 22) underwent a sodium lauryl sulfate (SLS) challenge prior to product application. All three emollients were well tolerated and showed good performances with only minor differences in instrumental measurements. After single and prolonged once-daily applications of Emollients 1–3 to dry skin and dry SLS-damaged skin, skin hydration significantly increased from baseline (BL) (by 38.1–72.4% in unchallenged skin, p < 0.001 for all three). This was paralleled by significant increases in skin elasticity parameters. Usage of Emollients 1 and 3 caused increases from BL in SC cholesterol (by 9.8–12.5%, p < 0.05 for both) and SC free fatty acid levels (by 3.7–26.3%, p < 0.05 for both) at the end of the study. No sustained effects on TEWL were recorded. Our findings support the once-daily use of all three emollients in adults with dry skin.
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During recent years several highly developed non-invasive methods for evaluation of skin physiology and pathology have been introduced. Against this background, the present studies were undertaken with the primary aim of assessing the effects of various skin care products on some properties of the skin. Skin topography was measured by profilometry on skin replicas, friction with a newly developed friction instrument, capacitance with a Corneometer, and barrier function both with an Evaporimeter to assess transepidermal water loss (TEWL) and by application of an irritant followed by measurement of the resulting irritative reaction. Initially some of the techniques were used to further characterize the differences between dry atopic skin and normal skin. Dry skin exhibits increased values of roughness parameters and a reduced number of topographical peaks. TEWL is increased, indicating impaired barrier function. The friction and capacitance are lower and correlate significantly to each other, whereas TEWL does not appear to relate to either of these parameters. The use of a scrub cream removes the outermost part of the stratum corneum, resulting in a smoother skin. Application of moisturizers modifies the frictional response of the skin. The friction instrument gave results comparable to those of panelists trained in sensory evaluation. The study suggests that measurement of skin friction can be used to predict the degree of liking of moisturizers. Furthermore, moisturizers increase the skin hydration. They provide water directly to the skin from their water phase. Skin hydration also increases with increased degree of occlusion, as measured as a decrease in TEWL. Moisturizers may also alter the diffusional resistance of the stratum corneum and reduce the skin susceptibility to the surfactant sodium lauryl sulphate (SLS). Lipids in moisturizers may influence already developed SLS-induced irritation. A significantly lower degree of irritation was found in areas treated with canola oil and its sterol-enriched fraction than in an area treated with water. These findings emphasize that skin care products do not only form an inert, epicutaneous layer, but that they may penetrate and influence the structure and function of the skin.
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Dry skin
Moisturizer
Sensitive skin
Skin Barrier
Barrier function
Skin care
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