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A functional mechanistic study of the effect of emollients on the structure and function of the skin barrier

2016; Oxford University Press; Volume: 175; Issue: 5 Linguagem: Inglês

10.1111/bjd.14684

1365-2133

Simon G. Danby, Joanne R Chalmers, Kirsty Brown, Hywel C Williams, Michael J. Cork,

Contact Dermatitis and Allergies

BackgroundPreventing relapses of atopic dermatitis (AD) through the regular use of topical products to repair the skin barrier defect is an emerging concept.It is still unclear if some commonly used emollients exert a positive effect on the skin barrier. ObjectivesTo determine the skin barrier effects of emollients commonly prescribed in the UK. MethodsTwo cohorts of volunteers with quiescent AD undertook observer-blind forearmcontrolled studies.The first (18 volunteers) treated the volar side of one forearm with 2 fingertip units of Doublebase TM gel twice daily for 4 weeks.The second cohort (19 volunteers) undertook the same regimen using Diprobase® cream.Transepidermal water loss (TEWL), stratum corneum integrity and hydration, skin-surface-pH and redness were determined at the test sites before and after treatment. ResultsNeither Diprobase® cream nor Doublebase TM gel significantly affected the underlying skin barrier function.Both emollients were associated with significantly increased skinsurface-pH immediately after application (by 0.8±0.19 and 1.0±0.18units respectively), and no erythema.Diprobase® cream artificially and transiently (6 hours) improved permeability barrier function by 2.9-3.1 g/m 2 /h TEWL and increased skin hydration by 6.0-6.2 units.Doublebase TM gel, containing humectants, was associated with a greater (between 10.1 and 13.0 units during the first 6 hours) and more sustained increase in hydration, lasting more than 12 hours following repeated use. ConclusionDiprobase® cream and Doublebase TM gel are not associated with skin barrier harm and appear to be appropriate for AD treatment.Whilst displaying emollient properties, neither formulation displayed an ability to actively improve sustained skin barrier function.