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A functional mechanistic study of the effect of emollients on the structure and function of the skin barrier.
Br J Dermatol. 2016 Nov; 175(5):1011-1019.BJ

Abstract

BACKGROUND

Preventing 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.

OBJECTIVES

To determine the skin barrier effects of emollients commonly prescribed in the U.K.

MATERIALS AND METHODS

Two cohorts of volunteers with quiescent AD undertook observer-blind forearm-controlled studies. The first cohort (18 volunteers) treated the volar side of one forearm with two fingertip units of Doublebase™ 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.

RESULTS

Neither Diprobase® cream nor Doublebase™ gel significantly affected the underlying skin barrier function. Both emollients were associated with significantly increased skin surface pH immediately after application (by 0·8 ± 0·19 and 1·0 ± 0·18 units, respectively), and no erythema. Diprobase® cream artificially and transiently (6 h) improved permeability barrier function by 2·9-3·1 g m-2 h-1 TEWL and increased skin hydration by 6·0-6·2 units. Doublebase™ gel, containing humectants, was associated with a greater (between 10·1 and 13·0 units during the first 6 h) and more sustained increase in hydration, lasting more than 12 h following repeated use.

CONCLUSIONS

Diprobase® cream and Doublebase™ gel are not associated with skin barrier harm and appear to be appropriate for AD treatment. While displaying emollient properties, neither formulation displayed an ability to actively improve sustained skin barrier function.

Authors+Show Affiliations

The Academic Unit of Dermatology Research, Department of Infection, Immunity and Cardiovascular Disease, The University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, U.K. s.danby@sheffield.ac.uk.The Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, U.K.The Academic Unit of Dermatology Research, Department of Infection, Immunity and Cardiovascular Disease, The University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, U.K.The Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, U.K.The Academic Unit of Dermatology Research, Department of Infection, Immunity and Cardiovascular Disease, The University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, U.K. The Paediatric Dermatology Clinic, Sheffield Children's Hospital, Sheffield, U.K. Department of Dermatology, Royal Hallamshire Hospital, Sheffield, U.K.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

27097823

Citation

Danby, S G., et al. "A Functional Mechanistic Study of the Effect of Emollients On the Structure and Function of the Skin Barrier." The British Journal of Dermatology, vol. 175, no. 5, 2016, pp. 1011-1019.
Danby SG, Chalmers J, Brown K, et al. A functional mechanistic study of the effect of emollients on the structure and function of the skin barrier. Br J Dermatol. 2016;175(5):1011-1019.
Danby, S. G., Chalmers, J., Brown, K., Williams, H. C., & Cork, M. J. (2016). A functional mechanistic study of the effect of emollients on the structure and function of the skin barrier. The British Journal of Dermatology, 175(5), 1011-1019. https://doi.org/10.1111/bjd.14684
Danby SG, et al. A Functional Mechanistic Study of the Effect of Emollients On the Structure and Function of the Skin Barrier. Br J Dermatol. 2016;175(5):1011-1019. PubMed PMID: 27097823.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A functional mechanistic study of the effect of emollients on the structure and function of the skin barrier. AU - Danby,S G, AU - Chalmers,J, AU - Brown,K, AU - Williams,H C, AU - Cork,M J, Y1 - 2016/08/23/ PY - 2016/04/12/accepted PY - 2016/10/30/pubmed PY - 2017/8/31/medline PY - 2016/4/22/entrez SP - 1011 EP - 1019 JF - The British journal of dermatology JO - Br J Dermatol VL - 175 IS - 5 N2 - BACKGROUND: Preventing 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. OBJECTIVES: To determine the skin barrier effects of emollients commonly prescribed in the U.K. MATERIALS AND METHODS: Two cohorts of volunteers with quiescent AD undertook observer-blind forearm-controlled studies. The first cohort (18 volunteers) treated the volar side of one forearm with two fingertip units of Doublebase™ 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. RESULTS: Neither Diprobase® cream nor Doublebase™ gel significantly affected the underlying skin barrier function. Both emollients were associated with significantly increased skin surface pH immediately after application (by 0·8 ± 0·19 and 1·0 ± 0·18 units, respectively), and no erythema. Diprobase® cream artificially and transiently (6 h) improved permeability barrier function by 2·9-3·1 g m-2 h-1 TEWL and increased skin hydration by 6·0-6·2 units. Doublebase™ gel, containing humectants, was associated with a greater (between 10·1 and 13·0 units during the first 6 h) and more sustained increase in hydration, lasting more than 12 h following repeated use. CONCLUSIONS: Diprobase® cream and Doublebase™ gel are not associated with skin barrier harm and appear to be appropriate for AD treatment. While displaying emollient properties, neither formulation displayed an ability to actively improve sustained skin barrier function. SN - 1365-2133 UR - https://www.unboundmedicine.com/medline/citation/27097823/A_functional_mechanistic_study_of_the_effect_of_emollients_on_the_structure_and_function_of_the_skin_barrier_ L2 - https://doi.org/10.1111/bjd.14684 DB - PRIME DP - Unbound Medicine ER -