Conflicts of interest I.B. and M.L. are employed by ACO HUD NORDIC AB, which provided funding for the research presented in this article. No other authors have anything to declare.
Changes in skin barrier function following long-term treatment with moisturizers, a randomized controlled trial
Article first published online: 18 JAN 2007
British Journal of Dermatology
Volume 156, Issue 3, pages 492–498, March 2007
How to Cite
Buraczewska, I., Berne, B., Lindberg, M., Törmä, H. and Lodén, M. (2007), Changes in skin barrier function following long-term treatment with moisturizers, a randomized controlled trial. British Journal of Dermatology, 156: 492–498. doi: 10.1111/j.1365-2133.2006.07685.x
- Issue published online: 18 JAN 2007
- Article first published online: 18 JAN 2007
- Accepted for publication 2 October 2006
- long-term treatment;
- skin barrier function;
- transepidermal water loss
Background Moisturizers are commonly used by patients with dry skin conditions as well as people with healthy skin. Previous studies on short-term treatment have shown that moisturizers can weaken or strengthen skin barrier function and also influence skin barrier recovery. However, knowledge of the effects on skin barrier function of long-term treatment with moisturizers is still scarce.
Objectives To investigate the impact of long-term treatment with moisturizers on the barrier function of normal skin, as measured by transepidermal water loss (TEWL) and susceptibility to an irritant, and to relate those effects to the composition of the designed experimental moisturizers.
Methods Volunteers (n = 78) were randomized into five groups. Each group treated one volar forearm for 7 weeks with one of the following preparations: (i) one of three simplified creams, containing only a few ingredients in order to minimize the complexity of the system; (ii) a lipid-free gel; (iii) one ordinary cream, containing 5% urea, which has previously been shown to decrease TEWL. The lipids in the simplified creams were either hydrocarbons or vegetable triglyceride oil, and one of them also contained 5% urea. After 7 weeks, treated and control forearms were exposed for 24 h to sodium lauryl sulfate (SLS) using a patch test. TEWL, blood flow and skin capacitance of both SLS-exposed and undamaged skin were evaluated 24 h after removal of patches. Additionally, a 24-h irritancy patch test of all test preparations was performed on 11 volunteers in order to check their possible acute irritancy potential.
Results Changes were found in the barrier function of normal skin after 7 weeks of treatment with the test preparations. The simplified creams and the lipid-free gel increased TEWL and skin response to SLS, while the ordinary cream had the opposite effect. One of the simplified creams also decreased skin capacitance. All test preparations were shown to be nonirritant, both by short-term irritancy patch test and by measurement of blood flow after long-term treatment.
Conclusions Moisturizers influence the skin barrier function of normal skin, as measured by TEWL and susceptibility to SLS. Moreover, the effect on skin barrier function is determined by the composition of the moisturizer. The ingredients which influence the skin barrier function need to be identified, and the mechanism clarified at the molecular level.