Funding sources This study was supported by research funding from the Kuwait Ministry of Health to T.Al-E. and A.S.
CLINICAL AND LABORATORY INVESTIGATIONS
The effect of aqueous cream BP on the skin barrier in volunteers with a previous history of atopic dermatitis
Article first published online: 11 JUL 2011
© 2011 The Authors. BJD © 2011 British Association of Dermatologists 2011
British Journal of Dermatology
Volume 165, Issue 2, pages 329–334, August 2011
How to Cite
Danby, S.G., Al-Enezi, T., Sultan, A., Chittock, J., Kennedy, K. and Cork, M.J. (2011), The effect of aqueous cream BP on the skin barrier in volunteers with a previous history of atopic dermatitis. British Journal of Dermatology, 165: 329–334. doi: 10.1111/j.1365-2133.2011.10395.x
Conflicts of interest None declared.
- Issue published online: 20 JUL 2011
- Article first published online: 11 JUL 2011
- Accepted manuscript online: 12 MAY 2011 09:39AM EST
- Accepted for publication 25 April 2011
Background The emollient aqueous cream BP is frequently used for the treatment of atopic dermatitis (AD), yet it is associated with a high rate of adverse cutaneous reactions. It contains the harsh anionic surfactant sodium lauryl sulphate, a known negative environmental factor associated with the exacerbation of AD.
Objectives To investigate the effect of aqueous cream BP on stratum corneum (SC) integrity and skin barrier function in volunteers with a predisposition to a defective skin barrier.
Methods Thirteen volunteers with a previous history of AD (no symptoms for 6 months) applied aqueous cream BP twice daily to the volar side of one forearm for 4 weeks. The other forearm was left untreated as a control. Permeability barrier function and SC integrity were determined before and after treatment by measuring transepidermal water loss (TEWL) in conjunction with tape-stripping. For comparison, 13 volunteers with current AD were recruited for assessment, without treatment, of SC integrity and skin barrier function at unaffected sites.
Results Topical application of aqueous cream BP resulted in significant elevation of baseline TEWL and a concomitant decrease in SC integrity. Measurements made after no treatment in volunteers with current AD, at unaffected sites, suggest that application of aqueous cream BP negatively affects the skin barrier towards the damaged state associated with onset of flares of the disease.
Conclusions Aqueous cream BP used as a leave-on emollient caused severe damage to the skin barrier in volunteers with a previous history of AD. Aqueous cream BP should not be used as a leave-on emollient in patients with AD.