Background/purpose: The eyelid constitutes a unique area on the face because of its soft, smooth and thin skin distinct from that of other facial portions. Its softness facilitates their easy compliance to blinking movement, which is indispensable to protect the wet surface of the eyeball. Moreover, the skin of the eyelid does not show any prominent follicular orifices or an oily appearance even in adults. Despite such uniqueness, its biophysical characteristics have remained unclear as compared with other facial skin.
Methods: We conducted non-invasive instrumental measurements on the skin of the upper eyelid of 22 healthy Japanese adults in comparison with those of the adjacent facial skin, i.e. the cheek and nose. Additionally, we examined 10 adult patients with atopic dermatitis (AD) whose facial skin remained clinically free from skin lesions for at least 2 months.
Results: The eyelid skin showed high transepidermal water loss like other facial skin. Its skin surface hydration state was as high as that of the adjacent skin, despite the fact that the eyelid skin revealed extremely low amounts of surface lipids unlike its neighboring skin regions. However, in contrast to small corneocytes found in other facial areas, the corneocytes of the eyelid skin displayed a significantly larger surface size, suggesting that slow turnover of its stratum corneum (SC) takes place to allow sufficient maturation of the corneocytes, enabling them to exert efficient water-binding capacity. Its pH tended to be higher than that of the adjacent skin. Its superficial blood flow was significantly higher than that of others, although skin color assessment showed lower color values for redness than those of the other facial skin sites. In clinically non-lesional skin of adult AD patients, we found increased blood circulation and a higher parameter for redness, suggesting the presence of invisible mild inflammation in the dermis even long after subsidence of visible inflammatory changes.
Conclusion: Our present biophysical findings suggest that, although the eyelid skin is poor in surface lipids, its extraordinary large superficial corneocytes play an important role in maintaining sufficient hydration state of its skin surface to keep it soft and flexible, enabling its good compliance with the blinking movement.