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Yoon EJ, Kwon EH, Kim JH, Delacruz J, Symons TB, Lee S, Park D. Influence of cosmetic foundation cream on skin condition during treadmill exercise. J Cosmet Dermatol 2024; 23:1884-1890. [PMID: 38444348 DOI: 10.1111/jocd.16205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 01/11/2024] [Accepted: 01/22/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND There is a growing trend of individuals wearing cosmetics while participating in physical activities. Nonetheless, there remains a need for further understanding regarding the effects of makeup on the facial epidermis during exercise, given the existing knowledge gaps. PURPOSE This study aimed to evaluate the effects of a cosmetic foundation cream on skin conditions during physical activity. METHODS Forty-three healthy college students, 20 males (26.3 ± 1.5 years) and 23 females (23.1 ± 1.0 years), were enrolled in this study. Foundation cream was applied to participants on half of the face in two different areas (MT: makeup T zone and MU: makeup U zone). The other half of the face served as internal control (T: non-makeup T zone and U: non-makeup U zones). Skin levels of moisture, elasticity, pore, sebum, and oil were measured using a skin analysis device (Aramhuvis, Gyeonggi, Republic of Korea) before and after a 20-min treadmill exercise. Paired t-test and independent t-test were performed for skin condition measurements at pre- and postexercise. RESULTS The skin moisture levels in both the T and MT significantly increased after exercise (p < 0.05) (pre-T: 24.5 ± 1.3, post-T: 38.5 ± 3.5 and pre-MT: 18.7 ± 0.7, post-MT: 40.4 ± 4.8). Elasticity also significantly improved in both the T and MT (p < 0.05) (pre-T: 25.6 ± 1.3, post-T: 41.5 ± 3.5 and pre-MT: 20.0 ± 0.9, post-MT: 41.7 ± 3.7). The size of the pores in the T zone observed a significant increase after exercise (p < 0.05) (pre-T: 41.7 ± 2.1, post-T: 47.8 ± 2.4). The sebum levels in the T zone exhibited a reduction following physical activity, whereas there was a notable increase in sebum levels in the makeup zones (p < 0.05) (pre-MT: 2.4 ± 0.7, post-MT:4.2 ± 0.8 and pre MU 1.8 ± 0.34, post MU 4.9 ± 0.9). The oil level was increased in the non-makeup zones (pre-T: 6.1 ± 1.4, post-T: 11.8 ± 2.0 and pre-U: 7.3 ± 1.5, post-U: 11.9 ± 1.9; p < 0.05) and decreased in the makeup zones (pre-MT: 13.3 ± 1.9, post-MT: 7.4 ± 2.3 and pre-MU: 22.1 ± 2.4, post-MU: 3.2 ± 1.0; p < 0.05). CONCLUSIONS The findings suggest that using foundation cream during aerobic exercise can reduce skin oil, causing dryness. Additionally, makeup can clog pores and increase sebum production. Therefore, wearing makeup may not be recommended for people with dry skin conditions based on the results of the current study. This research offers important insights to the public, encouraging them to consider the possible consequences of using makeup while exercising.
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Affiliation(s)
- Eun-Jung Yoon
- Department of Counselling, Health, and Kinesiology, Texas A&M University-San Antonio, San Antonio, Texas, USA
- Department of Life Sports Educator, Kongju National University, Kongju, Korea
| | - Eun Hye Kwon
- Department of Counselling, Health, and Kinesiology, Texas A&M University-San Antonio, San Antonio, Texas, USA
| | - Joo Hyun Kim
- Department of Counselling, Health, and Kinesiology, Texas A&M University-San Antonio, San Antonio, Texas, USA
| | - Jesse Delacruz
- Department of Counselling, Health, and Kinesiology, Texas A&M University-San Antonio, San Antonio, Texas, USA
| | - T Brock Symons
- Department of Counselling, Health, and Kinesiology, Texas A&M University-San Antonio, San Antonio, Texas, USA
| | - Sukho Lee
- Department of Counselling, Health, and Kinesiology, Texas A&M University-San Antonio, San Antonio, Texas, USA
| | - Dongsun Park
- Department of Biology Education, Korea National University of Education, Cheongju, Korea
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Filippi F, Chessa MA, Bardazzi F, Pileri A, Patrizi A. An easy to use, ceramide-containing skincare routine: effectiveness and improvement of quality of life in elderly patients with xerosis. Ital J Dermatol Venerol 2023; 158:429-436. [PMID: 37930017 DOI: 10.23736/s2784-8671.23.07533-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
BACKGROUND Xerosis negatively impacts the quality of life (QoL) for older adults by producing pruritus (itching), burning or stinging, and an uncomfortable sensation of tightness in the skin. Furthermore, chronic illness and pharmacological therapies could worsen skin health. Severe xerosis can also result in redness or cracking of the skin. The aim of this prospective open-label trial is to evaluate the effectiveness of a ceramide-based moisturizing cream and cleanser routine on elderly xerosis. METHODS During the 4-week treatment study, patients followed the routine according to the established protocol. At different timepoints (baseline, visit 1; after 28±5 days, visit 2) evaluations on the skin health and QoL of the patients were conducted by a healthcare professional (HCP), along with a patients' self-evaluation. RESULTS The study demonstrates that the treatment with the investigated products determines an overall significant improvement in all skin dryness criteria. In particular, after the observational period: 93% of the subjects had no or minimal skin roughness; 96% of patients had no or minimal discomfort due to skin dryness; 97% of patients did not present any fissures; patient self-assessments on skin dryness were consistent with HCP evaluation. QoL has globally improved in all patients, with a significant reduction of embarrassment, and a positive impact on social and daily activities. Patients' overall satisfaction was high in 87% of patients and 93% of them stated that they would continue the treatment also after the study had been completed. CONCLUSIONS After 4 weeks, the daily use of a ceramide-based routine significantly improved signs and symptoms of senile xerosis and chronic discomfort associated with xerosis in elderly adults. Furthermore, the impact of senile xerosis on subjects' QoL was also reduced after 4 weeks. The subjects also reported high satisfaction with the skincare regimen and its results.
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Affiliation(s)
- Federica Filippi
- Dermatology Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy -
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy -
| | - Marco A Chessa
- Dermatology Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Federico Bardazzi
- Dermatology Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Alessandro Pileri
- Dermatology Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Annalisa Patrizi
- Dermatology Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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Amin R, Völzer B, Genedy-Kalyoncu ME, Blume-Peytavi U, Kottner J. The prevalence and severity of dry skin and related skin care in older adult residents in institutional long-term care: A cross-sectional study. Geriatr Nurs 2023; 54:331-340. [PMID: 37950968 DOI: 10.1016/j.gerinurse.2023.10.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 11/13/2023]
Abstract
OBJECTIVES To identify possible factors associated with different severities of xerosis cutis and to describe possible associations between (skin) care dependency and application of moisturizers. DESIGN Cross-sectional study using baseline data from a cluster-randomized controlled trial. Demographic and health characteristics, skin physiological measurements, functional abilities and application of moisturizers were compared between the participants with mild and severe dry skin. Frequency of moisturization were also compared based on the participants' skin care dependency. RESULTS The more distal the body area, the more severe xerosis were observed. There were no or minor differences between the groups, except for the stratum corneum hydration and skin surface pH. Participants with severe xerosis received moisturizers less often. Skin care dependent residents received moisturizers frequently. CONCLUSION There is under-application regarding xerosis cutis treatment in long-term care. Skin care provided by nurses, in adequate frequencies, might be helpful compared to skin care performed by the residents themselves.
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Affiliation(s)
- Ruhul Amin
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Clinical Research Center for Hair and Skin Science, Charitéplatz 1, 10117 Berlin, Germany; BCSIR Laboratories Dhaka, Bangladesh Council of Scientific and Industrial Research, Dhaka, Bangladesh
| | - Bettina Völzer
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Clinical Nursing Science, Charitéplatz 1, 10117 Berlin, Germany
| | - Monira El Genedy-Kalyoncu
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Clinical Nursing Science, Charitéplatz 1, 10117 Berlin, Germany
| | - Ulrike Blume-Peytavi
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Clinical Research Center for Hair and Skin Science, Charitéplatz 1, 10117 Berlin, Germany
| | - Jan Kottner
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Clinical Nursing Science, Charitéplatz 1, 10117 Berlin, Germany.
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Yao D, Gong X, Ma Y, Gong T, Wang G. The prevalence and interventions of xerosis cutis among older adults: A systematic review and meta-analysis. Geriatr Nurs 2023; 54:219-228. [PMID: 37844538 DOI: 10.1016/j.gerinurse.2023.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/22/2023] [Accepted: 09/26/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Xerosis cutis in older adults is a geriatric public health issue that severely affects healthy aging, associated with adverse outcomes and increased nursing burden. Skin care plays a significant role in the management of xerosis cutis. AIM To assess the pooled prevalence and interventions of xerosis cutis among older adults. METHODS We searched ten databases systematically from inception to August 29, 2023. We estimated pooled prevalence of xerosis cutis using Stata 15.0. RESULTS 28 articles were included in this review. The pooled prevalence of xerosis cutis was 53 %(95 %CI:36-69 %). We found the prevalence of xerosis cutis was highest in nursing homes and developed countries. The prevalence of xerosis cutis was similar in males and females. The prevalence of mild xerosis cutis and xerosis cutis at lower limbs was relatively high. Regular use of humectant-containing leave-on skin care products and structured skin care regimens were helpful in alleviating xerosis cutis. CONCLUSION Older adults are at high risk for xerosis cutis. The research provides health professionals with a basic framework for the prevention and management of xerosis cutis.
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Affiliation(s)
- Dan Yao
- College of Nursing, Chengdu University of Traditional Chinese Medicine, No.1166 Liutai Road, Wenjiang District, Chengdu City, Sichuan province 611137, China
| | - Xiaoyan Gong
- College of Nursing, Chengdu University of Traditional Chinese Medicine, No.1166 Liutai Road, Wenjiang District, Chengdu City, Sichuan province 611137, China
| | - Yao Ma
- School of Medicine, University of Electronic Science and Technology of China, No.4, Section 2, Jianshe north Road, Chenghua District, Chengdu City, Sichuan province 610054, China
| | - Ting Gong
- Department of Nursing, Chengdu second people's hospital, No. 10, Qingyun South Street, Jinjiang District, Chengdu City, Sichuan province 610017, China
| | - Guorong Wang
- Department of Nursing, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Cancer Hospital affiliate to University of Electronic Science and Technology of China, No. 55, Section 4, Renmin south Road, Wuhou District, Chengdu City, Sichuan province 610042, China.
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Aoki M, Hata N, Yotsuya J. Effectiveness of Three Types of Moisturizers on Senile Dry Skin: A Randomized Controlled Pilot Trial. Dermatol Res Pract 2023; 2023:1809109. [PMID: 37520456 PMCID: PMC10374378 DOI: 10.1155/2023/1809109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 06/15/2023] [Accepted: 06/30/2023] [Indexed: 08/01/2023] Open
Abstract
Background For dry skin, the application of a hypoallergenic moisturizer twice daily is recommended in elderly individuals. However, it is not known which is the most effective and appropriate moisturizer among the commercially available moisturizers. Aims In this study, we aimed to investigate the efficacy of the three widely used moisturizers for the treatment of senile dry skin. Patients/Methods. This interventional study involved elderly individuals aged >65 years who were living in a nursing home. The participants were randomly divided into the interventional (moisturizers A, B, and C) and conventional care groups. Moisturizers A, B, and C were applied on the skin of each member of the three intervention groups twice daily for 8 weeks. The water content of the stratum corneum and transepidermal water loss (TEWL) were evaluated before and after the intervention. Changes in these parameters among the groups were compared using two-way analysis of variance and a posthoc test. Results Moisturizers A, B, and C and conventional care groups comprised six, seven, five, and four participants, respectively. The water content of the stratum corneum was significantly higher in the moisturizer A (p = 0.01) and B (p = 0.047) groups than in the conventional care group. There was no significant difference in TEWL among the groups. Conclusions In terms of the appearance of the skin, white powder and small scales were both reduced in group A. Taken together with the water content, this was considered a clinically significant change.
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Affiliation(s)
- Miku Aoki
- Division of Nursing, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Natsuki Hata
- Department of Nursing, Graduate School of Medical Sciences, University of Fukui, Fukui, Japan
| | - Junko Yotsuya
- Division of Nursing, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
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Bratkovskaya AV, Snarskaya ES. Novel filagrinol-containing emollient. VESTNIK DERMATOLOGII I VENEROLOGII 2022. [DOI: 10.25208/vdv1342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
ABSTRACT:In the last decade, there has been a significant increase in interest in the study of the role of epidermal barrier structural integrity in order to determine the prospects for its pathogenetic correction. It is now known that patients with filaggrin gene mutations have increased risk of developing atopic dermatitis, xerosis, ichthyosis, eczema. Filaggrin participates in the formation of a full-fledged stratum corneum, provides formation of a natural moisturizing factor, stabilizing the water balance of the stratum corneum. In Russia, the innovative filaggrin-containing "Admera" has been registered, which opens up prospects in the management impaired skin barrier function diseases.
Aims:efficacy and safety of "Admera" emollient in patients with primary and secondary xerosis.
Methods:A single-center prospective interventional study December 2021 - March 2022 at the Department of Skin and Venereal Diseases of the Sechenov University. The study included 32 patients (22 - main group, 10 - control group) aged 18 to 60 years (29 9.78), 14 men and 18 women diagnosed with skin xerosis. Patients applied moisturizers 3 times a day for 21 days. Performance was evaluated using vIGA-AD, POEM, EASI, 5D Elman scale, SKINDEX-29, HADS, on Capricorn AI, ANTERA 3D machines.
Results:A steady regression of clinical symptoms of xerosis was noted during the study by the dynamics of the study scales. The mean EASI score decreased by 67% from 25.25 18.78 - screening to 7.8 4.41 - control visit (p 0.001). Assessment of POEM index dynamics showed a significant decrease in total score from 18.65 to 6.6 (p 0.001). There was good tolerability of the drug and absence of adverse events.
Conclusion:The filagrinol-containing emollient "Admera" demonstrated high efficacy and safety in all patients. This emollient can be recommended as a basic care product for treatment and prevention of primary, secondary xerosis, relapses of atopic dermatitis.
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Shin KO, Mihara H, Ishida K, Uchida Y, Park K. Exogenous Ceramide Serves as a Precursor to Endogenous Ceramide Synthesis and as a Modulator of Keratinocyte Differentiation. Cells 2022; 11:cells11111742. [PMID: 35681438 PMCID: PMC9179460 DOI: 10.3390/cells11111742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/18/2022] [Accepted: 05/18/2022] [Indexed: 12/16/2022] Open
Abstract
Since ceramide is a key epidermal barrier constituent and its deficiency causes barrier-compromised skin, several molecular types of ceramides are formulated in commercial topical agents to improve barrier function. Topical ceramide localizes on the skin surface and in the stratum corneum, but certain amounts of ceramide penetrate the stratum granulosum, becoming precursors to endogenous ceramide synthesis following molecular modification. Moreover, exogenous ceramide as a lipid mediator could modulate keratinocyte proliferation/differentiation. We here investigated the biological roles of exogenous NP (non-hydroxy ceramide containing 4-hydroxy dihydrosphingosine) and NDS (non-hydroxy ceramide containing dihydrosphingosine), both widely used as topical ceramide agents, in differentiated-cultured human keratinocytes. NDS, but not NP, becomes a precursor for diverse ceramide species that are required for a vital permeability barrier. Loricrin (late differentiation marker) production is increased in keratinocytes treated with both NDS and NP vs. control, while bigger increases in involucrin (an early differentiation marker) synthesis were observed in keratinocytes treated with NDS vs. NP and control. NDS increases levels of a key antimicrobial peptide (an innate immune component), cathelicidin antimicrobial peptide (CAMP/LL-37), that is upregulated by a ceramide metabolite, sphingosine-1-phosphate. Our studies demonstrate that NDS could be a multi-potent ceramide species, forming heterogenous ceramide molecules and a lipid mediator to enhance differentiation and innate immunity.
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Affiliation(s)
- Kyong-Oh Shin
- Department of Food Science & Nutrition, Convergence Program of Material Science for Medicine and Pharmaceutics, Hallym University, Chuncheon 31151, Korea;
- The Korean Institute of Nutrition, Hallym University, Chuncheon 31151, Korea
- LaSS Lipid Institute (LLI), LaSS Inc., Chuncheon 31151, Korea
| | - Hisashi Mihara
- Takasago International Company, Hiratsuka 259-1207, Japan; (H.M.); (K.I.)
| | - Kenya Ishida
- Takasago International Company, Hiratsuka 259-1207, Japan; (H.M.); (K.I.)
| | - Yoshikazu Uchida
- Department of Food Science & Nutrition, Convergence Program of Material Science for Medicine and Pharmaceutics, Hallym University, Chuncheon 31151, Korea;
- The Korean Institute of Nutrition, Hallym University, Chuncheon 31151, Korea
- Veterans Affairs Medical Center, Department of Dermatology, School of Medicine, Northern California Institute for Research and Education, University of California, San Francisco, CA 94158, USA
- Correspondence: (Y.U.); (K.P.); Tel.: +82-33-248-3146 (Y.U.); +82-33-248-2131 (K.P.)
| | - Kyungho Park
- Department of Food Science & Nutrition, Convergence Program of Material Science for Medicine and Pharmaceutics, Hallym University, Chuncheon 31151, Korea;
- The Korean Institute of Nutrition, Hallym University, Chuncheon 31151, Korea
- Correspondence: (Y.U.); (K.P.); Tel.: +82-33-248-3146 (Y.U.); +82-33-248-2131 (K.P.)
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Kim S, Ly BK, Ha JH, Carson KA, Hawkins S, Kang S, Chien AL. A consistent skin care regimen leads to objective and subjective improvements in dry human skin: investigator-blinded randomized clinical trial. J DERMATOL TREAT 2022; 33:300-305. [PMID: 32239984 PMCID: PMC7529700 DOI: 10.1080/09546634.2020.1751037] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Dry, itchy skin can lower quality of life (QoL) and aggravate skin diseases. Moisturizing skin care products can have beneficial effects on dry skin. However, the role of a daily skin care routine is understudied. OBJECTIVE To understand how daily skin care with a mild cleanser and moisturizer impacts skin health and patients' QoL, in dry skin population. METHODS A randomized, investigator-blinded study of 52 participants with moderate to severe dry skin. The treatment group (n = 39) used mild cleanser and moisturizer twice daily for two weeks whereas the control group (n = 13) used mild cleanser without moisturizer. Total Clinical Score (TCS; erythema, scale and fissures), Visual Dryness Score (VDS) and subjective itch-related quality of life (ItchyQoL) were collected. RESULTS The treatment group showed significantly more improvement in TCS and VDS compared to the control group after two weeks. Among the three components of the ItchyQoL (symptoms, functioning, and emotions), symptom showed significantly greater improvement in the treatment compared to the control group. Over 80% of participants in the treatment group agreed that the regimen led to decrease in dryness/pruritus and improved skin texture. CONCLUSIONS A consistent skin care regimen should be an integral component of management of dry skin.
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Affiliation(s)
- Sooyoung Kim
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD,Department of Dermatology, Soonchunhyang University Hospital, Seoul, South Korea
| | - Baochau K. Ly
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Judy H. Ha
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Kathryn A. Carson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | | | - Sewon Kang
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Anna L. Chien
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD
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Mornane C, Peck B, Terry D, Ryan M. Twice-Daily Moisturizer Application for Skin Tear Prevention among Older Adults in Acute Care. Adv Skin Wound Care 2021; 34:1-4. [PMID: 33443915 DOI: 10.1097/01.asw.0000725180.14180.da] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine the effectiveness of twice-daily moisturizer application for patients admitted to an acute care setting on reducing the incidence of skin tear (ST) injuries. DESIGN, SETTING, AND PARTICIPANTS This prospective, nonrandomized, case-control study identified an experimental and control ward equivalent in demography and patient acuity in a large hospital in regional Victoria, Australia. Patients 70 years or older admitted to the wards were invited to participate. INTERVENTION Twice-daily application of a commercially available skin and body lotion to the arms and legs of participants. MAIN OUTCOME MEASURES The incidence of ST in the experimental and control settings in the pre-, intra-, and posttrial periods. MAIN RESULTS Although a decrease in ST incidence was observed over the study period (n = 128), this decrease was not significant pre- (median = 2.16, n = 73), intra- (median = 2.16, n = 73), or postintervention (median = 2.16, n = 69; χ[2, 152] = 0.502, P = .778). Similarly, there was no significant difference between wards (median = 9.86 [n = 152] vs median = 13.14 [n = 177]; U = 42.50, z = -1.198, r = 0.358, P = .231). CONCLUSIONS The moisturizer in this study did not have a direct influence on the frequency of STs in the study population, although the data would suggest an intermittent reduction in ST incidence. The authors postulate that this was correlated with behavior change effects from the study.
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Affiliation(s)
- Carolyn Mornane
- In Ballarat, Victoria, Australia, Carolyn Mornane, RN, is Clinical Nurse Consultant, Stomal Therapy, Wound Care, Breast Care, St John of God Ballarat Hospital; Blake Peck, PhD, RN, BN (Hon), is Senior Lecturer and Postgraduate Coordinator, School Health, Federation University; Daniel Terry, PhD, MS, BN, RN, is Senior Lecturer, School of Health, Federation University; and Michael Ryan, RN, BN, is Deputy Director of Nursing, St John of God Ballarat Hospital. Acknowledgment: The authors thank St John of God Ballarat Hospital, the hospital's Rehabilitation Ward clinical staff, Ms Elizabeth McEncroe (Nurse Unit Manager), Ms Helen Rundell (Clinical Risk and Quality Manager), Ms Michelle Franc (Manager, Health Information Services), and Hartmann Australia for agreeing to donate the MoliCare skin and body lotion for the purpose of this study. The authors have disclosed no other financial relationships related to this article. Submitted February 24, 2020; accepted in revised form April 7, 2020
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Khmaladze I, Leonardi M, Fabre S, Messaraa C, Mavon A. The Skin Interactome: A Holistic "Genome-Microbiome-Exposome" Approach to Understand and Modulate Skin Health and Aging. Clin Cosmet Investig Dermatol 2021; 13:1021-1040. [PMID: 33380819 PMCID: PMC7769076 DOI: 10.2147/ccid.s239367] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 11/26/2020] [Indexed: 12/13/2022]
Abstract
Higher demands on skin care cosmetic products for strong performance drive intense research to understand the mechanisms of skin aging and design strategies to improve overall skin health. Today we know that our needs and influencers of skin health and skin aging change throughout our life journey due to both extrinsic factors, such as environmental factors and lifestyle factors, as well as our intrinsic factors. Furthermore, we need to consider our microflora, a collection of micro-organisms such as bacteria, viruses, and fungi, which is a living ecosystem in our gut and on our skin, that can have a major impact on our health. Here, we are viewing a holistic approach to understand the collective effect of the key influencers of skin health and skin aging both reviewing how each of them impact the skin, but more importantly to identify molecular conjunction pathways of these different factors in order to get a better understanding of the integrated “genome-microbiome-exposome” effect. For this purpose and in order to translate molecularly the impact of the key influencers of skin health and skin aging, we built a digital model based on system biology using different bioinformatics tools. This model is considering both the positive and negative impact of our genome (genes, age/gender), exposome: external (sun, pollution, climate) and lifestyle factors (sleep, stress, exercise, nutrition, skin care routine), as well as the role of our skin microbiome, and allowed us in a first application to evaluate the effect of the genome in the synthesis of collagen in the skin and the determination of a suitable target for boosting pro-collagen synthesis. In conclusion, we have, through our digital holistic approach, defined the skin interactome concept, as an advanced tool to better understand the molecular genesis of skin aging and further develop a strategy to balance the influence of the exposome and microbiome to protect, prevent, and delay the appearance of skin aging signs and preserve good skin health condition. In addition, this model will aid in identifying and optimizing skin treatment options based on external triggers, as well as helping to design optimal treatments modulating the intrinsic pathways.
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Affiliation(s)
- Ia Khmaladze
- Skin Research Institute, Oriflame Cosmetics AB, Stockholm, Sweden
| | - Michele Leonardi
- Skin Research Institute, Oriflame Cosmetics AB, Stockholm, Sweden
| | - Susanne Fabre
- Skin Research Institute, Oriflame Cosmetics AB, Stockholm, Sweden
| | - Cyril Messaraa
- Research and Development, Oriflame Cosmetics Ltd, Bray, Ireland
| | - Alain Mavon
- Skin Research Institute, Oriflame Cosmetics AB, Stockholm, Sweden
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Abstract
Importance: Consumers purchase a wide variety of consumer products and come into contact with these products on a daily basis. Manufacturers invest deeply in developing new products or improving existing products, in order to produce a positive impact on the lives of consumers. Objective: The goal of this study was to determine the impact of over-the-counter skin care products on the quality of life (QoL) of female consumers. Design and Measures: A QoL instrument developed for consumer products (the Farage QoL with an added Skin Care Module) was used to assess the impact of a 28-day facial skin care regimen using commercially available products formulated to improve elasticity, firmness and hydration, and to correct age- and sun-related skin color. Responses were collected prior to study commencement, at completion of the product usage stage, and after a period of withdrawal of the product with reversion to a basic skin care regimen. Participants: Two main study groups from Australia included 89 new mothers, i.e., women with children 2 years and under (mean age ± SD was 34 ± 4.8), and a national representative sample of 91 women (45 ± 12). An additional test group from China consisted of 40 younger cosmetic users (25 ± 4.3). The Skin Care Module was not included in the instrument for the third group. Results: After 28-days of usage, both test groups in the main study showed significant improvement in three of five items in the Skin Care Module (improved feelings of empowerment, happiness and self-esteem). Improvements persisted after 2 weeks of product withdrawal. In the main QoL instrument, the New Mothers group showed significant improvement in the Well-Being domain, driven by improvements in the Self-Image and Self Competence subdomains. The National Representative group showed improvements in the Energy and Vitality domain, driven by improvements in the Personal Pleasure, Physical State and Routine Activity subdomains. The additional group in the China study showed results similar to the New Mothers group. Conclusions and Relevance: A quality and efficacious skin care regimen can have a positive impact on the QoL of consumers. Differences in responses of the test groups were likely related to differences in the mean age and differences in time available to look after themselves.
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Howell AN, Ghamrawi RI, Strowd LC, Feldman SR. Pharmacological management of atopic dermatitis in the elderly. Expert Opin Pharmacother 2020; 21:761-771. [PMID: 32100586 DOI: 10.1080/14656566.2020.1729738] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 02/11/2020] [Indexed: 12/22/2022]
Abstract
INTRODUCTION The prevalence of atopic dermatitis (AD) in geriatric populations of industrialized countries is currently estimated at 3-4% and continues to increase. AD is associated with significant morbidity, increased susceptibility to infection, and symptoms of pruritus and pain. Treatments may negatively affect elderly patients; thus, plans should be optimized for this population. AREAS COVERED This review summarizes treatment options for AD in the elderly. A systematic review of the literature was conducted using the key terms atopic dermatitis, elderly, geriatric, systemic therapy, therapy, and topical therapy in PubMed. Searches yielded articles on skincare management and topical and systemic pharmacotherapies. EXPERT OPINION Proper use of moisturizer is crucial in all patients with AD. Topical corticosteroids are commonly prescribed; however, they carry an increased risk of adverse events such as skin atrophy. Systemic corticosteroids should be avoided in elderly patients due to questionable efficacy and increased adverse events. Topical calcineurin inhibitors and crisaborole are similarly efficacious with an excellent safety profile. Cyclosporine, azathioprine, methotrexate, and mycophenolate mofetil are systemic agents available for the treatment of refractory AD; however, insufficient data exist to indicate the superiority of any one agent. Dupilumab is a safe and efficacious injectable therapy in elderly patients.
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Affiliation(s)
- Alexander N Howell
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine , Winston-Salem, NC, USA
| | - Rima I Ghamrawi
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine , Winston-Salem, NC, USA
| | - Lindsay C Strowd
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine , Winston-Salem, NC, USA
| | - Steven R Feldman
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine , Winston-Salem, NC, USA
- Department of Pathology, Wake Forest School of Medicine , Winston-Salem, NC, USA
- Department of Social Sciences & Health Policy, Wake Forest School of Medicine , Winston-Salem, NC, USA
- Department of Dermatology, University of Southern Denmark , Odense, Denmark
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13
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Maintaining skin integrity in the aged: A systematic review. Int J Nurs Stud 2019; 103:103509. [PMID: 31945604 DOI: 10.1016/j.ijnurstu.2019.103509] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 09/11/2019] [Accepted: 12/16/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND In aged nursing care receivers, the prevalence of adverse skin conditions such as xerosis cutis, intertrigo, pressure ulcers or skin tears is high. Adequate skin care strategies are an effective method for maintaining and enhancing skin health and integrity in this population. OBJECTIVES The objective was to summarize the empirical evidence about the effects and effectiveness of non-drug topical skin care interventions to promote and to maintain skin integrity and skin barrier function in the aged, to identify outcome domains and outcome measurement instruments in this field. DESIGN An update of a previous systematic review published in 2013 was conducted. DATA SOURCES Databases MEDLINE and EMBASE via OvidSP and CINAHL (original search January 1990 to August 2012, update September 2012 to May 2018) and reference lists were searched. Forward searches in Web of Science were conducted. METHODS A review protocol was registered in Prospero (CRD42018100792). Main inclusion criteria were primary intervention studies reporting treatment effects of basic skin care strategies in aged people with a lower limit of age range of 50 years and published between 1990 and 2018. Primary empirical studies were included with experimental study designs including randomized controlled trials and quasi-experimental designs. Methodological quality of included randomized controlled trials was evaluated using the Cochrane Collaboration's Tool for assessing risk of bias. Levels of evidence were assigned to all included studies. RESULTS Sixty-three articles were included in the final analysis reporting effects of interventions to treat and/or to prevent skin dryness, pruritus, general skin barrier improvement, incontinence-associated dermatitis, skin tears and pressure ulcers. Skin cleansers containing syndets or amphotheric surfactants compared with standard soap and water improved skin dryness. Lipophilic leave-on products containing humectants decreased skin dryness and reduced pruritus. Products with pH 4 improved the skin barrier. Application of skin protectants and structured skin care protocols decreased the severity of incontinence-associated dermatitis. Formulations containing glycerin and petrolatum reduced the incidence of skin tears. Thirty-five outcome domains were identified with nearly 100 different outcome measurement instruments. CONCLUSION Included studies showed substantial heterogeneity regarding design, interventions and outcomes. Basic skin care strategies including low-irritating cleansers and lipophilic humectant-containing leave-on products are helpful for treating dry skin and improving skin barrier in the aged. Lower pH of leave-on products improves the skin barrier. The number of different outcome domains was unexpectedly high. We recommend to identify critical outcome domains in the field of skin care to make trial results more comparable in the future and to measure possible performance differences between different skin care strategies and products.
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Messaraa C, Robertson N, Walsh M, Hurley S, Doyle L, Mansfield A, Daly L, Tansey C, Mavon A. Clinical evidences of benefits from an advanced skin care routine in comparison with a simple routine. J Cosmet Dermatol 2019; 19:1993-1999. [PMID: 31840424 DOI: 10.1111/jocd.13252] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 11/20/2019] [Accepted: 11/21/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND The use of a skin care routine is commonly promoted by the cosmetic industry, yet there is a lack of clinical evidence to support this practice over the use of a single skin care product. AIMS In the present study, we aimed at showing the clinical benefits of using a comprehensive skin care routine vs a simple one. METHODS Skin micro-/macro-topographic, skin color, and superficial/deep hydration were collected at baseline and after 4 weeks of use, on forty-nine women randomly allocated to two groups. The first one followed the use of an advanced routine (AR: Cleanser/Toner/Eye cream/Serum/Day & Night cream), while the other group was instructed to use a simple routine (SR: Cleanser & Day cream). RESULTS Hemoglobin heterogeneity was found to be significantly reduced only in the SR group. However, the AR outperformed the SR when it comes to improving superficial hydration, deep hydration, skin roughness, mean pore area, melanin heterogeneity, and crow's feet wrinkle depth. A significant increase in skin brightness from baseline was only recorded when using the AR while both routines significantly improved the nasolabial wrinkles. CONCLUSION These findings advocate for using a relevant daily routine as it demonstrates the visible skin benefits over a short period, while driving the creation of habits for the prevention of aging signs.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Alain Mavon
- Oriflame Skin Research Institute, Oriflame Cosmetics AB, Stockholm, Sweden
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15
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Lueangarun S, Soktepy B, Tempark T. Efficacy of anti‐inflammatory moisturizer vs hydrophilic cream in elderly patients with moderate to severe xerosis: A split site, triple‐blinded, randomized, controlled trial. J Cosmet Dermatol 2019; 19:1432-1438. [DOI: 10.1111/jocd.13183] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/03/2019] [Accepted: 09/17/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Suparuj Lueangarun
- Division of Dermatology Chulabhorn International College of Medicine Thammasat University Amphur Klongluang Thailand
| | - Bith Soktepy
- Division of Dermatology Chulabhorn International College of Medicine Thammasat University Amphur Klongluang Thailand
| | - Therdpong Tempark
- Department of Pediatrics Faculty of Medicine King Chulalongkorn Memorial Hospital Chulalongkorn University Bangkok Thailand
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Abstract
Human skin is the largest organ of the body and is an effective physical barrier keeping it from environmental conditions. This barrier function of the skin is based on stratum corneum, located in the uppermost skin. Stratum corneum has corneocytes surrounded by multilamellar lipid membranes which are composed of cholesterol, free fatty acids and ceramides (CERs). Alterations in ceramide content of the stratum corneum are associated with numerous skin disorders. In recent years, CERs have been incorporated into conventional and novel carrier systems with the purpose of exogenously applying CERs to help the barrier function of the skin. This review provides an overview of the structure, function and importance of CERs to restore the barrier function of the skin following their topical application.
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17
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Harrison IP, Spada F. Breaking the Itch-Scratch Cycle: Topical Options for the Management of Chronic Cutaneous Itch in Atopic Dermatitis. MEDICINES (BASEL, SWITZERLAND) 2019; 6:medicines6030076. [PMID: 31323753 PMCID: PMC6789602 DOI: 10.3390/medicines6030076] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 07/12/2019] [Accepted: 07/16/2019] [Indexed: 04/13/2023]
Abstract
Chronic itch is an unpleasant sensation that triggers a desire to scratch that lasts for six weeks or more. It is a major diagnostic symptom of myriad diseases, including atopic dermatitis for which it is the most prominent feature. Chronic itch can be hugely debilitating for the sufferer, damaging in terms of both the monetary cost of treatment and its socioeconomic effects, and few treatment options exist that can adequately control it. Corticosteroids remain the first line treatment strategy for atopic dermatitis, but due to the risks associated with long-term use of corticosteroids, and the drawbacks of other topical options such as topical calcineurin inhibitors and capsaicin, topical options for itch management that are efficacious and can be used indefinitely are needed. In this review, we detail the pathophysiology of chronic pruritus, its key features, and the disease most commonly associated with it. We also assess the role of the skin and its components in maintaining a healthy barrier function, thus reducing dryness and the itch sensation. Lastly, we briefly detail examples of topical options for the management of chronic pruritus that can be used indefinitely, overcoming the risk associated with long-term use of corticosteroids.
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Affiliation(s)
- Ian P Harrison
- Department of Research and Development, Ego Pharmaceuticals Pty Ltd., 21-31 Malcolm Road, Braeside VIC 3195, Australia
| | - Fabrizio Spada
- Department of Research and Development, Ego Pharmaceuticals Pty Ltd., 21-31 Malcolm Road, Braeside VIC 3195, Australia.
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Lechner A, Lahmann N, Lichterfeld‐Kottner A, Müller‐Werdan U, Blume‐Peytavi U, Kottner J. Dry skin and the use of leave-on products in nursing care: A prevalence study in nursing homes and hospitals. Nurs Open 2019; 6:189-196. [PMID: 30534408 PMCID: PMC6279727 DOI: 10.1002/nop2.204] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 08/02/2018] [Accepted: 08/06/2018] [Indexed: 11/19/2022] Open
Abstract
AIMS To describe the prevalence of dry skin in nursing homes and hospitals and to describe relationships between topical skincare interventions and dry skin. DESIGN Two multicentre descriptive cross-sectional prevalence studies. METHODS The studies were performed in German nursing homes and hospitals in 2015 and 2016. Data were collected by trained nurses based on a standardized data collection form. The severity of dry skin was measured using the Overall Dry Skin Score. RESULTS In total, 1,662 nursing home residents and 1,486 hospital patients participated. The prevalence of dry skin was 41.2% in nursing homes and 55.2% in hospitals. In case of skincare dependency, the proportions of participants with dry skin were higher, particularly in hospitals (70.2%). In both institutions, the application of leave-on products increased when dry skin was present but remained lower in hospitals. Considering the high amount of skin dryness in skincare-dependent participants, interventions seem not to be successful. Results indicate a need for skincare improvement in future.
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Affiliation(s)
- Anna Lechner
- Department of Dermatology and Allergy, Clinical Research Center for Hair and Skin ScienceCharité – Universitätsmedizin BerlinBerlinGermany
| | - Nils Lahmann
- Department of Geriatrics, Nursing Research Group in GeriatricsCharité – Universitätsmedizin BerlinBerlinGermany
| | - Andrea Lichterfeld‐Kottner
- Department of Dermatology and Allergy, Clinical Research Center for Hair and Skin ScienceCharité – Universitätsmedizin BerlinBerlinGermany
| | - Ursula Müller‐Werdan
- Department of Geriatrics, Nursing Research Group in GeriatricsCharité – Universitätsmedizin BerlinBerlinGermany
| | - Ulrike Blume‐Peytavi
- Department of Dermatology and Allergy, Clinical Research Center for Hair and Skin ScienceCharité – Universitätsmedizin BerlinBerlinGermany
| | - Jan Kottner
- Department of Dermatology and Allergy, Clinical Research Center for Hair and Skin ScienceCharité – Universitätsmedizin BerlinBerlinGermany
- University Centre for Nursing and MidwiferyGent UniversityGentBelgium
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Sujiaonori-Derived Algal Biomaterials Inhibit Allergic Reaction in Allergen-Sensitized RBL-2H3 Cell Line and Improve Skin Health in Humans. J Funct Biomater 2017; 8:jfb8030037. [PMID: 28850069 PMCID: PMC5618288 DOI: 10.3390/jfb8030037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 08/25/2017] [Accepted: 08/28/2017] [Indexed: 01/01/2023] Open
Abstract
Sujiaonori, a river alga growing in the Kochi prefecture, Japan, contains several bioactive compounds such as sulfated polysaccharides (ulvans), ω-3 fatty acids, and vitamins. Dietary intake of this alga-based supplement has been reported to increase circulatory adiponectin, a salutary hormone that is reported to be associated with healthy longevity and prevents a number of cardiovascular and metabolic disorders. This report highlights the anti-allergic and skin health enhancing effects of Sujiaonori-derived ulvan (Tosalvan) and supplement, respectively. RBL-2H3 cell line was used to investigate the anti-allergic effect of algal SP through the evaluation of β-hexosaminidase activity. Algal sulfated polysaccharides or SP (Tosalvan, Yoshino SP) were extracted from powders of dried alga samples provided by local food manufacturers. Report on the effect of daily dietary intake of Sujiaonori-based supplement on skin health is part of a four-week clinical investigation that, in comparison with a supplement made of 70% corn starch powder and 30% spinach powder mixture (twice 3 g daily), explore the beneficial effects of Sujiaonori algal biomaterial (SBM; 3 g taken twice daily) on cardiovascular, gastrointestinal and skin health in a sample of Japanese women. Transepidermal water loss (TEWL) was the skin health marker used in this study and was measured with the use of a corneometer. Significant reduction of β-hexosaminidase activity was observed in Tosalvan and Yoshino SP-treated cells (vs. control; p < 0.05), whereas dietary intake of SBM markedly reduced TEWL level after four weeks of supplementation, as compared to baseline TEWL (p < 0.001). Additionally, SBM improved TEWL better than the control product (p < 0.001). Findings contained in this report suggest that Sujiaonori-derived Tosalvan and Yoshino SP have anti-allergic potential and that the dietary intake of SBM has a beneficial effect on skin health.
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