Influence of probe application pressure on in vitro and in vivo capacitance (Corneometer CM 825(®)) and conductance (Skicon 200 EX(®)) measurements

Heel skin microclimate control: Secondary analysis of a self-controlled randomized clinical trial

OBJECTIVE

this study was undertaken to evaluate the efficacy of multilayer polyurethane foam with silicone (MPF) compared to transparent polyurethane film (TPF) dressings in the control of heel skin microclimate (temperature and moisture) of hospitalized patients undergoing elective surgeries.

METHOD

the study took of a secondary analysis of a randomized self-controlled trial, involving patients undergoing elective surgical procedure of cardiac and gastrointestinal specialties in a university hospital in southern Brazil, from March 2019 to February 2020. Patients served as their own control, with their heels randomly allocated to either TPF (control) or MPF (intervention). Skin temperature was measured using a digital infrared thermometer; and moisture determined through capacitance, at the beginning and end of surgery. The study was registered in the Brazilian Registry of Clinical Trials: RBR-5GKNG5.

RESULTS

significant difference in the microclimate variables were observed when the groups (intervention and control) and the timepoint of measurement (beginning and end of surgery) were compared. When assessing temperature, an increase (+3.3 °C) was observed with TPF and a decrease (-7.4 °C) was recorded with MPF. Regarding skin moisture, an increase in moisture (+14.6 AU) was recorded with TPF and a slight decrease (-0.3 AU) with MPF.

CONCLUSIONS

The findings of this study suggest that MPF is more effective than TPF in controlling skin microclimate (temperature and moisture) in heels skin of hospitalized patients undergoing elective surgeries. However, this control should be better investigated in other studies.

A comprehensive comparison of facial skin hydration based on capacitance and conductance measurements in Chinese women

OBJECTIVES

The aim of this study was to compare the data of conductance and capacitance measurements of facial skin hydration and to evaluate and discuss the advantages and disadvantages of the different approaches.

METHODS

We measured skin capacitance (Corneometer® CM 825) and skin conductance (Skicon-200EX®) on 30 pre-defined facial sites of 125 Chinese women, resulting in 3750 readings per device. The data were analysed and compared, and continuous colour maps were generated on a 3D avatar for capacitance, conductance, relative difference (Δ%) and correlation (R-value) by interpolating between the individual readings and converting the values to colours. This visualization allows a better interpretation of the results.

RESULTS

The complexity of facial skin hydration is revealed by this approach. The similarities and discrepancies in the facial hydration maps are clearly apparent. Due to the superiority of the Skicon in measuring high hydration levels, differences in skin hydration were evident on the forehead compared with the Corneometer maps, which may be related to the more superficial measurement of the Skicon within the stratum corneum. Conversely, a greater understanding of the complexity of facial skin hydration in the nasolabial fold was obvious when using the Corneometer. The best congruence between the instruments was found at two specific but separated facial areas, one around the inner eye region and the other one on a line between the nasolabial sulcus and the oblique, lateral jaw. Interestingly, the data were not normally distributed for both instruments and they had opposite skews. All facial clusters were statistically different from each other (p < 0.001), except the cheek and jaw for the Skicon. Larger than expected percentage coefficients of variance were found for the Corneometer on some facial sites that might be explainable by differences in stratum corneum physiology and biochemistry. Corneometer values of 48 AU and Skicon values of 132 μS were taken as the cutoff for normally hydrated facial skin.

CONCLUSIONS

Both devices have their advantages and disadvantages suggesting that bio-instrumental measurement of skin hydration is actually more complicated than commonly thought and that the different facial zones and the use of multiple instrumentation have not been adequately considered.

Regulatory effects of Lactobacillus plantarum-GMNL6 on human skin health by improving skin microbiome

Bacteria response to their environment by producing some compounds which are used in cosmetic and pharmaceutical applications. Some probiotics can regulate immune response and modulate the symptoms of several diseases. Bacteria affect skin response to skin care products. Bacteria are thought to play an important role in acne incidence, skin moisture, and nutrient metabolism, but only a few studies have focused on the extracts of Lactobacillus plantarum in skin care. In this study, we identified that L. plantarum-GMNL6 enhanced collagen synthesis and the gene expression of serine palmitoyltransferase small subunit A. Meanwhile, L. plantarum-GMNL6 reduced the melanin synthesis, the biofilm of Staphylococcus aureus, and the proliferation of Cutibacterium acnes. Information from clinical observation during the ointment for external face use in people displayed that the syndromes of skin moisture, skin color, spots, wrinkles, UV spots, and porphyrins were improved. The diversification of human skin microbiomes was affected by smearing the face of volunteers with L. plantarum-GMNL6. Understanding the potential mechanisms of the action of L. plantarum-GMNL6 in dermatologic conditions promotes the development of care products.

Measurement of skin hydration with a portable device (SkinUp® Beauty Device) and comparison with the Corneometer®

BACKGROUND

Epidermis hydration measurement is an important tool to assess its health. SkinUp^® is a portable device that measures moisture and oil levels of skin through impedance method, it is cheap and has small dimensions, but this equipment has not yet been cited in the scientific literature. Thus, the objective of this work was to validate SkinUp^® equipment by comparing its results with Corneometer^® CM825.

MATERIALS AND METHODS

Twenty subjects had skin hydration measurement on forearm, cheeks, and forehead. Measurements obtained with the two instruments were correlated by calculating the Pearson correlation coefficient and the P-value significance. The sensitivity of the equipment to different regions and treatments and their accuracy were also evaluated.

RESULTS

Positive correlations between equipment were found for skin hydration, with P ≤ .001. Both instruments presented high sensitivity to the different treatments (P < .001). When sensitivity to different regions was evaluated, both showed greater hydration in the cheek and forehead when compared to the forearm (P < .005). The measurements between the cheek and forehead showed no significant difference when compared to each other. In addition, the two devices have good repeatability in the measurements.

CONCLUSION

These results indicate that SkinUp^® can be used in the future for skin analysis in in vivo assays.

Stability, antioxidant activity, in vivo safety and efficacy of creams with standardized wild apple fruit extract: a comparison of conventional and biodegradable emulsifiers

OBJECTIVE

The aim of the study was in vitro and in vivo characterization of cosmetic cream with 6% of standardized wild apple fruit extract, stabilized by conventional non-ionic emulsifier-CEW, in order to determine the influence of emulsifiers (conventional vs. biodegradable) on the characteristics of creams and their effects on the skin.

METHODS

Organoleptic and physico-chemical (pH values and electrical conductivity) analysis was performed, determination of fruit acids-FAs content (using HPLC analysis) and estimation of its antioxidant activity-AA (using DPPH test) during 180 days. In vivo study included following examinations: screening of safety profile (after creams application under occlusion during 24 h at human skin); skin moisturizing potential, transepidermal water loss-TEWL, skin pH after 28 days of cream application and hypopigmentation efficacy 7 days of cream application at artificially induced skin hyperpigmentation.

RESULTS

Investigated cosmetic cream-CEW showed satisfactory organoleptic, physico-chemical characteristics, stability, FAs content (0.13%) and AA (19.25 ± 0.67 %RSC) after preparation, which remained unchanged over the study period. In vivo investigation revealed absence of skin irritation after CEW's application under occlusion. An increase of skin moisturization (after 14 days ΔEC was 18.52 ± 11.51 and after 28 days of applications 16.52 ± 9.36) during 28 day-study, with unchanged TEWL and skin pH values was shown. Decrease of melanin index was revealed, too (after 7 days ΔMI was -31.40 ± 16.50).

CONCLUSION

Cosmetic cream stabilized by conventional emulsifier showed better antioxidant potential and weaker moisturizing and hypopigmentation effects related to the cream with same composition but stabilized by biodegradable emulsifiers. Based on all mentioned above, investigated cosmetic cream might be considered for potential use as modern, stable, safe and efficient cosmetic product in the prevention and/or treatment of oxidative stress-related skin changes and/or damages, for moisturization of dry, even irritated skin as well as for lightening of hyperpigmented skin. RÉSUMÉ: OBJECTIF Le but de l'étude était la caractérisation in vitro et in vivo d'une crème cosmétique contenant 6 % d'extrait normalisé de pomme sauvage, stabilisée par un émulsifiant non ionique conventionnel-CEW, afin de déterminer l'influence des émulsifiants (conventionnels vs biodégradables) sur les caractéristiques des crèmes et les effets sur la peau. MÉTHODES: Des analyses organoleptiques et physico-chimiques (pH et conductivité électrique) ont été effectuées, la détermination de la teneur en acides de fruits et en acides gras polyinsaturés (par CLHP), et l'estimation de sa teneur en activité antioxydante (AA) (à l'aide du test DPPH) pendant 180 jours. L'étude in vivo comprenait les examens suivants : dépistage du profil d'innocuité (après application de crèmes sous occlusion pendant 24 h sur la peau humaine); potentiel d'hydratation de la peau, perte d'eau transépidermique (PETE), pH de la peau après 28 jours d'application de la crème et efficacité de l'hypopigmentation après 7 jours d'application de la crème sur une hyperpigmentation de la peau induite artificiellement. RÉSULTATS: La crème cosmétique-CEW étudiée a montré des caractéristiques organoleptiques, physico-chimiques, une stabilité, une teneur en AG (0,13 %) et en AA (19,25 ± 0,67 % RSC) satisfaisantes après préparation, qui sont demeurées inchangées au cours de la période de l'étude. L'étude in vivo a révélé l'absence d'irritation cutanée après l'application de CEW sous occlusion. Une augmentation de l'hydratation de la peau (après 14 jours de DEC était de 18,52 ± 11,51 et après 28 jours d'applications de 16,52 ± 9,36) pendant l'étude de 28 jours, avec une PETE et des valeurs de pH cutané inchangées, a été démontrée. Une diminution de l'indice de mélanine a été mise en évidence également (après 7 jours, ΔMI était de 31,40 ± 16,50).

CONCLUSION

La crème cosmétique stabilisée par un émulsifiant conventionnel a montré un meilleur potentiel antioxydant et des effets d'hydratation et d'hypopigmentation plus faibles par rapport à la crème de même composition mais stabilisée par des émulsifiants biodégradables. D'après les données précédentes, la crème cosmétique étudiée pourrait être considérée comme un produit cosmétique moderne, stable, sûr et efficace dans la prévention et/ou le traitement des changements et/ou dommages cutanés liés au stress oxydatif, pour l'hydratation de la peau sèche, voire irritée, ainsi que pour éclaircir la peau hyperpigmentée.

THz in vivo measurements: the effects of pressure on skin reflectivity

Terahertz (THz) light is non-ionizing and highly sensitive to subtle changes in water concentration which can be indicative of disease. The short THz penetration depth in bio-samples restricts in vivo measurements to be in a reflection geometry and the sample is often placed onto an imaging window. Upon contacting the imaging window, occlusion and compression of the skin affect the THz response. If not appropriately controlled, this could cause misleading results. In this work, we investigate and quantify how the applied pressure affects the THz response of skin and employ a stratified model to help understand the mechanisms at play. This work will enable future THz studies to have a more rigorous experimental protocol, which in turn will facilitate research in various potential biomedical applications under investigation.

Characterizing stratum corneum structure, barrier function, and chemical content of human skin with coherent Raman scattering imaging

The most superficial layer of the epidermis, the stratum corneum, plays a crucial role in retaining hydration; if its structure or composition is compromised, dry skin may result as a consequence of poor water retention. Dry skin is typically treated with topical application of humectant agents that attract water into the skin. Corneometry, the industry standard for measuring skin hydration, works by assessing the bulk electrical properties of skin. However, this technique samples a large volume of tissue and thus does not resolve the biochemical changes that occur at the cellular level that may underlie mechanisms of dry skin. These limitations can be addressed using coherent Raman scattering (CRS) microscopy to probe the intrinsic vibrational modes of chemical groups such as lipids and water. In the present study, ex vivo human skin explants undergoing dehydration and humectant-induced rehydration were measured via CRS imaging and corneometry. Corneometry data and chemically specific images were obtained from the stratum corneum of each patient sample at each timepoint. The resulting data was statistically analyzed using linear mixed effect model regression analysis. The cellular imaging data revealed water loss in the stratum corneum during dehydration that was correlated with corneometer readings. Interestingly, the imaging data and corneometer readings show differences under the experimental rehydration conditions. The rehydration results suggest that hydration restored by the humectant agents may not be retained by the corneocytes in the ex vivo model system. Given the complementary nature of corneometry, a bulk assessment tool, and CRS microscopy, a modality with subcellular resolution implemented here in an en-face tissue imaging setup, these techniques can be used to measure uptake and efficacy of topical compounds in order to better understand their mode of action and improve therapeutic applications.

Standardized extract of wild apple fruit in alkyl-polyglucoside-based cosmetic cream - estimation of stability, safety, antioxidant activity and efficiency

OBJECTIVE

The aim of this study was in vitro and in vivo characterization of cosmetic cream with 6% of wild apple fruit water extract, containing 3.5% of alpha-hydroxyacids-AHAs and polyphenolic compounds, stabilized by biodegradable alkyl-polyglucoside emulsifiers.

METHODS

In vitro characterization of cream included organoleptic and physico-chemical (pH values and electrical conductivity) analysis, antioxidant activity-AA estimation (using DPPH test) during 180 days of storage at 22±2°C and determination of cosmetic active substances content-AHAs (using HPLC analysis). In vivo estimation of skin irritation potential after creams application under occlusion during 24h was investigated employing the biophysical methods on 12 healthy volunteers; hydration efficiency, transepidermal water loss-TEWL, skin pH, erythema-EI and melanin index-MI on 10 healthy volunteers after 28 days of cream application and bleaching efficiency on 10 healthy volunteers after 7 days of cream application after artificially induced skin hyperpigmentation.

RESULTS

Investigated cosmetic cream was pale beige color, odorless, semi-solid consistency and homogeneous, with pH values of 6.53±0.14, electrical conductivity above 50 μS/cm and AA of 24.96%RSC after preparation and these characteristics were stable during investigated period. In vivo measurements revealed absence of skin irritation after cream application under occlusion, which was part of it's safety profile. Increase of skin hydration after 14 days of cream application was 17.28±12.23 and after 28 days 21.19±7.59. In addition, in performed experiment TEWL and skin pH values during cream application remained unchanged. Cream application after artificial hyperpigmentation induced decrease of MI (∆MI after 7 days was -45.30±18.55) CONCLUSION: Formulated cosmetic cream with 6% of standardized wild apple fruit water extract and stabilized by biodegradable alkyl-polyglucoside emulsifiers demonstrated good stability, acceptable level of in vitro antioxidant activity, absence of skin irritation after cream application under occlusion and positive effects of cream on human skin after application (hydrating and bleaching effects). All mentioned properties make the cream suitable for possible usage as cosmetic product for preventing the skin damages caused by oxidative stress, for moisturizing the dry skin and bleaching of skin hyperpigmentation. This article is protected by copyright. All rights reserved.

Understanding the effects of topography on skin moisturization measurement via two-dimensional capacitance imaging

OBJECTIVE

Methods which assess skin moisturization based on changes in its electrical properties are widely used in both cosmetic and medical research industries. However, the devices themselves often give results which are significantly different to each other. Recently two-dimensional imaging moisturization systems have become commercially available, which have the capability to provide a more detailed assessment of what is contributing to measured skin moisturization. Presented here is a new in vitro method for preparing textured model test substrates for use with these devices, and results of their use to provide a clearer insight into the devices operation.

METHODS

A variety of different textured model test substrates were measured using a commercially available skin moisturization measurement device, the Epsilon. The response of the Epsilon was also tested against conventional skin moisturization devices.

RESULTS

Surface morphology of model test substrates was found to have a significant influence on the measurement of its electrical properties with both the conventional and two-dimensional skin moisturization measurement devices. Through modification of the areas of the image being assessed for the two-dimensional moisturization mapping device, the parts of the model test substrate in contact with the device were indentified and analysed separately to areas not in contact with the sensor. This provided a more robust assessment of the electrical properties of substrate itself, rather than being influenced by texture like the conventional skin moisturization measurement devices.

CONCLUSIONS

While the two-dimensional moisturization mapping systems can be used like a conventional electrical skin measurement device giving a simple overall reading of skin moisturization for the test area, their true value over existing electrical measures comes from its ability to isolate the skin itself from areas which are not in contact with the sensor.

Effects of intake of Lactobacillus casei subsp. casei 327 on skin conditions: a randomized, double-blind, placebo-controlled, parallel-group study in women

Lactic acid bacteria are gut flora that play key roles in intestinal homeostasis, which may affect a variety of physiological functions. Our preliminary double-blind, placebo-controlled, parallel-group trials have suggested that intake of heat-killed Lactobacillus casei subsp. casei 327 (designated L. K-1) is effective for improving skin conditions. The aim of this study was to confirm the effect of L. K-1 intake in a randomized, double-blind, placebo-controlled, parallel-group study in healthy female volunteers. Sixty-four subjects were allocated to either the placebo food group (group P, n=32) or active food group (group A, n=32), in which subjects consumed lactobacillus K-1 50 mg (approximately 1 × 10¹¹ bacteria) daily for 8 weeks. After excluding subjects who declined to participate (n=1), violated restrictions (n=4), or were judged ineligible by the principal investigators (n=1), data obtained with 58 subjects (30 in group A and 28 in group P) were analyzed for efficacy by comparing differences from pretrial levels between the two groups. When the level of transepidermal water loss (TEWL) was measured at the arm, the level of TEWL at week 4 of the intake period was significantly lower in group A than group P (p=0.021), suggesting an improvement of skin barrier function. Analysis of skin condition questionnaire data revealed a significant reduction in skin flakiness on the face (week 4). No adverse events were associated with intake of the test foods. The safety of L. K-1 was also confirmed in an independent open-label trial in 11 healthy subjects who consumed excessive amounts of L. K-1 250 mg (approximately 5 × 10¹¹ bacteria). Intake of L. K-1 may therefore be beneficial to skin condition improvement.

Effects of oral intake of heat-killed Lactobacillus brevis SBC8803 (SBL88™) on dry skin conditions: A randomized, double-blind, placebo-controlled study

Lactobacilli are important in intestinal homeostasis, which involves the regulation of immune function, digestive health, cholesterol absorption and intestinal tumor growth amongst others. Our previous investigations have suggested that oral intake of heat-killed Lactobacillus brevis (L. brevis) SBC8803 (SBL88™) suppresses dermatitis by modulating the immune function in an atopic dermatitis mouse model. The aim of the present study was to investigate the effect of heat-killed L. brevis SBC8803 intake on skin hydration conditions in humans. A randomized, double-blind, placebo-controlled study was conducted with volunteers with slightly higher levels of transepidermal water loss (TEWL) on the forearm. The subjects (126 people aged between 21 and 59 years) were randomly allocated to three groups so that the level of TEWL and the age were distributed equally among the groups. The subjects took placebo or heat-killed L. brevis SBC8803 at a daily dose of 25 or 50 mg for 12 weeks. Following the exclusion of eight subjects for plausible reasons (two withdrawals from the study, two for study violations, one for not meeting exclusion criteria and three due to their physical condition), 118 subjects were subjected to the analysis. The results of the present study revealed that following the analysis of the whole populations, marginal differences were observed in TEWL (for example, suppression of skin water loss) at the neck in the 25 mg/day group at week 8 and at the lower eye region in the 50 mg/day group at week 4 (P=0.05 and 0.09, respectively, compared with the placebo group analyzed by Dunnett's test). A significant increase in corneal hydration was also observed at the neck in the 25 mg/day group at week 12 (P=0.06, as compared with the placebo group as analyzed by Dunnett's test). In the analysis of the subpopulations whose habitual frequency of taking lactic fermentation products was less than once per week, the levels of corneal hydration at the neck (in the 50 mg/day group) and lower eye region (in the 25 mg/day group) were significantly increased at week 12 (P<0.05). In conclusion, the results of the present investigation suggest that oral intake of heat-killed L. brevis SBC8803 is effective at improving skin hydration conditions in populations with low habitual frequency of taking lactic fermentation products.

Understanding effects of topical ingredients on electrical measurement of skin hydration

OBJECTIVE

Methods that assess skin hydration based on changes in its electrical properties are widely used in both cosmetic and medical research. However, the devices themselves often give results which are significantly different to each other. Although some work has previously been carried out to try and understand what these devices are actually reading, it was based on a technique for measuring the devices' responses to filter discs impregnated with different liquids, which could in itself be influencing the measurements. Presented here is a new method for measuring the devices' direct responses to different materials and solutions which removes any other confounding effects, thereby providing a clearer insight into their operation.

METHODS

The responses of a variety of different liquids and solutions were measured using the Corneometer^® and Skicon^® . A new method is presented, based on the use of a custom-designed PTFE block to hold the liquids, allowing their measurement without using a filter paper. This method was developed and tested against the existing filter paper-based approach.

RESULTS

Differences were observed in results between filter paper- and PTFE block-based approach, indicating that the filter paper itself is capable of influencing the measurements and as such is not to be recommended for assessing how different liquids impact on results from the devices. A positive correlation was observed between Corneometer^® and Skicon^® readings for certain solutions and under certain conditions. A large influence of salt concentration was noted for the Skicon^® device with no or minimal impact from the actual water itself, humectants and emollients. Salts, emollients, water and humectants were observed to have an effect on Corneometer^® readings.

CONCLUSIONS

Both the Corneometer^® and Skicon^® were influenced to different extents by chemicals other than water and therefore cannot be seen purely as measures of skin 'hydration'. Although there is strong evidence that the devices do correlate with expert assessment of skin dryness, the level of water in the skin is only part of the story when it comes to understanding the benefits of topical moisturizing products applied to the skin. An alternative approach would be to consider skin 'moisturization' as a property which is influenced by water, salts and other materials such as humectants and emollients, which is more consistent with how the stratum corneum itself helps to maintain its plasticity and flexibility. In the work presented here, the Corneometer^® was more suited to providing a measurement which reflects the impact of multiple different components.

The reliability of non-invasive biophysical outcome measures for evaluating normal and hyperkeratotic foot skin

Background

Hyperkeratosis of foot skin is a common skin problem affecting people of different ages. The clinical presentation of this condition can range from dry flaky skin, which can lead to fissures, to hard callused skin which is often painful and debilitating. The purpose of this study was to test the reliability of certain non-invasive skin measurement devices on foot skin in normal and hyperkeratotic states, with a view to confirming their use as quantitative outcome measures in future clinical trials.

Methods

Twelve healthy adult participants with a range of foot skin conditions (xerotic skin, heel fissures and plantar calluses) were recruited to the study. Measurements of normal and hyperkeratotic skin sites were taken using the following devices: Corneometer® CM 825, Cutometer® 580 MPA, Reviscometer® RVM 600, Visioline® VL 650 Quantiride® and Visioscan® VC 98, by two investigators on two consecutive days. The intra and inter rater reliability and standard error of measurement for each device was calculated.

Results

The data revealed the majority of the devices to be reliable measurement tools for normal and hyperkeratotic foot skin (ICC values > 0.6). The surface evaluation parameters for skin: SEsc and SEsm have greater reliability compared to the SEr measure. The Cutometer® is sensitive to soft tissue movement within the probe, therefore measurement of plantar soft tissue areas should be approached with caution. Reviscometer® measures on callused skin demonstrated an unusually high degree of error.

Conclusions

These results confirm the intra and inter rater reliability of the Corneometer®, Cutometer®, Visioline® and Visioscan® in quantifying specific foot skin biophysical properties.

Reliability of Repeated Measurements on Post-Burn Scars with Corneometer CM 825(®)

BACKGROUND/PURPOSE

The water content in burn scars, the parameter of stratum corneum water holding capacity, is an important feature in evaluation of biophysical properties of scars. Nevertheless, quantifiying this parameter is a challenge. In this study, the reliability of repeated water content measurements with Corneometer CM825(®) on (burn) scars was investigated.

METHODS

Intra-observer reliability, inter-observer reliability and day-by-day variability were examined on 30 scars by means of intra-class correlation coefficient (ICC) and within-subject coefficient of variation (WSCV). Bland-Altman plots with '95% limits of agreement' were constructed.

RESULTS

Results revealed excellent ICC values (ICCintra  = 0.985; ICCinter  = 0.984) with relatively low WSCV (WSCVintra  = 6.3%; WSCVinter  = 10.6%) for respectively intra- and inter-observer reliability. However, the Bland-Altman plot showed that more than 5% of differences were expected to exceed 4 a.u., the limit of what has been defined as a clinically acceptable difference. Results for day-by-day variability showed good ICC value (ICCday-by-day  = 0.849) and higher WSCV (WSCVday-by-day  = 20.5%).

CONCLUSION

The Corneometer CM825(®) is an objective and sensitive instrument for water content measurements. On the basis of our results, we concluded that the instrument can be used in clinical trials, but only under very strict conditions with standardized test protocol, preferably in combination with the evaluation of other physiological parameters.