Prevention, recognition and treatment of dry skin conditions

Dry eye and dry skin - is there a connection?

AIM

To enquire whether patients with dry eye symptoms also report dry skin, whether their perception could be corroborated with objective measurement, and whether dry eye disease might be suspected based on patients' complaints.

METHODS

This cross-sectional study included 50 subjects, 25 with and 25 without dry eye symptoms. Schein questionnaire was used to determine the severity of dry eye symptoms. Ocular signs were assessed by monitoring conjunctival hyperemia, ocular surface staining, meibomian gland expression, tear film lipid layer thickness, tear break-up time, lid parallel conjunctival folds, Schirmer test, and meibometry. Skin dryness was assessed by noting patients' self-perception of their facial skin dryness and measured by sebumeter.

RESULTS

Subjects without dry eye symptoms had self-reported oilier facial skin than those with dry eye symptoms (p < .001). Sebumetry scores measured on the forehead and cheek were significantly higher in subjects without dry eye symptoms than dry eye subjects (p = .003). After adjustment for age and gender in a logistic regression analysis, dry eye was independently and significantly associated with dry skin (AOR 0.69, p = .040), higher LIPCOF score of both eyes (AOR 2.28, p = .028), lower sebumetry score of the forehead (AOR 0.98, p = .041) and cheek (AOR 0.98, p = .041), and shorter TBUT score after gland expression (AOR 0.90, p = .018).

CONCLUSION

This study showed that ocular dryness was subjectively and objectively positively correlated to facial skin dryness. Patients reliably described their skin condition. People with dry facial skin also had drier eyes.

Novel filagrinol-containing emollient

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.

Beneficial Effect of Heat-Killed Lactiplantibacillus plantarum L-137 on Skin Functions in Healthy Participants: A Randomized, Placebo-Controlled, Double-Blind Study

To determine whether consuming heat-killed Lactiplantibacillus plantarum L-137 (HK L-137) influences skin functions, we performed a randomized, placebo-controlled, double-blind study in healthy participants who were conscious of dry skin. A total of 80 healthy participants (20 men, 60 women; mean age, 47.3 years) were assigned to receive a tablet containing HK L-137 or a placebo tablet daily for 12 weeks. Every 4 weeks, the skin water content and transepidermal water loss (TEWL) were measured at the forearm and face, and participants completed two skin-related questionnaires, the Dermatology Life Quality Index and a self-evaluation. The HK L-137 group tended to show greater increases from baseline of water content at the forearm and larger decreases of TEWL at the face. The total scores of both questionnaires improved significantly more in the HK L-137 group. Water content and TEWL improved significantly in participants in the HK L-137 group who were above the median age of study participants or had relatively dry skin. These findings suggest that daily HK L-137 intake can improve dry skin, thereby contributing to skin satisfaction.

Effectiveness of Dietary Supplement for Skin Moisturizing in Healthy Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background

The dietary supplement industry offers many oral cosmetics that purportedly assist in skin moisturization often with unclear evidence supporting efficacy and safety. To update the accessible proofs pertaining to the safety and effectiveness of oral dietary supplements to facilitate skin moisturizing via an all-around review and meta-analysis.

Methods

Three on-line databases [Pubmed, Embase, and Cochrane Library (CENTRAL)] were retrieved from January 2000 to November 2021. An overall 66 randomized controlled trials (RCTs) of skin care were recognized. Meta-analysis was performed for dietary supplements with four or more available research.

Results

Oral collagen or ceramide resulted in a statistically significant increase in skin hydration and a decrease in transepidermal water loss (TEWL) compared to placebo. No benefits regarding the improvement of skin conditions in terms of water content and TEWL were observed for lactic acid bacteria or Lactobacillus fermented foods. A statistically significant and positive effect on skin hydration was observed for both hyaluronan and procyanidin, with an unknown effect on TEWL due to insufficient RCTs. There was a non-significant improvement in the water content of stratum corneum for astaxanthin based on subgroup analyses. Among the dietary supplements trialed in ≤ 3 RCTs, the judgment regarding their effects on skin moisturizing was prevented by inconsistent conclusions as well as insufficient research. All food supplements were safe throughout the research (normally ≤ 24 weeks).

Conclusion

Oral dietary supplements, including collagen, ceramides, hyaluronan, and procyanidin, were proven to be effective for skin moisturization. At present, for skin moisturization, the proofs supporting the recommendation of other dietary supplements, such as lactic acid bacteria and astaxanthin, are insufficient.

Systematic Review Registration

http://www.crd.york.ac.uk/PROSPERO/ identifier CRD42021290818.

A Clinical Investigation of the Performance and Safety of Epaderm®, an Emollient Cream

Introduction

Emollients provide an occlusive barrier for dry and atopic skin, retain moisture, protect it from irritants, and form the basis of eczema treatment.

Methods and Analysis

A prospective interventional single arm study to evaluate the performance and safety of Epaderm^® Cream, an emollient and cleanser containing 25% (w/w) paraffin and 5% (w/w) glycerine (thereafter, an emollient cream), in patients with dry skin conditions. The primary outcome measure was participant evaluation of skin moisturisation after treatment with an emollient cream for up to 4 weeks. Secondary outcome measures included: evaluation of skin softness using a questionnaire and of pruritus on a visual analogue scale (VAS); clinician assessment of xerosis using Overall Dry Skin (ODS) score and measurement of skin hydration using a non-invasive device (MoistureMeterEpiD, Delfin Technologies) at each visit. Sign test and Wilcoxon signed rank test were used to analyse changes from baseline.

Results

A total of 114 participants completed the study. 84.2% (80 out of 95) of participants or parents strongly agreed or agreed that the cream improved skin moisturisation at 4 weeks of treatment at the target area (p<0.0001). 86.3% of participants agreed that skin softness improved after 4 weeks (p <0.0001). ODS score improved from 2.1 (standard deviation (SD) 1.0) to 0.7 (SD 0.8) at 4 weeks. Skin hydration at the target area improved from 31.5 (SD 9.3) to 40.5 (SD 8.3) (p<0.001) at 4 weeks. Mean skin itchiness reduced from 38.0 (SD 25.4) to 17.7 (SD 19.8) at 4 weeks (p<0.0001). Ten (8.3%) adverse device events (ADEs) were reported.

Conclusion

The emollient cream was well tolerated and demonstrated significant improvements in patient-reported skin moisturisation and softness as well as in clinical measurement of xerosis and skin hydration across all age groups including infants. The emollient cream can be recommended for dry skin conditions including atopic dermatitis and psoriasis.

Povezave med razjedo zaradi pritiska in ohranjanjem integritete kože pacienta v intenzivni zdravstveni obravnavi: pregled literature

Uvod: Namen raziskave je prikazati večdimenzionalne potrebe in možne dejavnike tveganja za razjedo zaradi pritiska pri odraslih pacientih v intenzivni zdravstveni obravnavi. Metode: Uporabili smo analizo in sintezo pregleda dokazov iz zbirke podatkov EMERALD, CINAHL, PubMed in ProQuest. Ključne iskalne besedne zveze so bile: »quality of care«, »pressure ulcer«, »prevention and treatment of pressure ulcers«, »skin integrity critical care patients«. Omejitveni kriteriji iskanja so bili: obdobje 2010 do 2013, celotno besedilo člankov v angleščini. Začetna merila je izpolnjevalo 280 zadetkov in 40 izbranih ustreznih prispevkov. Potek raziskave je prikazan v skladu z načeli Cochranove zbirke, ocena kakovosti dokazov pa v hierarhiji dokazov. Rezultati: Identificiranih je 191 kod, ki so združene v 11 vsebinskih kategorij: okolje intenzivne terapije – značilnosti nekaterih dejavnikov tveganja, čas bivanja v enoti, vazoaktivne učinkovine, spol, starost, administrativno diagnostična kategorija, postelja, ležišče, lestvica Waterlow, razjeda zaradi pritiska in pomen prve stopnje razjede. Diskusija in zaključek: Raziskava pokaže pomen uvedbe proaktivnih ukrepov za ohranjanje integritete kože pacienta. Osredotoča se na vitalnost tkiva in promocijo kakovostne zdravstvene oskrbe z vidika teorije. Potrebne so raziskave, ki bi za boljše razumevanje pojasnjevale številna druga tveganja in učinkovite programe za vitalnost kože.