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Atopic dermatitis (eczema) is a widespread disorder, with researchers constantly looking for more efficacious treatments. Natural oils are reported to be an effective therapy for dry skin, and medical textiles can be used as an alternative or supporting therapy. In this study, fibrous membranes from poly(vinyl butyral-co-vinyl alcohol-co-vinyl acetate) (PVB) with low and high molecular weights were manufactured to obtain nano- and micrometer fibers via electrospinning for the designed patches used as oil carriers for atopic skin treatment. The biocompatibility of PVB patches was analyzed using proliferation tests and scanning electron microscopy (SEM), which combined with a focused ion beam (FIB) allowed for the 3D visualization of patches. The oil spreading tests with evening primrose, black cumin seed, and borage were verified with cryo-SEM, which showed the advantage nanofibers have over microfibers as carriers for low-viscosity oils. The skin tests expressed the usability and the enhanced oil delivery performance for electrospun patches. We demonstrate that through the material nano- and microstructure, commercially available polymers such as PVB have great potential to be deployed as a biomaterial in medical applications, such as topical treatments for chronic skin conditions.

Background Hyaluronic acid (HA) is a key contributor to skin moisture (hydration), and MicroBotox demonstrates improvements for fine wrinkles of the face. Objectives The author sought to evaluate the safety and efficacy of intradermal injection of hydrotoxin (combined mixture of MicroHA and MicroBotox) for the treatment of skin roughness and dryness on facial dermis. Methods Fifty women who had thin, dry skin with fine wrinkles throughout the whole face, especially in the crow’s feet and forehead areas, were enrolled in the study. Two cc stabilized-HA filler and 1 cc (40 U) of botulinumtoxinA were mixed in the novel combined hydrotoxin mixture. Intended to hydrate the dermis and treat fine wrinkles of the face, the mixture was injected into the real dermal layer of the face. The volume of HA per site was 0.002 cc and toxin was 0.04 U. Skin roughness and stratum corneum hydration were measured at 1, 2, 3, and 6 months. Results One month post-treatment, skin roughness was reduced to 50.19% in topographic computer analysis utilizing 10× dermascope photos. Stratum corneum hydration on crow’s feet improved to 81.34% at 1 month and 56.12% at 2 months from pre-treatment baseline (P < 0.0001). Global Aesthetic improvement scale of Skin hydration and fine wrinkle improved. Conclusions The combination injection method of MicroHA and MicroBotox is not associated with side effects and showed significant synergic effect in improvement of skin roughness and moisturizing. Neuramix-hydrotoxin injection method is an easy and reproducible procedure to make constant injection depth and amount. Level of Evidence: 4

The feet have an increased load, they are often injured, especially with diabetes. Because of the violation of innervation, patients do not notice minor injuries: abrasions, bruises, cracks, cuts. Because of the circulatory disorders associated with diabetes, the protective function of tissues decreases, and the smallest injury can lead to the formation of a long-term wound that does not heal, which turns into an ulcer when infected. Despite advances in the study of the pathogenesis of diabetes and its complications, diabetic foot ulcers are difficult to treat, can recur, and lead to amputations of the lower limbs. The main reason for pathological dryness of the foot skin in diabetes is dysfunction of the sweat glands of the skin of feet due to diabetic neuropathy. Regular skin care with specially selected products can help restore and improve the barrier function of the skin, as well as increase the moisture level of the stratum corneum. Adequate skin hydration reduces itching and the risk of infection if the skin is damaged. In most patients with diabetes, conventional cosmetics slowly eliminate dry skin of the feet. In addition, traditional remedies contain a large amount of oils and can cause unpleasant sensations, which often causes rejection of their use. In patients with DM, it is desirable to use drugs that quickly and effectively eliminate dryness and cracks. Treatment of dry skin is indicated as a prevention of diabetic foot syndrome. Taking into account the fact that the skin of patients with diabetes mellitus has a low level of humidity, we recommend daily care using moisturizing or nourishing creams or lotions. Some studies have confirmed that the use of external dry skin care products containing dexpanthenol improves the protective function of the skin, increasing the hydration of the stratum corneum.

Introduction: Atopic dermatitis (AD) is a chronic relapsing skin condition characterized by intense itching, dry skin, redness, in_ammation and exudation with signi_cant morbidity. It often requires long-term use of topical corticosteroids but, patients’ adherence to corticosteroids may be limited by perceived risks and systemic adverse e_ects. Therefore, steroid-sparing topical agent is needed. To compare the e_cacy and safety of 0.1% tacrolimus ointment and 0.05% clobetasone butyrate ointment in patients with childhood AD. Materials and methods: This monocentric prospective open-label comparative study was carried out in the Department of Dermatology and Venereology, Chittagong Medical College Hospital. Two hundred patients of 2–10 years of age with mild to moderate AD involving _ 50% of the total body surface area (BSA) were randomly assigned. The treatment duration was 4 weeks and was followed-up for 12 weeks. The eczema area and severity index (EASI) and the physician’s global evaluation of clinical response were assessed and evaluated. Results: E_ective sample size was 176 as because 24 patients were dropped out during follow up. EASI score was signi_cantly changed from baseline in follow up weeks and there was a statistically signi_cant di_erence in the reduction of EASI of patients in Tacrolimus groups at the end of 2nd week, 4th week, 6th week than the other group (p < 0.05). At the end of 4 weeks treatment, a median improvement of _ 75% in EASI was observed in 86% and 57% of patients in Tacrolimus and Clobetasone Group, respectively. At the end of the 12 week follow-up period, these improvements persist. Both the regimens were well tolerated. Conclusions: The overall therapeutic e_ectiveness was in favour of topical Tacrolimus ointment (0.1%) over topical Clobetasone butyrate ointment (0.05%) for the treatment of AD in children.

A topical vehicle is a 'carrier system' for an active pharmaceutical (or cosmetic) substance, referred to hereafter as the drug, but a vehicle may also be used on its own as an emollient to ameliorate dry skin. It is well established that the vehicle plays an important role in determining the bioavailability of a given drug at its ultimate target within the skin. Yet in the treatment of atopic eczema/dermatitis (AD), wherein the structure and function of the skin's outer barrier play a pivotal role in the development and course of the condition, the interaction of the vehicle with this barrier carries a particular importance. It is now clear that the often-considered inert excipients of a vehicle bring about changes within the skin at the molecular level that promote barrier restoration and enhance innate immune defenses with therapeutic value to AD patients. Moreover, the vehicle control in randomized controlled trials (RCTs) increasingly displays significant efficacy. In light of this, we consider the implications of vehicle design in relation to AD pathophysiology and the role vehicles play as controls in RCTs of new drug treatments for this condition.

Erlotinib, an inhibitor of the epidermal growth factor receptor tyrosine kinase, causes skin disorders such as dry skin, which impairs the skin barrier function. Stratum corneum (SC) lipids play an important role in skin barrier function; therefore, this study aimed to investigate the relationship between erlotinib-related dry skin and changes in the intercellular lipid composition and structure of the SC. Overall, 21 patients with non-small lung cancer were enrolled in this study. All patients received 150 mg/day erlotinib orally. A SC sample of each patient was collected from the inner forearm using the tape stripping method on days 0, 7, 14, 28, and 56 after erlotinib administration. The intercellular lipid components of ceramide (CER), free fatty acid (FFA), and cholesterol sulfate (CS) in samples extracted from the tape were analyzed using liquid chromatography/time-of-flight/mass spectrometry. SC samples from six healthy subjects were collected as controls on days 0, 28 and 56 and analyzed similarly. Although total CER and FFA levels were not changed after erlotinib administration, the levels of CER subclasses [AP] and [AH] and hydroxy FFA, which are structural components of CER subclass [A], decreased. In contrast, the CS levels increased after erlotinib administration. Moreover, higher CS levels in the SC correlated with the clinical condition of dry skin. No changes were observed in the SC lipid composition in healthy subjects. Erlotinib-related dry skin was associated with a higher CS level in the SC.

Introduction The replenishment of skin lipids depleted in the dry skin state is a desirable therapeutic target to restore skin moisturization; however, there is limited evidence demonstrating the success of this approach through the use of topical emollients. The purpose of this study was to provide evidence of the benefits of a cream and equivalent lotion containing skin lipids in a multi-vesicular emulsion for the management of dry skin. The hypothesis was that the test cream and test lotion could sustain skin moisturization for longer than traditional emollients by sustainably delivering skin lipids. Methods A double-blind intra-subject vehicle-controlled single open-application test on the lower legs in people with dry, atopic dermatitis (atopic eczema)-prone, skin was conducted. There were six treatment sites, three per lower leg in each participant, which were treated with the test cream, the test lotion, three reference creams commonly prescribed in the UK and no treatment as a control. After baseline measurements of skin hydration, 100 μl of the test/reference creams was applied to each of the relevant treatment sites (random site allocation). Following treatment, measurements of skin hydration and scoring of visual dryness was conducted at timed intervals (3, 6, 12 and 24 h post-product application). Results The test cream and lotion both significantly increased skin hydration and reduced skin dryness for at least 24 h following a single application compared to a no treatment control site. Compared to three reference emollient creams the test cream and test lotion were the only products capable of sustaining clinically meaningful improvements in skin moisturization for 24 h. Conclusion The sustained moisturization imparted by the test products reduces the need for frequent emollient application, often requiring 3–4 applications per day for traditional emollients, and should reduce the high burden of managing dry skin conditions like atopic dermatitis.

Background: Acne vulgaris is an inflammatory condition of the pilosebaceous glands caused by various factors including excessive excretion of sebaceous glands. Excess sebum can be reduced using oil blotting paper (OBP), a thin paper with microspores that absorb the oil on the face. This study was conducted to determine the association between OBP application and sebum excretion according to the Oily Skin Self- Assessment Scale (OSSAS) questionnaire and acne severity according to the Global Acne Grading System (GAGS) questionnaire. Methods: This experimental study was conducted in 2017 among 60 students aged 17–22 years at the Faculty of Medicine, Atma Jaya Catholic University of Indonesia, recruited by purposive sampling. Data on sebum excretion and the degree of AV severity before and after intervention were analyzed using the chi- square test with a significant level of p < 0.05. Results: Before intervention, 11 (18.3%) students had dry skin, 23 (38.3%) had slightly dry skin, 17 (28.4%) had slightly oily skin, and 9 (15%) had oily skin. The prevalence of AV was 100%, with 48 (80%) students having mild severity and the remaining having moderate severity. There was no effect of using OBP on sebum excretion (p = 0.211); however, an improvement was noted on GAGS raw data score (p < 0.001). Conclusion: AV is an inflammatory disease of the pilosebaceous glands, and one of the etiologies is excessive sebum excretion, which can be reduced using OBP. This study demonstrated that OBP application did not reduce sebum excretion statistically but could improve the severity of AV. Keywords : GAGS, oily skin, OSSAS

Daily oral intake of 40 μg Aloe sterol was shown in a double‐blind clinical trial to significantly increase skin barrier function, moisture and elasticity. Ultrasonographic results also suggested that the intake of Aloe sterol increases collagen content in the dermis. Here, we evaluate the effects of a much smaller dose of Aloe sterol, approximately half that used previously, on skin functions in more detail. This is a monocentric, double‐blind, randomized, placebo‐controlled, supplementation study of the effects of low‐dose Aloe sterol on skin transepidermal water loss, hydration, collagen score, evaluation of objective or subjective symptoms, and safety after 12 weeks of daily intake. We randomly administrated either Aloe sterol or placebo to 122 healthy volunteers. Transepidermal water loss was significantly reduced and collagen score was increased in the Aloe sterol group compared with the placebo group at week 12. In the Aloe sterol group, there was significant improvement of objective skin condition (face erythema and pruritus of inner and outer arms) at week 12 compared with week 0, but not in the placebo group. Subjectively, there was significant improvement of visual analog scale of skin acne, fingernail brittleness and constipation in the Aloe sterol group. According to subgroup analysis, although not planned before the study initiation, subjects with dry skin in the Aloe sterol group had significantly increased skin hydration values at week 12 compared with the placebo group. Our results confirmed that even low‐dose Aloe sterol ingestion improves skin moisture by promoting skin barrier function and dermal collagen production, which contributes to maintenance of healthy skin.

Introduction Our previous clinical studies have demonstrated the short-term efficacy and safety of the sirolimus gel for patients with tuberous sclerosis complex (TSC). However, long-term clinical evidence is lacking. Our objective was to assess the safety and efficacy of long-term treatment with the sirolimus gel for the skin lesions of TSC patients. Methods We conducted a multicenter, open-label, uncontrolled clinical trial in 94 Japanese patients with TSC. Patients applied the 0.2% sirolimus gel on their face or head twice daily for > 52 weeks (maximum 136 weeks for safety). The safety endpoints were the rate of adverse event (AE)-caused discontinuation (primary endpoint) and the incidence of AEs. The efficacy endpoint was the response rate of angiofibromas, cephalic plaques, and hypomelanotic macules. Results Among 94 enrolled patients (mean age, 21 years; range 3–53 years), the rate of AE-caused discontinuation was 2.1% (2/94 patients). Although application site irritation and dry skin occurred relatively frequently, none of the drug-related AEs were serious; most of the drug-related AEs resolved rapidly. The major drug-related AEs (≥ 5% in incidence) were application site irritation (30.9%), dry skin (27.7%), acne (20.2%), eye irritation (8.5%), pruritus (8.5%), erythema (7.4%), dermatitis acneiform (6.4%), and dermatitis contact (5.3%). The response rates of angiofibromas, cephalic plaques, and hypomelanotic macules were 78.2% [95% confidence interval (CI) 68.0–86.3%], 66.7% (95% CI 51.1–80.0%), and 72.2% (95% CI 46.5–90.3%), respectively. Conclusions The gel was well tolerated for a long time by patients with TSC involving facial skin lesions and continued to be effective. Trial Registration ClinicalTrials.gov identifier: NCT02634931.

Background Facial blemishes resulting from skin disorders have a significant effect on the patient's self-esteem and impact quality of life (QOL). Aim To assess the impact of a corrective cosmetic (CC) on QOL on top of skin quality parameters. Methods An international observational study was conducted on subjects with visible facial flaws that would benefit from a corrective cosmetic. Investigators collected data regarding demographics, QOL using the Skindex-16 scale, skin dryness and tautness, subject and investigator satisfaction, cosmetic acceptability and tolerance at baseline and after 4 to 6 weeks of daily use. Results A total of 1840 subjects participated; the mean age was 31.5±11.1 and 95% were women. Acne accounted for 48.9% of skin conditions, followed by melasma (16.7%) and rosacea (15.3%). Of the subjects 81.2% had at least 10% of the face affected and the condition was rated as disfiguring by 45.3% of the subjects; 45.0% and 44.4%, respectively, had neither taut nor dry skin at baseline. Baseline Skindex-16 scores for symptoms, emotions, functioning and overall were 1.4±1.3, 3.5±1.6, 2.4±1.8 and 2.4±1.3, respectively, on a scale from 0 to 6. Compliance was 96.0±10.6%. At the end of the study, Skindex-16 scores had significantly (p

Roughly equimolar concentrations of ceramides, cholesterol, and free fatty acids arranged in lamellar sheets form the intercellular lipid barrier in the stratum corneum (SC). Intercellular lipid deficiencies, specifically ceramides, and barrier disruption are associated with many dermatologic conditions, including dry skin. This study explored the relationship between the improvement in the signs of dry skin and the amounts of ceramides in the SC by combining clinical observations with a biochemical analysis to quantify the level of SC intercellular lipids. The efficacy of a multilamellar vesicular emulsion (MVE), ceramide-containing moisturizing cream was evaluated in a randomized, investigator-blinded, split-leg study on female subjects with dry, itchy skin. The cream increased skin hydration and demonstrated an immediate and sustained reduction in the visible signs of dry skin and subject perceived sensory discomfort. Additionally, ceramide, cholesterol and free fatty acid levels in the SC significantly increased after 4 weeks of moisturizer application. Thus, the clinical effect of the ceramide-containing moisturizing cream on dry, itchy skin was accompanied by an increase in SC intercellular lipid levels. J Drugs Dermatol. 2020;19(4):372-376. doi:10.36849/JDD.2020.4796.

In recent years, it has become clear that zinc deficiency is closely related in several skin disorders. In elderly people, chronic itch and dry skin are common. In addition, the zinc concentrations are known to decrease with age. Therefore, we examined the beneficial effects of oral zinc supplementation on dry skin and itch in elderly people. Patients 65 years of age or older who visited the Jose Clinic (Odai-town, Mie Pref.) with serum zinc concentrations below 80 μg/dL were enrolled in the study (low zinc group). The participants were administered zinc acetate hydrate for 12 weeks from the start of the study, and transepidermal water loss (TEWL) and stratum corneum moisture content measurements, blood collection, and itch evaluation were performed every 4 weeks. Patients in the control group had serum zinc concentrations of ≥80 μg/dL (the normal zinc group). Results showed that TEWL was significantly higher in the low zinc group than in the normal zinc group, indicating that skin barrier function is impaired in the low zinc group. Serum zinc concentrations increased and TEWL decreased significantly over the 12 weeks of treatment. In addition, a negative correlation was observed between serum zinc concentrations and TEWL. Our results indicate that zinc supplementation is effective to improve the skin barrier function in elderly people.

Background Petrolatum is often used to suppress water evaporation from the skin surface. However, its stickiness, shininess, and other factors make it inconvenient for continuous use. Objective To compare the effectiveness and usability between a newly developed petrolatum-based ointment (NOV® II Moisture Balm) and white petrolatum. Methods Twenty-nine subjects with atopic dermatitis or xeroderma with symptoms of dry skin applied NOV® II Moisture Balm on the right sides of the face and white petrolatum on the left side, respectively, for 8-12 weeks. The skin conditions (erythema, exudate/crusting, dryness, and itch) were scored, stratum corneum water content and transepidermal water loss (TEWL) were measured, and the free amino acid and thymic stromal lymphopoietin (TSLP) levels in the stratum corneum were analyzed before and end of the trial. Results Dryness, exudate/crusting, and TEWL decreased significantly on both the white petrolatum and the NOV® II Moisture Balm sides, while stratum corneum water content and the free amino acid levels in the stratum corneum increased significantly. On the NOV® II Moisture Balm side, erythema and the TSLP levels decreased significantly. In a questionnaire on usability, the subjects felt NOV® II Moisture Balm spread better and were less sticky and shiny than white petrolatum, and more subjects wanted to continue using NOV® II Moisture Balm. Conclusions NOV® II Moisture Balm was equivalent to white petrolatum in moisturizing and improving the physiologic functions of the skin, but had superior usability.

The purposes of this study were to assess the levels of symptom distress, body image, and epidermal growth factor receptor inhibitors (EGFRI)-associated health-related quality of life (QoL); identify the factors related to EGFRI-associated health-related QoL; and examine the differences in EGFRI-associated health-related QoL by grade of skin toxicity in mCRC patients receiving target therapy. This cross-sectional study examined mCRC patients who received cetuximab-based target therapy from the oncology and CRC inpatient and outpatient departments of a medical center in northern Taiwan. Structured questionnaires were used to measure patients’ symptom distress, body image, and EGFRI-associated health-related QoL. Of the 111 mCRC patients studied, 79.2% reported acneiform eruption and 52.2% reported paronychia. The most common symptoms were dry skin and itching. Poor EGFRI-associated health-related QoL was associated with more symptom distress, more negative body image, a higher cumulative dose of target therapy, and being married; these factors explained 66.6% of the variance in EGFRI-associated health-related QoL. Patient-specific skin care and emotional support are needed to relieve distressful dermatological symptoms and emotional distress during and post-treatment for mCRC.

The skin problem often found on adolescents is acne vulgaris. The pathogenesis of acne vulgaris is multifactorial, from increased production of sebum, hyperproliferation of pilosebaceous follicles, colonization of Cutibacterium acnes, to inflammation process. The elevated sebum production which is often linked to oily skin type could result in acne vulgaris in adolescents. According to Baumann Skin Type, one of the parameters in categorizing skin type is having either oily or dry skin. Acne vulgaris is also found on dry skin. This research aims to find the association between skin types and acne vulgaris. It is an analitic research with cross-sectional method. The data were acquired from 93 students of SMA Santo Thomas 1 Medan who fulfilled the inclusion criteria with stratified random sampling method. The collection of data were primarily carried out with dermatology examination and Baumann Skin Type questionnaire to determine the skin types. Then, they were analyzed with Chi-square test to see the relationship between skin types and acne vulgaris. The obtained results show that 73 (78,5%) out of 93 students suffered from acne vulgaris with predominance being female (39,8%) than male (38,7%), and those in 15-year age group (38,7%). The most commonly observed skin type on samples is oily skin (79,6%). The bivariate analysis with acquired p-value of 0,002 (p

Latar Belakang: Setiap orang pernah menderita kekeringan kulit, gatal, bersisik dan kemerahan karena berbagai macam penyebab. Kulit kering atau Xerosis cutis merupakan kelainan kulit dimana kulit menjadi kasar, bersisik, berkeriput dan kurang elastis dibandingkan kulit normal dan kering pada perabaan. Prevalensi xerosis di Indonesia adalah 50%-80% sedangkan pada beberapa negara lain seperti Brazil, Australia, Turki, dan lain-lain adalah 35%-70%. Merawat kulit secara teratur dapat dilakukan menggunakan lulur tradisional dari bahan alam. Penggunaan biji pepaya pada umumnya hanya dibuang atau di tanam atau dimanfaatkan sebagai bibit untuk dibudidayakan, padahal sebenarnya biji pepaya bisa diolah menjadi suatu sediaan yang bermanfaat. Biji pepaya kaya akan manfaat untuk kulit. Selain itu perawatan kulit kering juga dapat dilakukan dengan menggunakan kacang kedelai dan minyak zaitun. Tujuan: Membuat dan menguji stabilitas sediaan secara organoleptis dan pH pada sediaan lulur serbuk tradisional untuk mengatasi kulit kering dari biji pepaya (Carica papaya L) dan pati kedelai (Glycine max L) dengan minyak zaitun sebagai penambah aroma. Metode: Desain penelitian ini adalah penelitian tindakan atau action research dengan instrumen lembar pengamatan. Pengujian stabilitas sediaan lulur serbuk tradisional dilakukan selama 3 minggu pada suhu sejuk 100C dan suhu kamar 250C. Hasil: Menunjukkan bahwa sediaan lulur serbuk tradisional biji pepaya dan pati kedelai yang disimpan pada suhu sejuk 100C memiliki stabilitas organoleptik bentuk, bau, warna serta tidak adanya jamur dan memiliki pH yang lebih baik dibandingkan dengan penyimpanan pada suhu kamar 250C. Simpulan: Dari penelitian ini memberikan hasil dan stabilitas yang baik selama 3 minggu. Diharapkan penelitian selanjutnya dapat melakukan pengujian lain selain uji organoleptis dan pH dengan bentuk sediaan yang berbeda dari bahan biji pepaya dan kacang kedelai.

Introduction: Uremic pruritus is a common symptom in patients with end-stage renal disease (ESRD). Intense pruritus can lead to uncontrollable scratching, impaired sleep, anxiety, depression, therefore significantly lowering patient's life quality. Although the prevalence of uremic itch in patients on dialysis has declined over time, it is still present in peritoneal dialysis (PD) and hemodialysis (HD) patients. Aim: The aim of this study is to investigate the prevalence of pruritus in HD patients compared to PD patients, as well as possible differences in its presentation and correlation with demographic and clinical characteristics of the population. Material and methods: A total of 50 HD and 50 PD patients were included. Dialysis modality, patient demographic, clinical characteristics, and laboratory data were recorded. Data on the presence and duration of itching, skin dryness and scaling were obtained from a general itch questionnaire. The visual-analogue scale (VAS) and the 5-D itch scale were used for evaluation of pruritus. Results: Pruritus was present in 42% of PD patients and 24% of HD patients (p = 0.056), without statistically significant differences in the distribution and intensity of pruritus in patients on different dialysis modality. A significantly higher number of PD patients had dry (41 vs 31; p = 0.026) and scaling skin (31 vs 15; p = 0.001). Patients with pruritus in PD had significantly higher levels of intact parathyroid hormone (iPTH) (386.57±302.29 pg/mL vs 159.25±163.52 pg/mL; p = 0.033) and AST (23.84±11.36 U/L vs 14.7±3.73 U/L; p=0,002), while having significantly lower levels of urea (18.78±7.60 mmol/L vs 23.65±4,31 mmol/L; p=0.028), creatinine (717.96 ± 229.50 mmol/L vs 940.06±207.57 mmol/L; p=0.009) and potassium (4.17 ± 0,63 mmol/L vs 5.80 ± 0.80 mmol/L; p = 0.000) in comparison to HD patients with pruritus. Conclusion: Pruritus is a common symptom among ESRD patients treated with dialysis. In our study, a higher prevalence of pruritus was observed in PD patients. Dry skin and higher levels of iPTH have been singled out as possible contributing factors to the occurrence of itch.

The barrier function of the skin protects it from external stresses to which it is constantly exposed, such as dryness, ultraviolet rays, and chemicals. Lipids, in particular a type of sphingolipid known as ceramides, play a central role in the barrier function of the skin by preventing dryness. The number of ceramides in the skin is known to decrease with age, which has led to the development of a large number of anti-aging cosmetic products that contain ceramides. Recently, it has become evident that oral intake of ceramides can also improve the quality of the skin. To elucidate the effects of oral ceramide intake on skin moisture content, we conducted a randomized, double-blinded, placebo-controlled parallel comparative study in which males and females between 20 and 60 years of age who were worried about dry skin ingested a food with acetic acid bacteria containing 0.8 mg of dihydroceramide or a placebo for 12 weeks. Concurrently, we investigated the safety of continuous ingestion of the ceramide-containing food over 12 weeks. Oral intake of ceramide over the 12 weeks significantly improved stratum corneum hydration, i.e. the moisture content of the skin, and did not result in harmful effects in any of the participants.

OBJECTIVE: The physiological skin surface pH is crucial for several epidermal barrier functions, like stratum corneum integrity, cohesion and restoration. Alterations of the “normal” acidic nature of the skin surface have been shown to correlate with specific skin conditions like aged or inflamed skin and are leading to impaired skin barrier function and formation. It is previously demonstrated that topical acidification in atopic dermatitis improves stratum corneum function, skin barrier structure and clinical signs in dermatitis. Against this background, we examined the impact of a slightly acidic skin care product containing urea on stratum corneum hydration, skin surface pH and epidermal barrier function in subjects with dry skin and atopic diathesis. METHODS: Stratum corneum hydration, skin surface pH and transepidermal water loss were biophysically measured before and after a 4-week treatment period with the test product (pH 4.5, 10% urea) compared to the reference product in 25 volunteers. In addition, dynamic epidermal barrier parameters like stratum corneum integrity, cohesion and recovery were investigated by using a previously described tape stripping approach. RESULTS: It was shown that the test product (pH 4.5, 10% urea) significantly elevated stratum corneum hydration and improved the acidic nature of the skin surface by lowering the skin surface pH to a greater extent compared to the reference product. After the 4-week treatment period a significant faster barrier restoration was detected on the test site treated with the test product compared to the reference product. Moreover, the test product strengthens the skin barrier integrity and cohesion. CONCLUSION: The present marketed skin care lotion was shown to increase epidermal barrier function after 4 weeks of application. Balancing and controlling the skin surface pH in subjects with dry and atopic-prone skin by application of the herein tested o/w emulsion with a given pH of 4.5, in combination with a 10% urea content seems to be effective and beneficial. The results are important for the formulation of topical products for dry and atopic-prone skin.

Background: Factors predicting allergic sensitization in the first 6 months of life are poorly understood. We aimed to determine whether eczema, dry skin, and high transepidermal water loss (TEWL) at 3 months were associated with allergic sensitization at 6 months of age and, secondarily, to establish whether these characteristics predicted sensitization from 3 to 6 months of age. Methods: At 3 months of age, 1,994 infants from the population-based PreventADALL birth cohort in Norway and Sweden were assessed for eczema and dry skin on the cheeks and/or extensors; impaired skin barrier function, defined as TEWL in the upper quartile (>9.4 g/m(2)/h), and allergen-specific IgE levels = 2 mm larger than negative control. Results: Any sensitization was found in 198 of the 1,994 infants (9.9%), the majority to food allergens (n = 177, 8.9%). Eczema, dry skin, and high TEWL at 3 months increased the risk of sensitization at 6 months; adjusted odds ratios 4.20 (95% CI 2.93-6.04), 2.09 (95% CI 1.51-2.90) and 3.67 (95% CI 2.58-5.22), respectively. Eczema predicted sensitization with 55.6% sensitivity and 68.1% specificity; dry skin with 65.3% sensitivity and 57.3% specificity; and high TEWL with 61.7% sensitivity and 78.1% specificity. Conclusion: Eczema, dry skin, and high TEWL at 3 months predicted allergic sensitization at 6 months of age.

Dry skin or xerosis is a common ailment occurring both as a separate disease entity and as a symptom of other diseases, e.g. it is a cardinal symptom of atopic dermatitis1 . Infections have been described in xerosis associated with dermatitis2 . Whether xerosis without dermatitis is a risk factor for skin infections remains unknown. We therefore tested if individuals with xerosis had a risk of skin infections.

Objective: Newborns require special care because their skin is much more sensitive and thinner than adults. From the products to be selected to the umbilical cord care; prevention of the pus; Parents and health professionals should pay attention to some important points in so many issues ranging from bathing conditions. In this study, it is aimed to systematically examine the studies about skin care of newborns. Materials and Methods: A total of 2792 studies published between 2012 and 2019 were examined. A total of nine publications were included in the study and evaluated in terms of comparison, limitations and results. Results: From the few studies with comparable data, there was no evidence that there was no significant difference between the tested washing products and the water or the tested baby wipes and water. There was some evidence to suggest daily use of emollients in a full-body bath. However, the use of olive oil or sunflower oil for the baby's dry skin may adversely affect the skin barrier. There was no evidence of hair/scalp care or baby massage. Conclusion: Although there is evidence of significant randomized controlled trials comparing the use of certain products to water or another product alone for bathing, cleaning and diaper care, the strength of this evidence is low due to the inconsistency of the outcome measures in terms of treatment area or time. It is recommended to increase the number of randomized controlled trials with the appropriate methodology for skin care of newborns. Keywords: Newborn, Skin care, Nursing care

The skin is the largest human organ, comprising the epidermis that is composed of epithelial tissue, the dermis composed of connective tissue, and the innermost subcutaneous tissue. Generally, skin conditions are due to aging and the influence of the external environment, but empirically patients with gastrointestinal diseases are more prone to pruritus and inflammation caused by dry skin. A decrease in the skin barrier function, involving immunocompetent mast cells and oxidative stress, was noted in indomethacin-induced small intestine inflammation, dextran sodium sulfate (DSS)-induced ulcerative colitis, and azoxymethane+DSS-induced colorectal cancer. A possible correlation was found to exist between inflammatory gastrointestinal diseases and the skin, and this correlation was investigated using a rheumatoid arthritis model as representative of inflammatory diseases. Similar to previously reported results, deterioration of the skin barrier function was observed, and new information was obtained by analyzing changes in inflammatory markers in the blood and skin tissues. Understanding the underlying mechanism of decreased skin barrier function will help in establishing effective prophylaxis and treatment methods and clarify the importance of crosstalk between organs. It will also help accelerate drug development.

Many dermatological conditions, such as eczema and psoriasis, are treated with topical therapeutic products. Instead of applying the active drug directly onto the skin, it is combined with a vehicle to aid in its delivery across the stratum corneum (SC) and into deeper regions of the skin, namely the epidermis and dermis. Absorption into the systemic circulation is minimized. Topical vehicles are also used as cosmetic moisturizers (often termed emollient therapy) to ameliorate dry skin, which is a cornerstone of the management of various dermatological conditions, including xerosis, eczema, psoriasis, and aging. The most common topical vehicles include ointments, creams, gels, and lotions, among others. It is crucial that topical vehicles are chosen based upon the size and properties (wet/dry, mucous/non-mucous, healthy/diseased) of the skin to be treated in order to optimize application and contact of the product with the skin, as this can have profound impacts on potency, efficacy, and patient compliance. This review examines common topical vehicles used for drug delivery and cosmetic moisturizers, including their formulation, advantages and disadvantages, and effects on the skin. The unique rules imposed by governing regulatory bodies in Australia and around the world, in terms of topical product claims, are also briefly examined.

Background Loss-of-function mutations in the skin barrier gene filaggrin (FLG) increase the risk of atopic dermatitis (AD), but their role in skin barrier function, dry skin and eczema in infancy is unclear. Objectives To determine the role of FLG mutations in impaired skin barrier function, dry skin, eczema and AD at 3 months of age and throughout infancy. Methods FLG mutations were analysed in 1836 infants in the Scandinavian population-based PreventADALL study. Transepidermal water loss (TEWL), dry skin, eczema and AD were assessed at 3, 6 and 12 months of age. Results FLG mutations were observed in 166 (9%) infants. At 3 months, carrying FLG mutations was not associated with impaired skin barrier function (TEWL > 11 center dot 3 g m(-2) h(-1)) or dry skin, but was associated with eczema [odds ratio (OR) 2 center dot 89, 95% confidence interval (CI) 1 center dot 95-4 center dot 28; P < 0 center dot 001]. At 6 months, mutation carriers had significantly higher TEWL than nonmutation carriers [mean 9 center dot 68 (95% CI 8 center dot 69-10 center dot 68) vs. 8 center dot 24 (95% CI 7 center dot 97-8 center dot 15), P < 0 center dot 01], and at 3 and 6 months mutation carriers had an increased risk of dry skin on the trunk (OR 1 center dot 87, 95% CI 1 center dot 25-2 center dot 80; P = 0 center dot 002 and OR 2 center dot 44, 95% CI 1 center dot 51-3 center dot 95; P < 0 center dot 001) or extensor limb surfaces (OR 1 center dot 52, 95% CI 1 center dot 04-2 center dot 22; P = 0 center dot 028 and OR 1 center dot 74, 95% CI 1 center dot 17-2 center dot 57; P = 0 center dot 005). FLG mutations were associated with eczema and AD in infancy. Conclusions FLG mutations were not associated with impaired skin barrier function or dry skin in general at 3 months of age, but increased the risk for eczema, and for dry skin on the trunk and extensor limb surfaces at 3 and 6 months.

Recent publications describe various skin disorders in relation to phototypes and aging. The highest phototypes (III to VI) are more sensitive to acne, with the appearance of dark spots due to the inflammation induced by Cutibacterium acnes (previously Propionibacterium acnes). Dryness with aging is due to a lower activity of specific enzymes involved in the maturation of lipids in the stratum corneum. To observe and understand these cutaneous issues, tissue engineering is a perfect tool. Since several years, pigmented epidermis with melanocytes derived from specific phototypes allow to develop in vitro models for biological investigations. In the present study, several models were developed to study various skin disorders associated with phototypes and aging. These models were also used to evaluate selected ingredients’ ability to decrease the negative effects of acne, inflammation, and cutaneous dryness. Hyperpigmentation was observed on our reconstructed pigmented epidermis after the application of C. acnes, and pollutant (PM10) application induced increased inflammatory cytokine release. Tissue engineering and molecular biology offer the capability to modify genetically cells to decrease the expression of targeted proteins. In our case, GCase was silenced to decrease the maturation of lipids and in turn modify the epidermal barrier function. These in vitro models assisted in the development of ethnic skin-focused cosmetic ingredients.

Dry skin is one of the indicators of a compromised skin barrier. An intact skin barrier is not only important to reserve the hydration within the epidermal tissue but also to protect our skin from environmental stressors and inhibit pathogen invasion, damage to the skin barrier may lead to inflammatory skin diseases. Some microbial metabolites such as short chain fatty acids may inhibit or destroy harmful bacteria and regulate the host immune system. The impact of the skin microbiome and short chain fatty acids on skin barrier function was studied in two groups of 75 participants each. The cohort was equally divided in dry and moist skin types, based on stratum corneum (SC) functionality index (SCFI), reflecting the ratio of transepidermal water loss (TEWL). A dry group represents a low SCFI and a moist group a high SCFI. Compared with the dry skin group, propionate and Cutibacterium levels (previously known as Propionibacterium acnes) were significantly higher (p &lt, 0.001) in the moist group. Levels of Cutibacterium were negatively correlated with those of Staphylococcus (p &lt, 0.0001) in both dry and moist groups. The moist group also had a significantly higher propionate concentration (p &lt, 0.001). This study showed that the microbial community and short chain fatty acid concentration may be considered as significant determinants of the SCFI of the skin.

In order to effectively treat atopic dermatitis (AD), the restoration of the skin barrier abnormalities and immunologic abnormalities should be carried out together in smart healthcare products. In this study, the anti-inflammatory effect of guaiazulene (GAZ) was confirmed by measuring the expression level of pro-inflammatory cytokines, interleukin 6 (IL-6) and interleukin 8 (IL-8) in tumor necrosis factor‐alpha (TNF‐α) stimulated human keratinocyte cell line, HaCaT cells. Based on the in vitro anti-inflammatory properties of GAZ, cosmetics containing both ceramide NP (CER NP) which has a significant effect on skin barrier function and GAZ were developed and clinical trials were conducted on the effects of itching relief caused by dry skin by measuring skin moisture content, transepidermal water loss (TEWL), and visual analog scale (VAS). As a result, (1) In the skin moisture content, the rate of change after 2 weeks and 4 weeks of test products use statistically significantly increased by 89.804% and 91.980%, respectively, compared with before test products use; (2) In the TEWL, the rate of change after 2 weeks and 4 weeks of test products use statistically significantly decreased by 11.026% and 9.938%, respectively, compared to before test products use; (3) In the VAS grade, the rate of change after 2 weeks and 4 weeks of test products use statistically significantly decreased by 66.191% and 83.944%, respectively, compared with before test products use. This study proved the outstanding clinical effect of the cosmetics containing 2% CER NP and 0.02% GAZ on itching relief caused by dry skin.

Manpreet Randhawa,1 Thomas Meyer,2 Mukta Sachdev,3 Ratan K Chaudhuri1 1Sytheon Ltd, Boonton, NJ, USA; 2Meyer Sun & Skin Care Consulting, LLC, Memphis, TN, USA; 3MSCR Pvt Ltd, Bengaluru, IndiaCorrespondence: Manpreet RandhawaSytheon Ltd, 315 Wootton Street, Boonton, NJ, USATel +1 973 947 1109Email manpreet@sytheonltd.comBackground: Identification of long-lasting natural antioxidants to protect against and repair skin damage induced by exposure to environmental pollution is in high demand.Objective: To investigate a standardized Terminalia chebula (TC) fruit extract for its long-lasting antioxidant and anti-inflammatory properties and its ability to reverse the visible signs of pollution-induced skin damage in an 8-week clinical study.Material and Methods: Chemical and cell-based in vitro studies were performed to characterize long-lasting antioxidant and anti-inflammatory properties; a clinical study with subjects with normal to dry skin living in a high-pollution city for the previous 5 years was conducted to assess if a formulation containing 1% standardized TC fruit extract affected significant improvements in skin’s visible condition and appearance compared with its placebo.Results: The standardized TC fruit extract provided longer-lasting and more efficient neutralization of reactive oxygen species (ROS) than tocopherol; treatment of keratinocytes with the fruit extract prior to being stressed with urban dust safeguarded against increases in intracellular ROS, inhibited release of inflammatory cytokines IL-6 and IL-8 and protected membrane lipids against peroxidation. A clinical study yielded statistically significant improvements in dermatologist scores and subject self-assessments for skin texture, hydration, tone, firmness and radiance as compared to its placebo.Conclusion: These studies validate the use of this standardized TC fruit extract not only as a restorative to diminish visible signs of existing damage but also as a preventative to help defend skin against damages caused by chronic exposure to environmental pollution.Keywords: long-lasting antioxidant, pollution, skin hydration, skin radiance, Terminalia chebula

Background Acne vulgaris is one of the most prevalent skin diseases responsible for dermatological consultations. Several internal and external factors can affect acne occurrence and severity. Outdoor air pollution is an external factor discussed to trigger inflammation of the skin. The objective of this study was to find a link between the exposure to ambient air pollution and inflammatory acne occurrence in the Lebanese adult population. Methods A cross-sectional study was conducted, using an online questionnaire to collect the required data from different Lebanese regions. The survey covered pollution exposure questions as well as queries on several factors known to have a role on acne occurrence. Results A total of 372 participants were included in the study, aged 18 to 55 years old. The results of a logistic regression taking the presence/absence of acne as the dependent variable, showed that female gender (aOR = 4.39), younger age (aOR = 1.05), using hydrating cream (aOR = 4.30), working near a power plant vs not (aOR = 3.07), having a severe NO2 exposure compared to none (aOR = 8.24), a higher number of family members with acne or history of acne (aOR = 1.48) were significantly associated with higher odds of having acne, whereas having a dry skin compared to normal (aOR = 0.20) was significantly associated with lower odds of having acne. Conclusion The occurrence of inflammatory acne in Lebanese adults was found to be associated with ambient exposure to high levels of NO2 and employment near a power plant known to emit CO2, CO, SO2, NO2 and PM. Therefore, our findings can serve as a first step towards implementing awareness on a skin care routine suitable for highly polluted areas.

BACKGROUND Clinical studies have clarified the usefulness of moisturizers for dry skin diseases. However, few reports exist on the appropriate application of moisturizers with respect to the skin physiological functions. AIMS To clarify the optimal moisturizer application method on the basis of skin physiological functions. METHODS This study investigated the appropriate time, dose, and frequency of moisturizer application from the perspective of skin physiology. In healthy subjects, the stratum corneum water content (SCW) was compared between different moisturizer application times (immediately [≤5 min] and 90 min after bathing), doses (0.5, 1.0, and 2.0 mg/cm2 ), and frequencies (once and twice daily). Thereafter, patients with dry skin were treated with the moisturizer once or twice daily for 8 weeks at the time, and application dose was determined to be optimal for the healthy subjects; the moisturizing effect was evaluated based on the SCW, trypsin activity, and desmoglein 1 localization score in the stratum corneum. RESULTS In healthy subjects, compared to at control sites, the SCW was significantly higher at sites treated with the moisturizer immediately after bathing, with 1.0 and 2.0 mg/cm2 of the moisturizer, and with once- and twice-daily applications. In patients with dry skin, the SCW was significantly higher compared to control sites and the desmoglein 1 localization score was significantly lower after 8 weeks only when the moisturizer was applied twice daily. CONCLUSIONS Moisturizer application of ≥1.0 mg/cm2 twice daily (immediately after bathing at night and in the morning) had a moisturizing effect, as verified from the skin physiological functions.

Asteatosis is characterized by decreased stratum corneum water content, and the basic treatment is to keep the skin moisturized. Poor application of moisturizers by patients may reduce treatment efficiency, so it is important to continue application as instructed by dermatologists. Application instructions based on the finger-tip unit are useful for patients, but there is no clear evidence of its efficacy. We investigated the effects of the volume of the moisturizer (Hirudoid® Cream 0.3%) administrated with 1/3 finger-tip unit and 1 finger-tip unit equivalent doses per target lower leg of patients with asteatosis (twice daily, 28 days) on the overall dry skin scores, itch numerical rating scale scores, and skin physiological parameters (stratum corneum water content, transepidermal water loss, and skin pH). Sixty patients were randomized with a 1:1 allocation ratio into two groups: the 1/3 finger-tip unit and 1 finger-tip unit equivalent dose groups. The results showed that 43.3% of the patients in the 1 finger-tip unit equivalent dose group, compared with 13.3% in the 1/3 finger-tip unit equivalent dose group, presented zero overall dry skin scores 1 week later. As the overall dry skin scores improved, the stratum corneum water content also increased. In patients with moderate itching, the itch numerical rating scale scores of the 1 finger-tip unit equivalent dose group decreased significantly compared with those of the 1/3 finger-tip unit equivalent dose group. The results suggested that the application of 1 finger-tip unit equivalent dose of the moisturizer twice daily in clinical practice could induce remission more quickly. With the 1/3 finger-tip unit equivalent dose, prolonged treatment may be necessary to achieve the desired effect; therefore, application adherence is strictly required. In conclusion, the application of a 1 finger-tip unit equivalent dose would be quite reasonable in clinical practice.

Background: Filaggrin-derived natural moisturizing factors (NMF) play an important role in skin barrier function and in atopic dermatitis (AD). Its deficiency is associated with dry skin and increased surface pH. Studies on childhood environmental exposures and associations with NMF levels are scarce. Objectives: To investigate previous exposures and genetic factors and their associations with NMF levels in young children. Methods: In a case-control study nested in a prospective birth cohort (Odense Child Cohort), 169 healthy controls (HC) and 99 children with AD were included consecutively at the age of 7 years based on previous responses from questionnaires administered at 18 months, 3 years and 5 years, pertaining to past medical history, including allergy-specific questions. NMF levels were measured via a stratum corneum tape-stripping technique, genotyping for filaggrin (FLG) gene variants was performed and data on external exposures, including usage of moisturizer and topical steroids, antibiotics and early pet exposures, were obtained from questionnaires. Results: Natural moisturizing factors levels were significantly lower in AD participants compared to HC (P < 0.001). This significance persisted after stratifying for AD subgroups of present AD, current AD during the last year and previous AD (P < 0.001, P = 0.039, P = 0.009 respectively). There was a significant association between NMF and FLG genotype (P = 0.016, P = 0.002 for HC, AD respectively). NMF levels were negatively correlated with early age moisturizer use (2 cytokine milieu suppressing these levels.

Neuronal morphological changes in the epidermis are considered to be one of causes of abnormal skin sensations in dry skin-based skin diseases. The present study aimed to develop an in vitro model optimised for human skin to test the external factors that lead to its exacerbation. Human-induced pluripotent stem cell-derived sensory neurons (hiPSC-SNs) were used as a model of human sensory neurons. The effects of chemical substances on these neurons were evaluated by observing the elongation of nerve fibers, incidence of blebs (bead-like swellings), and the expression of nicotinamide mononucleotide adenylyl transferase 2 (NMNAT2). The nerve fiber length increased upon exposure to two common cosmetic preservatives—methylparaben and phenoxyethanol—but not to benzo[a]pyrene, an air pollutant at the estimated concentrations in the epidermis. Furthermore, the incidence of blebs increased upon exposure to benzo[a]pyrene. However, there was a decrease in the expression of NMNAT2 in nerve fibers, suggesting degenerative changes. No such degeneration was found after methylparaben or phenoxyethanol at the estimated concentrations in the epidermis. These findings suggest that methylparaben and phenoxyethanol promote nerve elongation in hiPSC-SNs, whereas benzo[a]pyrene induces nerve degeneration. Such alterations may be at least partly involved in the onset and progression of sensitive skin.

A decrease in the ceramide content of the stratum corneum is known to cause dry and barrier-disrupted skin. In this literature review, the clinical usefulness of preparations containing natural or synthetic ceramides for water retention and barrier functions was evaluated. The PubMed, Cochrane Library, and Igaku Chuo Zasshi databases were searched using keywords such as "ceramide", "skincare products", "barrier + hydration + moisture + skin", and "randomized trial". All database searches were conducted in February 2019. Forty-one reports were selected based on the following criterion: comparative control studies that evaluated the effects of ceramide-containing formulations based on statistical evidence. Among the 41 reports, 12 were selected using the patient, intervention, comparison, and outcome approach. These 12 reports showed that external ceramide-containing preparations can improve dry skin and barrier function in patients with atopic dermatitis. However, a double-blinded comparative study with a large sample size is warranted for appropriate clinical use.

Diabetes mellitus (DM) in Indonesia has rapidly increased during recent years. World Health Organization (WHO) predicted that in 2030, Indonesia would be ranked fourth for the largest DM patients in the world. As the disease progresses, uncontrolled type 2 DM (T2DM) results in dry skin as the most prevalent skin disorder. Despite the prevalence and morbidities that lead to infection, ulcer, gangrene that can lead to amputation when insufficiently treated, dry skin in T2DM has limited therapeutic options. Currently, available therapies for dry skin in T2DM have not considered factors of hyperglycemia and hyperinsulinemia, which disturb skin homeostasis. Nonetheless, in T2DM, there are neuropathy and biostructural changes of the skin which induce dry skin. Alternative herbal medicine, Centella asiatica is getting well-known nowadays because of its vast amount of benefits. Centella asiatica has been studied for its antioxidant, antidiabetic, anti-inflammation, antiglycation, and neuroprotective activities. Furtherly, these properties may display benefits when introduced to T2DM dry skin therapy. The previous clinical study had shown that topical C. asiatica improved dry skin. This clinical study was also supported by in vitro studies. Currently, pharmacological profile studies of C. asiatica including dosage, toxicity, and safety have been available. This article aimed to review the current literature on the potential of C. asiatica as an alternative to treat dry skin in T2DM.

The term, Skin of Colour (SOC), refers to individuals of African, Latinx, Asian, Native Hawaiian, Pacific Islander and Indigenous descent. These individuals typically have darker skin tones as compared to white individuals and they often present with unique disorders of the skin or with common disorders that have a unique appearance. Certain skin conditions commonly associated with SOC patients, in contrast to individuals with lighter skin tones, are explained by structural and functional differences between this population and the white population. Variations in functional differences between these two groups are dependent on structural differences in melanosomes, stratum corneum, epidermis and dermis. Understanding the structural distinctions between white populations and SOC populations, will provide insight into common disorders in skin of colour patients, including hyperpigmentation, hypopigmentation, dry skin, scaliness, xerosis, sensitive skin and keloids. Furthermore, understanding structural and functional skin difference will encourage more research regarding etiology of disease and therapeutic interventions.

Dry indoor air has been identified as the main cause of dry skin in winter which greatly affects older occupants' wellbeing, but HVAC design standards are based on average adults and do not specify a humidity level that can prevent dry skin. A field study was carried out to understand the difference between the younger and older people with regards to thermal and humidity comfort and skin condition in winter. The study proves a research procedure that is friendly to and preferred by the participants to measure the effect of the indoor environment on their comfort and skin condition in a real living environment setting. The results suggest that younger and older occupants are different in thermal comfort, specifically older occupants prefer a warmer environment than younger occupants, and the neutral temperature produced by the predicted mean vote method is not warm enough for older occupants. The study also suggests stratum corneum hydration appears to be a good indicator to present the effect of indoor humidity on the occupants' skin condition, which can be used to determine the minimum humidity level to reduce the risk of suffering dry skin in winter.

Many endogenous or exogenous factors, isolated or combined, can trigger dry skin disorder, leading to a water/lipids-depleted stratum corneum concomitant with uncomfortable rough and scaly skin surface. In a defensive reaction, the alteration of the skin barrier stimulates the production of cytokines to initiate homeostasis restoration but this can also induce an inflammatory response that further weakens the barrier. The two phenomena intertwining one another lead to the creation of a vicious circle, here called Inflamm'dryness, that maintains dry skin state. It is thus very important to investigate biological mechanisms involved in Inflamm'dryness to better manage dry skin.A 3D model mimicking dry skin has been developed. Adjustment of tape stripping level allowed to reproduce skin barrier alterations and resulting inflammation involved in dry skin. The effect of Helichrysum stoechas extract on this downward spiral was then investigated to validate the concept.Tape-stripping permitted to successively remove the cell layers of the stratum corneum: the barrier function was altered and skin was inflamed creating a vicious circle, mimicking very dry skin prone to Inflamm'dryness. Helichrysum stoechas extract was not only able to resolve inflammation but also to reverse concurrently adverse tape-stripping effects and imparted significant structural and functional recovery of the barrier (e.g. on NMF and ceramides levels, TEWL, tissue organization).This 3D model reproduces Inflamm'dryness vicious circle present in dry skin and highlights the importance of breaking this process to improve dry skin conditions. Helichrysum stoechas extract is a promising active ingredient for the management of dry skin.De nombreux facteurs endogènes ou exogènes, isoles ou combines, peuvent être à l’origine de sècheresse cutanée, conduisant à une peau en manque d’eau et de lipides : la peau tiraille, présente parfois un l’aspect rugueux (voire la présence de squames) et des sensations d’inconfort. Cette altération de la barrière cutanée induit la production de cytokines permettant la restauration de l'homéostasie de la peau mais induisant également une réponse inflammatoire fragilisant davantage la barrière cutanée. Ces deux phénomènes conduisent à la création d'un cercle vicieux, l’Inflamm'dryness, qui entretient l'état de sécheresse de la peau. Il semble donc important d’étudier les mécanismes biologiques impliqués dans le phénomène d’Inflamm’dryness afin de mieux prendre soin des peaux sèches. MÉTHODES: Un modèle 3D mimant une peau sèche a été développé. Un ajustement du nombre de tape-strippings a été nécessaire afin de reproduire les défauts de barrière ainsi que de l'inflammation caractéristiques des peaux sèches. L'effet d’un extrait d'Helichrysum stoechas sur cette spirale négative a ensuite été étudié pour valider le concept. RÉSULTATS: L’étape de tape-stripping a permis de retirer successivement les couches superficielles du stratum corneum: la fonction barrière est altérée et la peau est enflammée créant un cercle vicieux, mimant une peau très sèche sujette à l’Inflamm’dryness. L'extrait d'Helichrysum stoechas est non seulement capable de résoudre l'inflammation, mais également de restaurer la fonction barrière de la peau (quantités de NMF et de céramides, la perte insensible en eau, organisation des tissus…).Ce modèle 3D reproduit le cercle vicieux de l’Inflamm'dryness caractéristique des peaux sèches et met en évidence l'importance de rompre ce processus afin de remédier à la sécheresse cutanée. L'extrait d'Helichrysum stoechas développé est un actif prometteur pour le soin des peaux sèches.

Emollients are widely used by thousands of people on a daily basis to help manage chronic dry skin conditions However, evidence has been growing in the last 10 to 15 years about the fire risk caused when emollients transfer to and dry on fabric, creating a highly flammable combination that can lead to serious injury or death This article discusses recent campaigns raising awareness among health professionals and patients about these risks