The Role of Topical Moisturizers in Managing Compromised Skin - PowerPoint Presentation

Slide1

The Role of Topical Moisturizers in Managing Compromised Skin

Slide2

Natural

protective barrier

fromphysical injurypathogenic microbeschemical agentsUV radiationextreme temperaturesHelps to restrict fluid and water lossSensory perception: temperature, pressure, touch and painTemperature regulation of the body

Skin Function

1. Irving V: Caring for and protecting the skin of pre-term neonates.

J Wound Care

 2001, 10:253-6.

2. Nikolovski J, Stamatas GN, Kollias N, Wiegand BC: Barrier function and water-holding and transport properties of infant stratum corneum are different from adult and continue to develop through the first year of life.

J Invest Dermatol

 2008, 128:1728-36.

Slide3

Bricks & Mortar

Slide4

The Infant Skin Barrier: Can We Preserve, Protect, and Enhance the Barrier? Lorena S. Telofski, A. PeterMorello III, M. CatherineMack Correa, and Georgios N. Stamatas; Dermatology Research and Practice

Volume 2012, Article ID 198789, 18 pages

doi:10.1155/2012/198789Infant vs Adult Skin

Slide5

L.S

T

e

l

osfski

et

a

l

.

D

e

rmatology Research and Practice, vol 2012 G.N. Stamatas et al. International Journal of Cosmetic Science, 2011, 33, 17-24

↗ permeability

↗ water retention

SKIN PARAMETER

ADULT

INFANTSurfaceMicrorelief linesLess denseMore denseCell sizeCorneocytes (SC)LargerSmallerGranular KeratinocytesLarger Less denseSmallerMore densely packedThicknessStratum corneumThicker~ 10µmThinner~ 7µmEpidermisThickerThinner (-20% vs adult)Dermal structureDermal papillae (density, size, morphology)Less homogenousMore homogenousDistinction between papillary and reticular dermisPresentAbsent

Structure

Slide6

↘

UV protection

NMF: Natural moisturizing factor

↗

skin hydration

↗

dryness

↘

hydro-lipid film protection

SKIN PARAMETER

ADULT

INFANT

Water content

Stratum corneum

Lower

Higher

(in older infants)

Drier at birth

Inter-personal variability

LowerHigherNMFNatural moisturizing factor concentrationHigherLowerSurface lipidsSebumHigherLower(7-10 month-old infant)CollagenFiber density

Higher (young adult)

Lower

Melanin

Density

Higher

Lower

Composition

L.S

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osfski

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ogy

R

esea

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and

P

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act

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ce,

vol

2012

G.

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. Sta

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atas

et

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. Inte

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,

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17

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24

Slide7

↗ potential infections

TEWL: Trans-epidermal water loss

↗ water evaporation

SKIN PARAMETER

ADULT

INFANT

Protective barrier

Skin barrier function

Competent

Competent – still maturing

TEWL

Trans-epidermal water loss

Lower

Higher

Water handling

Rate of water absorption

Lower

Higher

Rate of water desorption

LowerHigherCell proliferationTurnover rateLowerHigherpHSurface pHLowerMore alkaline(newborn only)FunctionL.S Telosfski et al. Dermatology Research and Practice, vol 2012 G.N. Stamatas et al. International Journal of Cosmetic Science, 2011, 33, 17-24

Slide8

Role of skin lipids

Slide9

G.N

. Sta

matas et al. International Journal of Cosmetic Science, 2011, 33, 17-24Babies

are born with skin pH cl

ose to neu

tr

a

l

:

6

.6

- 7.5Adults have a much more acidic skin with pH values: 4.5 - 6.7

Acidic skin pH affects several activities:Maturation and maintenance of the epidermal permeability barri

erControl of the de

squamation processRegulation of bacterial prolifer

ation on the skinImportance of proper pH

Slide10

Epidermal Barrier Dysfunction in Atopic Dermatitis. Michael J. Cork, et al., Journal of Investigative Dermatology (2009) Vol 129

Slide11

L.S

T

elosfski et al. Dermatology Research and Practice, vol 2012 G.N. Stamatas

et al. International Journal

of Cosmet

i

c

Sc

i

ence,

20

11, 33, 17-24Healthy Barrier Function

Slide12

Oats in Skincare

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Attributes of Oats in Skin Care

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ECZEMA

(N=33)

SENILE SKIN

WINTER ITCH

SENILE PRURITUS

PH

NORMAL pH RANGE 4.2-5.5

pH LEVEL IMMEDIATELY AFTER TREATMENT WITH COLLOIDAL OATMEAL

pH LEVEL BEFORE TREATMENT

Grais M. AMA Arch Derm Syphilol.1953;68(4):402-407.

pH measured on forearm

(N=33)

(N=16)

(N=14)

Buffering Capacity of Colloidal Oatmeal Restores

the pH of Damaged Skin to Within the Normal Range

Slide15

Avenanthramides

Slide16

Vollhardt J, Fielder DA, Redmont MJ. Identification and cosmetic application of powerful anti-irritant constituents

of oat grain. XXI IFSCC International Congress 2000, Berlin. Proceedings; 395-402.

Separated oat fractions tested in a skin erythema model/

Patients received 1.5 MED of UVB/Products applied 24 hours after irradiation/Clinical erythema evaluation 24 hours after product application

% of redness attenuation per gram after

UV irradiation. Measure 24h after application

Avenanthramides

Flavonoids

Saponins

0

50

100

150

200

250

The avenanthramide fraction is the most effective oat component in reducing UV-induced redness 24 hours after dermal application

Avenanthramides

vs other oat fractions

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Avenanthramides: Inhibition of Markers Related to Topical Skin Irritation

IL-8 Release (pg/mL)

from Keratinocytes

150

180

210

240

270

Unstimulated

Avenanthramide (μg/mL)

Stimulated

1

10

100

IL-8=interleukin-8.

Wallo W, et al. Poster presented at: 65th annual meeting of the AAD. February 2-6, 2007; Washington, DC.

Slide18

Oat Lipids

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Composition of Oat Lipids

Total lipid content of oats: from 2%–11.8% dry weight

Triglycerides

PhospholipidsLecithinGlycolipidsFree fatty acidsOleic, Linoleic, Palmitic, Stearic

Zhou M, et al. J American Oil Chem Soc. 1999;76(2):159-169.

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Oat Oil Reduces TEWL Compared to Control Sites

Potter RC et al. US Patent 5620692. April 15, 1997.

TEWL=transepidermal water loss.

Slide21

Whole Oat Oil Lipid Class Composition

Southall M, et al. The Dermatologist. September 2012 (suppl):1-4.

Slide22

Clinical Evidence Supporting the Use of Oat-Containing Products in Skin Care

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Colloidal Oatmeal Cream vs Rx Barrier Emulsion for Improving Skin Barrier in Moderate-to-Severe Dry Skin

-35

-15

-20

-30

4

-25

9

Days

1

7

Percent Mean Reduction in

Water Loss

Regression

Period

Colloidal Oatmeal Cream

Rx Skin Barrier Emulsion

Nebus J, et al. J Am Acad Dermatol. 2011;64:AB71.

Slide24

Effectiveness of a colloidal oat lotion vs vehicle for the relief of dry, itchy skin

A Randomized, Double-Blind Bilateral Controlled Study to Evaluate the Effectiveness of an Oatmeal Containing Lotion vs Vehicle for the Relief of Dry, Itchy Skin, data on file.

Slide25

*Colloidal oatmeal with ceramides and dexpanthenol.

Wallo W, et al. Poster presented at: 65th annual meeting of the AAD; February 2–6, 2007; Washington DC.

Colloidal Oatmeal Bath* in the Treatment of Dry and Sensitive Skin in Atopic Dermatitis

0

1.2

Before

After

Itching

Burning

Grading Score

0.2

0.6

1.0

0.4

0.8

4-week, investigator-blinded, crossover study (N=25)

50%

67%

Slide26

Dermatologist Assessment: EASI Composite Score (ages 12–60 years)

EASI=eczema area and severity index .

*Significant improvement (

P<0.001).Fowler JF, et al. J Drugs Dermatol

. 2012;11(7):804-807.

Daily Oat-based Skin Care Regimen for Atopic Skin: EASI Composite Score

0

6

2

8

EASI (Mean)

Baseline

Week 8

Week 2

Week 4

4

*

*

*

Slide27

Nebus J, Wallo W, Eichenfeld L, MD; Poster presented at the 34th Annual Meeting of the Society of Pediatric Dermatology. July 2008

Evaluating the Tolerance and Safety of a Colloidal Oat and Ceramide containing Moisturizing Cream and Oatmeal containing Moisturizing Wash in Babies and Children with Atopic Dermatitis

Slide28

*Assessment of AVEENO® Eczema Therapy Moisturizing Cream through a multi-centric clinical study on infants, children and adults with Atopic dermatitis. (n=71 patients in total aged 6 months to adult; topical steroid data based on n=19 patients who previously used topical steroids during the washout period).

Assessment of a Colloidal Oatmeal and Ceramide containing Moisturizing Cream through a multi-centric clinical study on infants, children and adults with AD*

Slide29

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Obrigada

Danke

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Tack

Gracias

Thank You !

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