Article

Effect of Olive and Sunflower Seed Oil on the Adult Skin Barrier: Implications for Neonatal Skin Care

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Abstract

Natural oils are advocated and used throughout the world as part of neonatal skin care, but there is an absence of evidence to support this practice. The goal of the current study was to ascertain the effect of olive oil and sunflower seed oil on the biophysical properties of the skin. Nineteen adult volunteers with and without a history of atopic dermatitis were recruited into two randomized forearm-controlled mechanistic studies. The first cohort applied six drops of olive oil to one forearm twice daily for 5 weeks. The second cohort applied six drops of olive oil to one forearm and six drops of sunflower seed oil to the other twice daily for 4 weeks. The effect of the treatments was evaluated by determining stratum corneum integrity and cohesion, intercorneocyte cohesion, moisturization, skin-surface pH, and erythema. Topical application of olive oil for 4 weeks caused a significant reduction in stratum corneum integrity and induced mild erythema in volunteers with and without a history of atopic dermatitis. Sunflower seed oil preserved stratum corneum integrity, did not cause erythema, and improved hydration in the same volunteers. In contrast to sunflower seed oil, topical treatment with olive oil significantly damages the skin barrier, and therefore has the potential to promote the development of, and exacerbate existing, atopic dermatitis. The use of olive oil for the treatment of dry skin and infant massage should therefore be discouraged. These findings challenge the unfounded belief that all natural oils are beneficial for the skin and highlight the need for further research.

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... The positive effects of olive oil in promoting wound healing are probably the result of the modulation of early phases such as inflammation and the stimulation of dermal reconstruction (Nasopoulou et al., 2014). Evidence suggest, however, that dermally applied olive oil disrupts the stratum corneum integrity and impairs the skin's normal lipid barrier function (Danby et al., 2013;Darmstadt et al., 2002;Jiang & Zhou, 2003) by changing the lipid ordering (T.-K. Lin et al., 2017), which is assumed to be due to oleic acid. ...
... After applying six drops of the oil twice a day for 5 weeks on the forearm of adult skin, the oil demonstrated the ability to preserve the stratum corneum integrity and prevent transepidermal water loss without inducing erythema, compared with untreated skin. Sunflower oil was also shown to reduce the severity of atopic dermatitis and hydrate the skin (Danby et al., 2013). ...
... Vegetable butters and oils have been proven to effectively express emollient action and thereby indirectly improve skin hydration (Janeš & Kočevar Glavač, 2018). The prevention of the increased transdermal water loss of the injured skin is another effect confirmed in several studies reviewed in the previous section (Boucetta et al., 2014;Danby et al., 2013;Mandawgade & Patravale, 2008;Velazquez Pereda et al., 2009). Direct substantiation of the observed hydrating effect may be found in research (Patzelt et al., 2012) showing that dermally applied vegetable oils remain on the skin surface and form a thin semiocclusive layer that significantly decreases transepidermal water loss. ...
Article
The use of vegetable butters and oils shows promising results in the treatment of skin wounds, as they have an effective impact on the phases of the wound‐healing process through their antimicrobial, anti‐inflammatory, and antioxidative activities and by promoting cell proliferation, increasing collagen synthesis, stimulating dermal reconstruction, and repairing the skin's lipid barrier function. In this article, in vitro and in vivo studies of argan (Argania spinosa), avocado (Persea americana), black cumin (Nigella sativa), calophyllum (Calophyllum inophyllum), coconut (Cocos nucifera), cranberry (Vaccinium macrocarpon), grape (Vitis vinifera), green coffee (Coffea arabica), lentisk (Pistacia lentiscus), linseed (Linum usitatissimum), lucuma (Pouteria lucuma), mango (Mangifera indica), olive (Olea europaea), pomegranate (Punica granatum), pumpkin (Cucurbita pepo), rapeseed (Brassica napus), sea buckthorn (Hippophae rhamnoides), and sunflower (Helianthus annuus) oils were reviewed. In many cases, vegetable oils proved to be more effective than synthetic wound‐healing compounds used as controls. The fatty‐acid components of vegetable oils are assumed to play a major role in the wound‐healing process, in particular polyunsaturated fatty acids such as linoleic acid. Evidence shows that oils with a higher linoleic to oleic acid ratio are more effective for lipid barrier repair. However, in depth studies are needed to gain knowledge about vegetable oils' effects on the skin and vice versa.
... This was ascribed to the fact that when EVOO, which is rich in monounsaturated fatty acid, is applied to the skin, it forms a greasy film as a result of its linoleic acid content, prevents fluid loss through the skin by accelerating proliferation of the epidermis, and provides skin hydration. Moreover, EVOO, which is easily absorbed through the skin, corrects the moisture level of the skin and gives it elasticity [12,15,16]. Adequate hydration of the skin protects the skin against mechanical injuries as well as prevents the formation of PIs [16]. ...
... Furthermore, EVOO is compatible with human tissue cells due to its lipid structure, and its topical application does not cause allergy or irritation [17][18][19][20]. It is also widely used [15,16,[21][22][23], and is cheap and easily obtainable [24,25]. Therefore, it may be effective in preventing PIs, an important health problem, and its use will contribute to the economy of any country, such as Turkey, that produces it, while significantly reducing the workload of nurses. ...
... When topically applied to the skin, it forms a greasy film due to its linoleic acid content, prevents fluid loss through the skin by accelerating proliferation of the epidermis, and provides skin hydration. EVOO, which is easily absorbed through the skin, corrects the moisture level of the skin, and thus provides optimal hydration and elasticity [12,15,16]. Adequate hydration of the skin prevents skin dryness as well as the formation of PIs by preventing the skin from peeling or tearing in those people at risk [16]. ...
Article
Background and purpose Different moisturizing products are used in the prevention of pressure injuries, but there is a limited number of studies on the effectiveness of extra virgin olive oil, which is an herbal and natural product. The aim of this study was to examine the effect of topically applied extra virgin olive oil on the prevention of pressure injuries. Methods and materials This was a randomized controlled experimental study conducted between February and October 2015 with a total of 129 patients, of whom 64 were in the control group and 65 in the extra virgin olive oil group. Results 16.9% of patients in the extra virgin olive oil group (n = 11) and 32.8% of patients in the control group (n = 21) developed pressure injuries, and the difference was found to be statistically significant. Conclusion This study showed that the application of extra virgin olive oil is effective in preventing pressure injuries.
... Natural olive oil and mustard oil have been used for many years as emollients. Studies have shown that these disrupt the skin barrier and hence should not be used [5,38] (Strong recommendation; Level of evidence II). Vegetable oils high in linoleic acid such as safflower oil or sunflower oil are recommended for infant's skin. ...
... Vegetable oils high in linoleic acid such as safflower oil or sunflower oil are recommended for infant's skin. Skin barrier recovery occurs faster with sunflower seed oil and petrolatum, whereas it gets delayed with mustard seed oil, soybean oil and olive oil [5,38]. Oleic acid content of olive oil inhibits synthesis of arachidonic acid, increases membrane permeability and TEWL. ...
... Oil acts as a source of warmth and nutrition and helps in weight gain of the babies. Coconut oil, sunflower oil, synthetic oil and mineral oil are being used for massage [5,38,46,47]. Babies massaged with oil showed less stress behavior and lower cortisol levels than those who were given massage without oil [48]. Thus, oil massage has multiple benefits and hence is recommended ...
Article
Objective: To develop standard recommendations for skin care in neonates, infants and children to aid the pediatrician to provide quality skin care to infants and children. Justification: Though skin is the largest organ in the body with vital functions, skin care in children especially in newborns and infants, is not given the due attention that is required. There is a need for evidence-based recommendations for the care of skin of newborn babies and infants in India. Process: A committee was formed under the auspices of Indian Academy of Pediatrics in August, 2018 for preparing guidelines on pediatric skin care. Three meetings were held during which we reviewed the existing guidelines/ recommendations/review articles and held detailed discussions, to arrive at recommendations that will help to fill up the knowledge gaps in current practice in India. The initial draft of the manuscript based on the available evidence and experience, was sent to all members for their inputs, after which it was finalized. Recommendations: Vernix caseosa should not be removed. First bath should be delayed until 24 hours after birth, but not before 6 hours, if it is not practically possible to delay owing to cultural reasons. Duration of bath should not exceed 5-10 minutes. Liquid cleanser with acidic or neutral pH is preferred, as it will not affect the skin barrier function or the acid mantle. Cord stump must be kept clean without any application. Diaper area should be kept clean and dry with frequent change of diapers. Application of emollient in newborns born in families with high risk of atopy tends to reduce the risk of developing atopic dermatitis. Oil massage has multiple benefits and is recommended. Massage with sunflower oil, coconut oil or mineral oil are preferred over vegetable oils such as olive oil and mustard oil, which have been found to be detrimental to barrier function.
... The main non-specific dermal activity of vegetable butters and oils is the emolliency of triglycerides, which results in improved skin hydration due to decreased transepidermal water loss (TEWL) (Danby et al., 2013). Specific effects include antimicrobial (Darmstadt et al., 2005;Verallo-Rowell et al., 2008), anti-inflammatory (Lucas et al., 2011) and antioxidative (Bardaa et al., 2016) action, expressed by free fatty acids and compounds of unsaponifiable matter (Poljšak et al., 2019). ...
... It is not clear, however, if low-oleic acid or mid-oleic acid sunflower oil was used in the study (Kanti et al., 2014). Oleic acid-rich triglycerides of olive oil were previously shown to damage the lipid barrier integrity in adult skin (Danby et al., 2013). Based on the aforementioned negative effect of the frequent use of refined sunflower oil every three to 4 hours (Kanti et al., 2014), the importance of unsaponifiable matter may also be taken into account. ...
... Finally, we must emphasize that in terms of long-term safety, it is advisable to use vegetable butters and oils on infants only when necessary, as the penetration of dermally applied oils through the non-mature skin of babies was found to be significant because the triglyceride profile in blood changed after an oil massage four times a day for five days (Solanki et al., 2005). Coconut, sunflower and olive oils were used in three studies on skin affected by atopic dermatitis (Verallo-Rowell et al., 2008;Danby et al., 2013;Evangelista et al., 2014). Coconut oil, characterized by the predominant saturated fatty acids in triglycerides, was superior to mineral oil (Evangelista et al., 2014). ...
Article
Full-text available
While the chemical composition of vegetable butters and oils has been studied in detail, there is limited knowledge about their mechanisms of action after application on the skin. To understand their dermal effects better, 27 clinical studies evaluating 17 vegetable oils (almond, argan, avocado, borage, coconut, evening primrose, kukui, marula, mustard, neem, olive, rapeseed, sacha inchi, safflower, shea butter, soybean and sunflower oils) were reviewed in this research. The reviewed studies focused on non-affected skin, infant skin, psoriasis, xerosis, UVB-induced erythema, atopic dermatitis, molluscum contagiosum, tungiasis, scars, striae and striae gravidarum. We conclude that in inflammation-affected skin, vegetable oils with a high content of oleic acid, together with the lack of or a low linoleic acid content, may cause additional structural damage of the stratum corneum, while oils high in linoleic acid and saturated fatty acids may express positive effects. Non-affected skin, in contrast, may not react negatively to oils high in oleic acid. However, the frequency and duration of an oil’s use must be considered an important factor that may accelerate or enhance the negative effects on the skin’s structural integrity.
... Although studies have shown that SSO and AO oils have positive effects on infants' skin and adverse reactions are rare, contact dermatitis, atopic dermatitis, and candida infection or other local reactions such as dryness, erythema, vesicles were monitored. [15][16][17] Skin Moisture Meter. The DMM Skin Moisture Meter (Beijing, China) was calibrated and used to measure SCH. ...
... Nurses should be familiar with natural oils such as olive, sunflower seed, almond, and coconut oils to advise parents in their use, although no oil can be recommended definitively. 15,16 They also should inform parents and caregivers that infant skin is more sensitive and drier than adult skin and requires moisturization. ...
Article
Objective: To investigate the effect of sunflower seed oil (SSO) and almond oil (AO) on stratum corneum hydration and Neonatal Skin Condition Scores (NSCSs) of preterm infants. Methods: This randomized controlled trial recruited 90 preterm infants whose gestational ages were between 32 and 37 weeks in the neonatal ICU. Infants were randomly assigned to three groups (SSO, AO, or control). The oils were applied to the whole body of each infant except for the head and face by a nurse researcher four times a day (4 mL/kg) for 5 days. Main outcome measures: Skin condition of the infants as evaluated with the NSCS; hydration as measured by a skin moisture meter before and after application. Main results: When average stratum corneum hydration was compared, infants in the SSO and AO groups had better hydration than infants in the control group. The NSCS scores in the control group were significantly higher than in the intervention groups, but there was no difference between the SSO and AO groups. Conclusions: Neither SSO nor AO has harmful effects on the skin, and their use may improve stratum corneum hydration. These oils can be used by nurses to hydrate the skin of preterm infants. Further studies are needed to evaluate the efficacy of natural oils on infant skin.
... Low levels of linoleic acid 18:2(n-6) also impair the epidermal barrier function and increase permeability of comedonal wall (Cunliffe et al., 2004). Consequently, sunflower oil high in linoleic acid 18:2(n-6) better preserves lipid integrity, does not cause erythema, and improves skin hydration in contrast to application of olive oil (Danby et al., 2013). However, many randomized controlled trials performed with evening primrose (Bamford et al., 2013) or borage (Foster et al., 2010) oils showed only minor to no beneficial effects on skin health outcomes, suggesting that minor components of linoleic-rich oils or increased proportion of oleic acid in these and other high linoleic oils could be partially responsible for these observations. ...
... Infant skin is susceptible to dryness and irritation from external factors, including topical skin care products not formulated for the infant's skin (Kuller, 2016). Topical products with adverse effects on skin barrier function, however, carry a potential to develop atopic dermatitis or eczema (Danby et al., 2013). The practice of recommending and using topical oils for the prevention or treatment of baby dry skin or for massage, including the increased societal interest in natural interventions, often ignores the fact that specific topical oils may have an adverse effect on skin barrier function (Cooke et al., 2011). ...
Article
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Botanical oils have a long history of traditional use and are routinely applied to skin care. The focus of this review is to contrast the functionality of skin oils versus the differential biological and toxicological effects of major plant oils, and to correlate them to their compositional changes. In total, over 70 vegetable oils were clustered according to their lipid composition to promote awareness of health practitioners and botanical product manufacturers for the safety and efficacy of oil-based interventions based on their fatty acid profiles. Since multiple skin disorders result in depletion or disturbance of skin lipids, a tailored mixture of multiple botanical oils to simultaneously maintain natural skin-barrier function, promote repair and regeneration of wounded tissues, and achieve corrective modulation of immune disorders may be required. As bioactive constituents of botanical oils enter the human body by oral or topical application and often accumulate in measurable blood concentrations, there is also a critical need for monitoring their hazardous effects to reduce the possible over-added toxicity and promote maximal normal tissue sparing. The review also provides a useful tool to improve efficacy and functionality of fatty acid profiles in cosmetic applications.
... Оливковое масло для ухода за кожей использовалось еще в Древнем Египте, и хотя это средство ухода за кожей стало популярным во многих странах, опубликовано лишь небольшое количество исследований, свидетельствующих о его смягчающем действии [25][26][27][28]. ...
... Рандомизированные контролируемые исследования показали, что, в отличие от подсолнечного, оливковое масло, преобладающим компонентом которого является олеиновая кислота, значительно повреждает кожный барьер и, следовательно, может способствовать развитию дерматита и усугублять уже имеющийся атопический дерматит. В связи с этим не рекомендуется использовать чистое оливковое масло для смягчения сухой кожи и для массажа у младенцев, однако это не относится к косметическим средствам, в т. ч. детским, в состав которых входит оливковое масло [28]. ...
Article
V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russian Federation The skin of a newborn is a delicate structure that is the first barrier protecting from exposures. Skin conditions in newborns are common due to adaptation to novel environment. The choice of an adequate moisturizing and skincare product is still an important issue. This paper discusses the structural and functional specificity of the skin of newborns and the role of lipids in the healthy functioning of skin barrier. Inadequate acid mantle and skin microbiome, gradual maturation of immune defense account for the frequent occurrence of infective inflammatory skin disorders, in particular, in skincare defects. Fatty oils are commonly used as emollients or the basis of care products, while essential oils and aromatic compounds are widely applied in perfume and cosmetic industries (including the production of skincare products for babies and toddlers). The effects of natural oils (e.g., olive, sunflower-seed, mustard-seed oil etc.) on skin hydration and permeability and their abil ity to induce inflammation. A single standard for certifying natural cosmetics including skincare products for babies is highlighted. Keywords: skin, newborn, care product, natural oil, essential oil. For citation: Ryumina I.I. Natural oils for skincare of newborns and infants. Russian Journal of Woman and Child Health. 2021;4(2):178–183. DOI: 10.32364/2618-8430-2021-4-2-178-183.
... Since oleic acid acts as a penetration enhancer, its action could improve the penetration through the stratum corneum of vesicles. The skin barrier repairing properties of linoleic acid are well known, related to increased keratinocyte proliferation and lipid synthesis [28,29]. Therefore, it is our opinion that the combination of the two unsaturated fatty acids could provide a topical delivery system capable by itself of inducing an improvement in the pathological condition of the skin. ...
Article
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Linoleic and oleic acids are natural unsaturated fatty acids involved in several biological processes and recently studied as structural components of innovative nanovesicles. The use of natural components in the pharmaceutical field is receiving growing attention from the scientific world. The aim of this research work is to design, to perform physico-chemical characterization and in vitro/in vivo studies of unsaturated fatty acids vesicles containing ammonium glycyrrhizinate, obtaining a new topical drug delivery system. The chosen active substance is well known as an anti-inflammatory compound, but its antioxidant activity is also noteworthy. In this way, the obtained nanocarriers are totally natural vesicles and they have shown to have suitable physico-chemical features for topical administration. Moreover, the proposed nanocarriers have proven their ability to improve the in vitro percutaneous permeation and antioxidant activity of ammonium glycyrrhizinate on human keratinocytes (NCTC 2544 cells). In vivo studies, carried out on human volunteers, have demonstrated the biocompatibility of unsaturated fatty acid vesicles toward skin tissue, indicating a possible clinical application of unsaturated fatty acid vesicles for the treatment of topical diseases.
... Linoleic acid was shown to activate a specific receptor, i.e., the peroxisome proliferator-activated receptor alpha (PPAR-α), in keratinocytes, which is involved in the regulation of keratinocyte proliferation, inflammation and the maintenance of skin homeostasis. Linoleic acid contributes to reduced transepidermal water loss and thus improves the skin's hydration [10,28]. Squalene and tocopherols have antioxidant properties and protect the skin against lipid peroxidation [17]. ...
Article
Full-text available
Research on new, untapped seed oil sources is receiving increased attention. In this study, 18 different seed samples of Tilia cordata and Tilia platyphyllos from various locations in Slovenia were collected and oil was extracted. The compositions of triglyceride fatty acids and unsaponifiable compounds were determined using GC-MS, while antioxidant activity was evaluated using the DPPH method. The oil content in the seeds varied significantly, from 9.1% to 21.7%. Linoleic acid (50–60%) was found to be the predominant fatty acid, followed by oleic acid (18–22%) and palmitic acid (8–9%). Characteristic cyclopropene fatty acids (sterculic, dihydrosterculic and malvalic acids) were present in the average range of 4–8.4%. Antioxidant activity ranged from 8.9% to 65.5%, and was higher, on average, for T. platyphyllos. Higher antioxidant activity was closely correlated with higher γ-tocopherol contents. Statistically significant correlations were confirmed between antioxidant activity and γ-tocopherol, between Δ-tocopherol and phytol, between stigmasterol and β-sitosterol and between squalene and malvalic acid. Tilia oil may be of great interest for cosmetic and dermal preparations. It is, however, not considered a good source of dietary fatty acids due to the undesired, significant content of omega-6 fatty acids.
... So, the material is safe for the skin. The olive oil is one of the oil that recommended as skin care, for neonatal until adult [13]. The mixture of the test sample contains safe ingredients and useful for the skin. ...
Article
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Pidih is a cosmetic used on Javanese bride's foreheads called paes. Peel material that is commonly used is wax which is colored as desired and has easy sticking properties. The aim of this research is to provide an alternative use of natural ingredients for pidih that used on the bride's forehead makeup. Experiment was conducted to obtain black powder made from recycled dried coconut leaves and olive oil with the appropriate composition and then applied as paes in the Solo Putri style bride. The use of cosmetics with natural ingredients such as the leaves of the ash of dried coconut leaves added with olive oil with a ratio of 5 grams: 4 mL can produce black, shiny, easily painted on the forehead, and rather oily. The use of cosmetics in this material can be used as an alternative for pidih that is made of wax. Alternative pidih from the ash of dried coconut leaves can be used as a substitute for conventional pidih.
... Indeed, a large range of oilseed has been used as skin products and hair cosmetics for a long time in several cultures, including sunflower and olive oil. The application of sunflower seed oil has been shown to preserve the stratum corneum integrity and improve hydration of the adult skin without inducing erythema [50]. Budiyanto et al. [51] reported that olive oil topically applied after UVB exposure can effectively reduce UVB-induced murine skin tumors, possibly via its antioxidant effects in reducing DNA damage by reactive oxygen species, and that the effective component may be labile to UVB. ...
Article
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The phenol content of vegetable oil and its antioxidant activity are of primary interest for human health. Oilseed species are considered important sources of these compounds with medicinal effects on a large scale. Total phenol content (TPC) and antioxidant activity (AA) of safflower oil were previously studied. Nevertheless, there is no report on genotypic differences and antiaging activity of safflower oil. The aim of this study was to determine the TPC, diphenyl-picrylhydrazyl (DPPH), and antiaging activity on three respective accessions from Syria, France, and Algeria of seed oil of safflower grown under semi-arid conditions during 3 consecutive years (2015, 2016, and 2017). The results showed that phenol content as well as antioxidant and antiaging activity varied according to both genotype and years. In 2017, the mean value of TPC in oil seed was two times higher than in 2015 and 2016. Moreover, accessions presented different TPC values depending on the year. The highest antioxidant activity was observed among accessions in 2017 compared to 2015 and 2016. As expected, a positive correlation was found between TPC and antioxidant activity. The inhibition in the collagenase assay was between 47% and 72.1% compared to the positive control (83.1%), while inhibition in the elastase assay of TPC ranged from 32.2% to 70.3%, with the positive control being 75.8%. These results highlight the interest of safflower oil as a source of phenols with valuable antioxidant and antiaging activity, and uses for cosmetics.
... Sunflower oil is characterized by its low occlusive chemical components, including essential fatty acids, proteins, vitamins (B1, B2, and vitamin E with antioxidant properties), minerals, and trace elements [21]. White beeswax has a number of advantages: It forms a film coating on the skin, which does not clog the pores, does not inhibit skin breathing as opposed to mineral films, improves skin regenerative capacity, has bactericidal and calming properties, and prevents inflammation [22]. ...
Article
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Semisolid dosage forms are recommended for the dermal care of babies and children. If we look at the ingredients of these preparations, there are still many cases in which there are substances (occlusive agents, preservatives) that no longer meet certain requirements of the modern age, so it is timely to replace them with other substances. The aim of this work was to formulate a science-based formulation with new components that keep or improve its moisturizing properties, rheological parameters, and microbiological stability. Occlusive oils, like white petrolatum and liquid paraffin and the preservative parabens are traditional ingredients in oil in water creams, were replaced with white beeswax, sunflower oil, and phenoxyethanol, respectively. Cocoa butter, urea, and glycerol were added to improve long-lasting hydration and support the barrier function of the reformulated creams. The rheological properties of the formulations were determined. The effects of the preparations on skin hydration and on the barrier function of the skin were tested. Furthermore, microbiological stability was investigated. The result of the reformulation was an o/w cream that provided a good longer-lasting hydration effect; supported the barrier function of the baby skin without occlusion; and had adequate consistency, easy spreading, a pleasant skin feeling, proper pH, and good microbiological stability.
... 5,6 Olive oil has also been found effective in reducing the TEWL and improving the skin barrier and reducing the severity of atopic dermatitis. 7,8 Aloe vera is also known for its antiinflammatory properties as it inhibits the cyclooxygenase pathway and reduces prostaglandin E2 production from arachidonic acid. It also possesses antiseptic, moisturizing and anti-aging effect and has been found to improve the skin integrity. ...
Article
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Background Traditional medicinal systems are widely practiced in the Indian subcontinent for a wide variety of diseases. We aimed to identify the various home remedies used by people to treat numerous pediatric dermatoses. Material and Methods It was an observational study carried out over 18 months in which 150 children attending our clinics were recruited. A detailed history regarding the various indigenous preparations used was taken from caregivers and noted in a proforma. Results A total of 150 children (M:F‐89:61) aged between 4 months to 18 years were included. Atopic dermatitis and eczema (n=28) were the most common dermatoses whereas the most common home remedies used for these either solo or in combination were coconut oil (13), olive oil (11), mustard oil (7), aloevera gel (6), ghee (6), curd (4) and honey (2). Acne was the second most common dermatoses (n=22), products used for acne were Fuller’s earth, aloevera gel, turmeric, gram flour, mustard oil, lime and sandalwood paste. Other dermatoses treated by indigenous products included impetigo and other bacterial infections, seborrheic dermatitis, dermatophytoses, verruca, molluscum, hypopigmentary disorders etc. Conclusion In Indian setup, home remedies are commonly used by the caregivers before visiting a dermatologist to treat various pediatric dermatoses. This article is protected by copyright. All rights reserved.
... [24] Furthermore, it has been reported that herb seed oils reinforce skin barrier properties and prevent dehydration. [25] Therefore, it would appear that the seed oil T. orientalis also has a moisturizing effect on the skin. Figure 2. All values are expressed as the mean ± standard deviation. ...
... In dogs, the clinical efficacy against surface pyoderma of L-Mesitran1 Ointment (Triticum medical, Maastricht, Limbourg, Netherlands), which contains 48% Yucatan honey, did not significantly differ from that of a 3% chlorhexidine shampoo [31]. However, this result is inconclusive evidence for the therapeutic potential of all medical honeys because of inadequate statistical testing (41% of lesions were found on the same 7 dogs), and because L-Mesitran1 additionally contains 7 other wound-healing ingredients [32][33][34][35][36][37][38]. Lacking a honey-free ointment arm and an inert treatment arm, this trial result may have benefited from unaccounted antimicrobial potentiation and/or placebo effects [39]. ...
Article
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Intertrigo is a skin fold dermatitis often requiring recurrent treatment with topical antiseptics or antibiotics, which can select antimicrobial resistance. To minimize this risk, we tested the effectiveness of medical-grade Manuka honey at treating intertrigo as compared to a placebo hydrogel. We additionally characterized the culturable microbial flora of intertrigo and recorded any adverse effect with either treatment. During this randomized, placebo-controlled, double-blinded, adaptive group-sequential trial, the owners washed the affected sites on their dog with water, dried and applied a thin film of either the honey or the placebo product once daily for 21 days. Cytological and lesional composite scores, owner-assessed pruritus, and microbial cultures were assessed prior to treatment and on Day-22. The fixed effects of time, treatment, and animal-related variables on the pruritus and on each composite score, accounting for random dog effect, were estimated separately with generalized linear mixed models for repeated count outcomes (α = 0.05). The null hypothesis of equal treatment effects was rejected at the first interim analysis. The placebo (n = 16 dogs) outperformed the medical honey (n = 13 dogs) at improving both the cytological score (Treatment×Time = -0.35±0.17; P = 0.04) and clinical score (Treatment×Time = -0.28±0.13; P = 0.04). A microbial burden score higher than 4 increased the severity of the cytological score (dichotomous score: 0.29±0.11; P = 0.01), which in turn increased the severity of the clinical score and pruritus score. For every unit increase in cytological score, the linear predictor of clinical score increased by 0.042±0.019 (P = 0.03), and the one of pruritus score increased by 0.12±0.05 (P = 0.01). However, medical honey outperformed the placebo at alleviating the dog’s owner-assessed pruritus after statistically controlling for masking effects (Time = -0.94±0.24; P = 0.002; and Treatment×Time = 0.80±0.36; P = 0.04). Unilateral tests of the least-square mean estimates revealed that honey only significantly improved the pruritus (Hommel-adjusted P = 0.003), while the placebo only improved the cytological and clinical scores (Hommel-adjusted P = 0.01 and 0.002, respectively). Taken together, these results question the value of Manuka honey at treating nasal intertrigo in dogs.
... Studies show mustard oil to be harmful to infant skin, and olive oil increased TEWL as a measure of skin barrier function in a mouse model of infant skin [41]. Detrimental effect of topical olive oil on adult skin integrity has also been documented, discouraging use of olive oil for infant massage [42]. In MP, mustard oil was most commonly used followed by olive oil. ...
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Background Knowledge of the prevailing infant care practices and their effects is important to inform practice and public programs. Infant massage is a traditional practice in India but remains less studied. This study was conducted to study the prevalence and perceptions of infant massage practices in two states of India. Methods A total of 1497 caretakers of children under 18 months of age were interviewed in a cross-sectional study at immunisation units of medical schools in Maharashtra (MH) and Madhya Pradesh (MP) states and through home visits in villages in MH during March through August 2018. Results Infant massage was a prevalent practice (93.8% [95%CI: 92.4,94.9]) in both study states – 97.9%[95%CI:96.9,98.8] in MH and 85.3%[95%CI: 81.9,88.3] in MP – and the prevalence did not vary between male (94.5%) and female (93.5%) infants (p = 0.44). Massage was mostly initiated in the first week of life (82%); it is widely viewed as a traditional practice. It was common to massage the baby once daily (77%), before bathing (77%), and after feeding (57%). Massage was mostly conducted using oils (97%). In MH, preferred oils were a sesame oil-based proprietary traditional medicine oil (36%) and coconut oil (18%) while olive (29%) and mustard (20%) oils were most popular in MP. Commonly reported application techniques included gentle massage with minimal pressure, pressing (30%) and manually stretching certain joints (60%). Commonly reported perceived benefits of infant massage included increased bone strength, better sleep and growth, while no harm was perceived (95%). Conclusion Infant oil massage is a highly prevalent traditional practice in MH and MP. Clear guidance on the use of massage, choice of oil, and techniques for application is required to optimize benefits and minimize risks of this popular traditional practice.
... The authors concluded that the use of olive oil should be discouraged for treating dry skin and in infant massage. 51 More research seems warranted to determine the relative safety and effectiveness of olive oil in this context. ...
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Recent epidemiologic evidence suggests an association between olive oil consumption and a lower incidence of cardiovascular disease and certain cancers. The use of topical oil has also been reported in recent years to be effective in treating xerosis, rosacea, psoriasis, atopic dermatitis, contact dermatitis, eczema (including severe hand and foot eczema), seborrhea, pruritus, and various inflammations. The antiinflammatory and antioxidant properties displayed by olive oil are thought to account for its efficacy in addressing cutaneous disorders. At a more granular level the benefits to the skin derived from the use of olive oil are ascribed to key constituents such as oleuropein, oleocanthal, and hydroxytyrosol. Novel and encouraging signs have recently been associated with olive oil aiding in wound healing and protecting against the damage incurred from ultraviolet radiation exposure. Olive oil is currently used in topical applications for the treatment of several skin conditions, including dry skin, itch, and inflammation as well as disorders such as rosacea.
... On the other hand, their results in treating AD have been unsatisfactory. Therefore, recent studies have focused on alternative medicine to control AD [6][7][8]. ...
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Many trials have been conducted to treat atopic dermatitis (AD), but these therapies are generally unsuccessful because of their insufficiency or side effects. This study examined the efficacy of β-glucan derived from oats with fermented probiotics (called Synbio-glucan) on an AD-induced mouse model. For the experiment, Nc/Nga mice were exposed to a house dust mite extract (HDM) to induce AD. The mice were placed in one of four groups: positive control group, Synbio-glucan topical treatment group, Synbio-glucan dietary treatment group, and Synbio-glucan topical + dietary treatment group. The experiment revealed no significant difference in the serum IgE concentration among the groups. Serum cytokine antibody arrays showed that genes related to the immune response were enriched. A significant difference in the skin lesion scores was observed between the groups. Compared to the control group tissue, skin lesions were alleviated in the Synbio-glucan topical treatment group and Synbio-glucan dietary treatment group. Interestingly, almost normal structures were observed within the skin lesions in the Synbio-glucan topical + dietary treatment group. Overall, the β-glucan extracted from oats and fermented probiotic mixture is effective in treating atopic dermatitis.
... It has smoothing properties and is considered noncomedogenic. A simple yet cost-effective oil, well tried and tested for generations in a wide variety of emulsions formulated for face and body Products [57][58]. ...
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There are thousands of herbs that are used in preparation of various herbal cosmetics and toiletries preparations. Day-by-day, use of herbal cosmetics and toiletries preparations are increasing as currently available cosmetics are showing unwanted effects upon prolong used. They are prepared by using different herbs or their extracts or juice derived from them. Herbal cosmetics and toiletries preparations are being used by Indian peoples and peoples from Indian sub-continental region since ancient time. They are used to improve the appearance of the skin. Herbal cosmetics are becoming more popular because they are comparatively cheaper, safe and easily available. WHO as well as AYUSH department of India, encourages the peoples to use these types of cosmetics for routine use. In the present paper, we have covered various pharmacognostic and relevant information of medicinal plants used in the cosmetics and toiletries preparations.
... 10 Whereas SSO preserved stratum corneum integrity and improved skin hydration. 22 Lastly, 24 Psoriasis. A study of patients with chronic plaque psoriasis undergoing psoralen and ultraviolet A or narrow-band phototherapy ultraviolet B therapy who were pretreated with coconut oil (CCO) showed that CCO treatment failed to accelerate psoriasis clearance in comparison with nonpretreated lesions. ...
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Complementary and alternative medicine (CAM) treatments are growing in popularity as alternative treatments for common skin conditions. Objectives: To perform a systematic review and meta-analysis to determine the tolerability and treatment response to CAM treatments in acne, atopic dermatitis (AD), and psoriasis. Methods: PubMed/Medline and Embase databases were searched to identify eligible studies measuring the effects of CAM in acne, AD, and psoriasis. Effect size with 95% confidence interval (CI) was estimated using the random-effect model. Results: The search yielded 417 articles; 40 studies met the inclusion criteria. The quantitative results of CAM treatment showed a standard mean difference (SMD) of 3.78 (95% CI [-0.01, 7.57]) and 0.58 (95% CI [-6.99, 8.15]) in the acne total lesion count, a SMD of -0.70 (95% CI [-1.19, -0.21]) in the eczema area and severity index score and a SMD of 0.94 (95% CI [-0.83, 2.71]) in the scoring of atopic dermatitis score for AD, and a SMD of 3.04 (95% CI [-0.35, 6.43]) and 5.16 (95% CI [-0.52, 10.85]) in the Psoriasis Area Severity Index score for psoriasis. Limitations: Differences between the study designs, sample sizes, outcome measures, and treatment durations limit the generalizability of data. Conclusions: Based on our quantitative findings we conclude that there is insufficient evidence to support the efficacy and the recommendation of CAM for acne, AD, and psoriasis.
... Lubricant oils are a factor that makes it impossible to compare the results directly with the results obtained in this study. They largely affect the condition of the epidermis barrier function, skin pH, and its hydration [45]. ...
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Background: Cellulite (gynoid lipodystrophy, panniculopathy) affects approximately 85% of women and is related to genetic and hormonal factors, diet, and low physical activity. Vibrotherapy is a promising method of physical therapy to help fight cellulite that has not been studied exhaustively yet. Materials and Methods: Sixty healthy women (age: 19–43 years) with cellulite of at least grade I on the Nurnberg–Muller scale were recruited. The participants were randomly assigned to four groups, receiving a series of 15 vibration treatments in a sitting or lying position for 30 or 60 min. Before and after the first and last treatment, selected skin parameters were measured with the use of Courage and Khazaka equipment. Results: Skin hydration and transepidermal water loss (TEWL) of thighs and buttocks differed significantly at all time points. Post hoc tests showed that each treatment caused a decrease in TEWL but no long-term effect was observed. For skin pH, a significant difference was observed between the measurements I and IV. The lying position caused a greater reduction in the value of the acid–base balance. Conclusions: A series of vibration treatments improved the hydration and pH of the skin. The treatments limited TEWL; however, no long-term effect was observed.
... Topical application of olive oil for 4 weeks caused a significant reduction in stratum corneum integrity and induced mild erythema in volunteers with and without a history of atopic dermatitis. Study group mentioned that olive oil has the potential to promote the development of, and exacerbate existing, atopic dermatitis (Danby et al., 2013). But these results are mainly different from literature and it was also mentioned that further studies were needed. ...
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The balanced presence of polyunsaturated fatty acids and specific bioactive components of high-polyphenol extra virgin olive oil (HP-EVOO)result in the presumed health benefit. Enrichment of its principal polyphenols is shown to be protective in oxidative damage and improves mitochondrial dysfunction. We investigated the effect of different concentrations of HP-EVOO applications on mitochondrial functions and antioxidant defense status on human keratinocyte cells (HaCaT) under the H2O2 induced stress conditions. Our data showed that HP-EVOO has prominentantioxidant capacityin 2%, 5% and 10% HP-EVOO groups (p = 0.000) especially under H2O2 toxicity. Mitochondrial gradients for ATP production were preserved with the increase in mitochondrial membrane potential (MMP) with 2% (p = 0.001), 5% (p = 0.000), 10% (p = 0.003) EVOO application, which resulted in improving cell viability.Hereby, it was concluded that EVOO might have a beneficial effect on skin health by increasing antioxidant status and by providing higher MMP to maintain the mitochondrial function of the keratinocytes in our study.
... Camphor is known with antiseptic, antifungal, analgesic, antipruritic, anti-inflammatory properties [9]. Sunflower seed oil (SFO) repairs the skin barrier, significantly increases skin hydration, has low potential for irritation or allergy, possess anti-inflammatory effect, is readily available and economical [4,6,16]. Linoleic acid is the predominating fatty acid both in SFO and skin-barrier lipids, causes the activation of peroxisome proliferator-activated receptor-alpha (PPAR-a) that stimulates differentiation of keratinocytes, enhances skin barrier function, and improves skin lipid metabolism [16]. ...
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Candida albicans is the most prevalent human fungal commensal organism and is reported to be the most frequent aetiological factor responsible for infection associated with incontinence-associated dermatitis (IAD). Aim: The aim of the study was to investigate the Candida spp. colonisation and efficacy of camphorated oil in the skin care of the patients with incontinence-associated dermatitis. Materials and methods: In patients of the study group (n=104), a local application of camphorated oil was used to clean and protect their skin from urine and/or faeces. In 30 patients of the control group routine wet wipes 3 in 1 or a combination of cleansing foam with protective cream were used. Pre-treatment (day 1) and post-treatment (day 30±1) study evaluations included detailed description of eruption, assessment by evaluation tools, and mycological culture for Candida spp. from sites with fungal-appearing rash. Results: Fungal-appearing rash was found in almost a half (51.0%) of patients at pre-treatment examination and in less than one-third (31.7%) of the patients after the course of application of camphorated oil. Candida spp. was cultivated in 39 (37.5%) patients. Fungal-appearing rash was approved by mycological culture in 56.6%. In patients with urine incontinence, Candida spp. negative cases (43.3%) were significantly prevalent over Candida spp. positive (22.1%). At post-treatment, this prevalence become more noticeable, accordingly obtaining 62.5% of negative and 2.9% of positive results. In patients with double incontinence, Candida spp. negative cases (19.2%) were almost equal to the number of Candida spp. positive (15.4%). After a course of study treatment, Candida spp. negative cases (26.0%) significantly overpassed Candida spp. positive level (8.7%). At an early and moderate grade of IAD Candida spp. negative cases were prevalent, but at severe grade did not differ from the number of positive mycology cultures. Conclusions: The topical use of camphorated oil in skin care of the incontinence-associated dermatitis significantly decreases the severity of disease, reduces fungal appearing rash and Candida spp. colonisation. Camphorated oil was superior to routine products in the controlling of yeast colonisation of the skin in incontinence-associated dermatitis, especially in cases with double incontinence.
... Man et al. [79] reported that topical applications of hesperidin improved epidermal functions, including reductions in skin surface pH, acceleration of permeability barrier recovery and stimulation of keratinocyte differentiation, in aged mice. Other natural ingredients, such as petrolatum, glycerol, coconut oil and sunflower oil, can also improve stratum corneum hydration and epidermal permeability barrier [132][133][134][135][136]. Interestingly, bathing with soybean oil could also decrease transepidermal water loss, while increasing stratum corneum hydration, in comparison to bathing without soybean oil [137]. ...
Article
Chronologically-aged skin displays multiple functional changes in both the dermis and the epidermis. It appears that epidermal dysfunction, compromised permeability homeostasis, reduced stratum corneum hydration and elevated skin surface pH predispose to the development of aging-associated cutaneous and extracutaneous disorders. Improvements in epidermal function have been shown to be an effective alternative therapy in the prevention and treatment of some aging-associated cutaneous disorders, including eczematous dermatitis, pruritus, and xerosis. Recent studies demonstrated that epidermal dysfunction leads to the development of chronic, low-grade systemic inflammation, termed 'inflammaging,' which is linked to the development of aging-associated systemic disorders. Thus, correction of epidermal dysfunction could comprise a novel strategy in the prevention and treatment of aging-associated systemic disorders as well. In this review, we summarize aging-associated alterations in epidermal function, their underlying mechanisms, and their clinical significance. Regimens to improve epidermal function in the elderly are also discussed.
... Antioxidant protects the keratinocytes from oxidative damage, and nourish cells and tissues [63]. Vitamin E in olive oil protects skin from free radicals, responsible for the aging of skin [64]. In combination with vitamin A, vitamin E stimulates cell regeneration. ...
Article
Olive oil has been received a great importance around the globe because it provides unique functional value. Olive oil prevents the risks of several chronic and acute metabolic disorders because it is enriched with monounsaturated fatty acids, antioxidant phenolic compounds, vitamin E and vitamin K. Unfortunately, oxidative deterioration of fatty acids in olive oil provides short shelf life and reduces biological activities. It is responsible for undesirable organoleptic properties. It may belief that one of the solutions to preserve the quality of olive oil is microencapsulation. In this review, comprehensive information about techniques to prepare olive oil microcapsule is represented. To prepare olive oil microcapsule, emulsification of olive oil with different wall materials (matrixes) has been adopted as a primary step. Subsequently, dehydration of emulsion by spray drying or freeze drying or coacervation process has been adopted to prepare olive oil microcapsule. Moreover, microcapsule of olive oil has been prepared by extrusion technology. Biopolymers, such as proteins and polysaccharides have been used as wall material for encapsulation of olive oil. As stable emulsification is one of important issue to produce microcapsule, several emulsifiers, such as lecithin, tween 20 have been used during emulsion preparation. Different characteristics of the microcapsule of olive oil are summarized because it is influenced by several factors during preparation of microcapsule. In later exercise, several applications of encapsulated olive oil in food, pharmaceutical and cosmetic industries are represented in comprehensive way. It may expect that this review article will receive attention in industries and academic sectors.
... Sunflower oil was also found to preserve and retain the integrity of stratum corneum and improved its hydration too via increasing its emollient action without inducing erythema (Lin et al., 2018). In one of the comparative studies performed by Simon G. Danby et al., the efficacy of olive and sunflower seed oil on skin barrier was evaluated in maintaining the integrity of stratum corneum and the findings obtained clearly revealed the higher efficacy of later one without inducing erythema and also found to improve the skin hydration in comparison to former (Danby et al., 2013). ...
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Background: Atopic eczema a chronic inflammatory skin disorder affecting 2-3% of world's population worldwide and is characterised by the appearance of rashes, itchiness and excessive dryness on the skin. The manifestation is triggered by the genetic and environmental factors hampering with the integrity of skin barrier and increasing its susceptibility to enhanced penetration by various allergens/pathogens worsening the condition further and could result in lethal hypersensitivity reactions too therefore listing as one of the most serious ailments globally. Methods: Application of synthetic drugs suffers from the worst kind of side effects and long-term adverse reactions affecting the quality of life adversely. As per the literature available, medicinal plants possess compounds with varying chemical configuration including free fatty acids, phenolic compounds, sterols, terpenoids, alkaloids destined to modulate pathological conditions hence used. The article reviews many such structures and their related chemistry along with the recent advances in knowing their mechanism of action and pharmacological function executed by them owing to the presence of stereo-specific and regio-selective chemical structures present in them. Discussion and Conclusions: Nimbidin, nimbolide, morgolon, tocopherols, unsaturated fatty acids, oleic acid, linoleic acid, rosmarinic acid, gamma linoleic acid are some of the prominent ones used to manage the skin infections, possessing the excellent ability to heal the eczematous skin and the lesions associated with atopic eczemaby maintaining the integrity of skin, retaining its hydration capacity and normal tone, balancing skin pH and supporting its microbial flora. They have been found to protect the outer layers of epidermis from pathogenic bacteria, fungi, virus and many more invaders as they do possess the effective penetration tendency and able to seep into the depth of stratum thus providing complete relief in comparatively short duration with almost minimal side effects.
... 10 On the other hand, in a controlled study of 19 adults who applied OO on one forearm, OO resulted in significant damage to the skin barrier. 11 This negative effect of OO on skin barrier could be attributed to a specific component of OO, which is oleic acid. According to a laboratory study on mice, oleic acid might increase the epidermal permeability. ...
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The use of topical olive oil (OO) for skin health is common among Saudis and worldwide. Therefore, this cross-sectional study is aimed at assessing the use of topical OO for skin health among Saudis in Riyadh, Saudi Arabia. The questionnaire was administered to Saudis at four different malls in Riyadh, Saudi Arabia. A total of 401 participants were enrolled in the study. The results showed that the average knowledge score of the participants was 3.4±0.3 (out of 5) and 87% had fair knowledge. The top source of knowledge among the participants was friends/relatives. In the attitude section, the average score was 4.1±0.5 (out of 5). Females had a higher attitude score 4.2±0.5 as compared to males 4±0.5 (P=0.03). The most common reason for using topical OO among the participants was skin moisturizing (73%). Female gender was the only significant factor associated with the use of topical OO (P<0.001). The use of topical OO for skin health is highly prevalent in Riyadh, Saudi Arabia. Therefore, more awareness of the benefits and adverse effects of topical OO use is required especially from health educational organizations. The preliminary results of this study suggest further research with a larger sample in an academic setting across the nation.
Article
Atopic dermatitis (AD) is one of the most common chronic inflammatory skin diseases and is caused by multiple factors including genetic factors, skin barrier defects, host immune responses, allergen sensitivity, environmental effects, and infections. Commonly, bacterial and viral infections are present in the eczematous lesions of AD patients and clearly aggravate the symptoms. However, studies of fungal infections in AD are limited in spite of the fact that there are reports showing that Malassezia, Candida, and some dermatophytes can affect the symptoms of AD. Moreover, certain fungal infections are sometimes overlooked and need to be considered particularly in AD patients with treatment failure as clinical features of those fungal infections could mimic eczematous lesions in AD. Here, we review the epidemiology, pathogenesis, clinical manifestations, and overlooked features of fungal infections associated with the symptoms of AD including the diagnosis and effectiveness of fungal treatments in AD patients.
Article
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.
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Due to its structural and functional immaturity, the skin of neonates is more susceptible to mechanical damage and chemical irritation. Neonatal skin care aims at preventing physical injury, minimizing transepidermal water loss and avoiding infection. The optimal emollient for skin care remains to be determined. The benefits of emollient care need to be weighed against potential side‐effects. Anionic detergents such as sodium lauryl sulfate and emollients containing emulsifiers can emulsify stratum corneum lipids, thus increasing permeability and skin dryness. Common ingredients such as lanolin can cause contact allergies, others such as parabenes or triclosan can act as endocrine disrupting agents.
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Background and rationale: Xerosis cutis (also referred to as xeroderma, dry skin, asteatosis) affects more than 10 million individuals in Germany. It is among the most common dermatological diagnoses and a cardinal symptom of many dermatological, internal and neurological diseases. Even though it has been established that basic skin care plays a significant role in the management of patients with xerosis cutis, there are as yet no evidence-based algorithms for diagnosis and treatment. Objective: The present position paper provides physicians across all specialties with a practical, symptom-based approach to the prevention, diagnosis and treatment of xerosis cutis. Methods: Within a structured decision-making process, a panel of experienced dermatologists first defined questions relevant to everyday clinical practice, which were then addressed by a systematic review of the literature. Based on the evidence available as well as expert consensus, diagnostic and treatment algorithms were subsequently developed and agreed upon. Results: Xerosis cutis is generally diagnosed on clinical grounds. Possible trigger factors must be avoided, and comorbidities should be adequately and specifically treated. Suitable skin care products should be chosen with a view to improving skin hydration and restoring its barrier function. They should therefore contain both rehydrating and lipid-replenishing components. The "drier" the skin appears, the greater the lipid content should be (preferably using water-in-oil formulations). The choice of ingredients is based on a patient's individual symptoms, such as scaling (e.g., urea), fissures/rhagades (e.g., urea or dexpanthenol), erythema (e.g., licochalcone A) and pruritus (e.g., polidocanol). Other factors to be considered include the site affected and patient age. Ingredients or rather combinations thereof for which there is good clinical evidence should be preferentially used. The best evidence by far is available for urea, whose efficacy in the treatment of xerosis is further enhanced by combining it with other natural moisturizing components and ceramides. The "xerosimeter" is a tool developed in an effort to facilitate patient management and for training purposes. It not only includes practical tools for diagnosis and follow-up but also a classification of ingredients and a structured treatment algorithm. Conclusion: The structured symptom- and evidence-based approach proposed herein contains a road map for diagnosis and treatment of xerosis cutis. It aims to raise awareness in terms of prevention and early treatment of this condition and may thus improve quality of life and prevent potential sequelae.
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The breakdown of epidermal barrier and consequent loss of skin hydration is a feature of skin aging and eczematous dermatitis. Few treatments, however, resolve these underlying processes to provide full symptomatic relief. In this study, we evaluated isosorbide di-(linoleate/oleate) (IDL), which was generated by esterifying isosorbide with sunflower fatty acids. Topical effects of IDL in skin were compared to those of ethyl linoleate/oleate (EL), which has previously been shown to improve skin barrier function. Both IDL and EL down-regulated inflammatory gene expression, but IDL more effectively up-regulated the expression of genes associated with keratinocyte differentiation (e.g., KRT1, GRHL2, SPRR4). Consistent with this, IDL increased abundance of epidermal barrier proteins (filaggrin and involucrin) and prevented cytokine-mediated stratum corneum degradation. IDL also down-regulated expression of "unhealthy skin signature" genes linked to loss of epidermal homeostasis and uniquely repressed an interferon-inducible co-expression module activated in multiple skin diseases including psoriasis. In a double-blind placebo-controlled trial enrolling females with dry skin, 2% IDL lotion applied over 2 weeks significantly improved skin hydration and decreased transepidermal water loss (NCT04253704). These results demonstrate mechanisms by which IDL improves skin hydration and epidermal barrier function, supporting IDL as an effective intervention for treatment of xerotic pruritic skin.
Article
Psoriasis is a chronic inflammatory skin disease, which does not have effective treatment options. However, olive oil has been suggested as an alternative to treat psoriasis, but no study has evaluated the mechanisms involved in the effects of olive oil on psoriasis. Thus, the current study investigated whether olive oil could ameliorate psoriasiform skin inflammation. To test this, mice received topical application of imiquimod to induce inflammation and were treated orally with olive oil. Human immortalized keratinocytes were also treated with imiquimod and olive oil. Epidermal thickness and keratinocyte proliferation were increased in imiquimod-induced lesions of olive-oil-treated animals. In both in vitro and in vivo studies, protein levels of nuclear factor erythroid 2-related factor 2 (Nrf2) were elevated following imiquimod and olive oil administration. Inhibition of Nrf2 abolished the increased proliferation of keratinocytes treated with imiquimod and olive oil, demonstrating the role of Nrf2 in olive oil-mediated exacerbation of psoriasiform skin inflammation. In addition, lower levels of linoleic acid and higher levels of oleic acid were observed in imiquimod- and olive-oil-treated animals, which may also contribute to the adverse effects of olive oil on psoriasis. In conclusion, dietary intake of olive oil aggravates the symptoms of psoriatic skin lesions through the overexpression of Nrf2 and an imbalance in oleic and linoleic acids levels, suggesting that a diet rich in olive oil may have significant negative effects on psoriasis.
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In the treatment of acne and rosacea, several essential oils may play a therapeutic role via both antimicrobial and anti-inflammatory pathways. The particular microbial target in acne vulgaris appears to be the Cutibacterium acnes bacterium. Essential oils investigated for this review include tea tree oil, Oregon grape root oil, pomegranate seed oil, rosemary oil, witch hazel, rose oil, rosehip oil, orange/citrus oil, Korean fir oil, frankincense oil, chamomile oil, clary sage oil, lavender oil, ylang-ylang oil, juniper berry oil, and clove basil oil. Many of these essential oils need a carrier oil to avoid evaporation, and carrier oils reviewed here include olive oil, jojoba, coconut, sesame seed, grape seed, sweet almond, and sunflower seed oil. Of those listed, tea tree oil is the most common and well-known essential oil with evidence available in both acne and rosacea treatments.
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Conventional treatments for atopic dermatitis include topical corticosteroids, emollients, and topical and/or systemic immunomodulators (e.g., dupilumab). However, there is an increasing interest and demand from patients for alternative therapies. In this chapter, we discuss CAM approaches with clinical evidence in atopic dermatitis. Topics discussed include topical and oral oils, topical and oral micronutrients, bathing additives, fabrics, and topical endocannabinoids. Evidence-based CAM therapies can be strategically integrated with conventional therapies to augment response in appropriate cases.
Article
Objective Provide a review of atopic dermatitis management, focusing on optimizing topical therapy, creating a stepwise approach for treatment plans, and guide when to start systemic therapy. Data Sources PubMed search of English-language articles regarding atopic dermatitis in all ages. Study Selection Articles on the subject matter were selected and reviewed. Results Topical corticosteroids are first-line treatment for managing atopic dermatitis. Topical nonsteroidal agents, calcineurin inhibitors, crisaborole, and recently ruxolitinib, that cause no cutaneous atrophy are options for reducing use of topical corticosteroids, including on sensitive sites. Emerging topical agents are in clinical trials. Proactive management, with continued application 2-3 times weekly of a mid-potency topical corticosteroid or tacrolimus, may maintain control for clear or almost clear, localized sites of dermatitis that rapidly recur when topical anti-inflammatory medication is stopped. If topical therapy alone cannot control disease and quality of life is impacted, re-evaluation to confirm diagnosis, manage comorbid conditions, address compliance and patient-specific concerns, and optimize topical therapy must be undertaken before deciding to advance to systemic medication. Dupilumab, an interleukin-4 receptor inhibitor, has become first-line systemic therapy, given its efficacy and safety, allowing long-term treatment without laboratory monitoring. Other biologics and Janus kinase inhibitors are emerging as alternatives that could eliminate the need for immunosuppressants with their higher risks. Conclusion Several options are now available for topical treatment. A stepwise approach is needed to consider alternative therapies and diagnoses before advancing to systemic treatment, but the safety of newer immunomodulators will lower the threshold for more aggressive intervention.
Article
Objective: This study was performed to determine the effect of olive cream on the severity of pain and healing of caesarean section wounds. Method: This study is a parallel randomised clinical trial that was conducted on women who had caesarean sections at Ayatollah Taleghani Hospital in Arak, Iran. Women were assigned to intervention, placebo and control groups by a block randomisation method. Women in the intervention and placebo groups were asked to use olive cream and placebo cream, respectively, twice a day from the second day after surgery to the tenth day. The wound healing score and pain intensity score were assessed using the REEDA and VAS scales, respectively, before and at the end of the intervention. Results: The intervention group consisted of 34 women, the placebo group of 34 women and the control group of 35 women. We found a statistically significant difference between the intervention and placebo groups, intervention and control groups, and placebo and control groups in terms of the pain intensity (p<0.05 in all three cases). Also, we found a statistically significant difference between the intervention and placebo groups, and intervention and control groups in terms of the scores of wound healing on the tenth day after surgery (p<0.05 in both cases). Conclusion: Olive cream can be effective in relieving pain and enhancing caesarean section wound healing, and since no specific side effects were reported, the use of olive cream is recommended.
Chapter
Atopic dermatitis is a complex disease process requiring a multifactorial approach in managing baseline disease, responding appropriately to flares, and optimizing preventative measures. This chapter reviews the role of bathing practices, topical anti-inflammatories, and topical antimicrobials in such management. Bathing practices, including frequency, duration, use of additives, and choice in cleansers/soaps, can improve or worsen the epithelial barrier. Although data are mixed and recommendations vary by organization and region, we recommend daily bathing in lukewarm water for less than ten minutes using neutral to mildly acidic non-soap cleansers, followed by the immediate application of emollients. Topical anti-inflammatories include topical corticosteroids, topical calcineurin inhibitors, and phosphodiesterase-4 inhibitors. Topical corticosteroids are the standard therapy for acute flares and patients who have failed conservative management with emollient alone. Providers must be astute in their utilization and optimize dosing, application vehicle, frequency, duration, and body location, to maximize benefit while minimizing potential side effects. Topical calcineurin inhibitors represent a steroid-sparing alternative that can be used for patients who require application to sensitive areas such as the face, eyelids, or genitalia, or who have developed side effects from or failure to respond to topical corticosteroids. Phosphodiesterase-4 inhibitors are a newer steroid-sparing alternative also to be considered. Topical antimicrobial methods include judicious utilization of topical antibiotics and the use of dilute bleach baths for prevention/decolonization. The data on the benefit of such methods are mixed, but they can be considered adjunctive therapy in those patients with frequent disease flares.
Article
Allergists are often asked to evaluate children with atopic dermatitis (AD) for allergen triggers to disease. Testing, particularly for food triggers, often leads to elimination diets in an effort to improve AD control. However, the dual exposure hypothesis suggests that oral tolerance to food antigens is promoted through high-dose oral exposure, where sensitization occurs through lower dose cutaneous exposure. This suggests that strict elimination diets may pose some risks in children with AD. In addition, emerging evidence suggests an important role of skin inflammation in further allergic disease and the importance of dietary exposure to maintain oral tolerance. This work group report reviews current guidelines-based management for children with moderate-to-severe AD, the evidence for current recommendations for the evaluation and management of these children, provides a nuanced examination of these studies, and addresses current knowledge gaps in the care of these children.
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Moisturizers help regulate the skin barrier and continue to be the foundation of maintenance treatment for atopic dermatitis. Though a tremendous variety of moisturizers at difference price points exist on the market, studies do not show that one moisturizer or moisturizer ingredient is significantly better than another in patients with atopic dermatitis.
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Herpes vegetans is a rare form of Herpes simplex virus (HSV) infection in immunocompromised patients that clinically presents as a verrucous and hypertrophic lesion. In this case, we present a 36- year-old man with exophytic verrucous masses in the genital area that was initially suspected as a malignancy. Difficulty to properly diagnose the patient resulted in a few failed attempts at treating the lesion. After excluding other differential diagnoses, the atypical lesion proved to be caused by vegetative herpes infection due to a good response to HSV therapy. Reevaluation of biopsy also showed signs of HSV etiology. Atypical presentation of herpes simplex in immunocompromised patients still proves to be a challenge to diagnose and treat. Proper clinical identification and workup are needed to diagnose and to choose proper regiments
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The skin, the largest organ of the human body, performs many functions. Perhaps, the most important of which is protecting the internal organs from environmental toxins and pathogens. Diseases of the skin are now a global public health issue. Xerosis (dry skin) and pruritis (itch), the most common dermatological conditions, result from damage to the skin. Olive oil is known as “liquid gold.” Its consumption improves health, reducing the incidence of cardiovascular and neurodegenerative diseases. Wrinkles, xerosis, and pruritis can be treated with molecules found naturally in olive oil which have antioxidant and antiinflammatory effects. This chapter reviews the effects of olive oil on skin.
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In recent years, interest in the health effects of natural antioxidants has increased due to their safety and applicability in cosmetic formulation. Nevertheless, efficacy of natural antioxidants in vivo is less documented than their prooxidant properties in vivo. Plant extracts rich in vitamins, flavonoids, and phenolic compounds can induce oxidative damage by reacting with various biomolecules while also providing antioxidant properties. Because the biological activities of natural antioxidants differ, their effectiveness for slowing the aging process remains unclear. This review article focuses on the use of natural antioxidants in skincare and the possible mechanisms underlying their desired effect, along with recent applications in skincare formulation and their limitations.
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Background Ethnobotanical studies investigating a large number of traditional herbs and uses have an important role in the discovery of new drugs. Nowadays, some of these traditional herbs are researched directly in the clinical trials. In this study, it is aimed to evaluate the 19 plant species that have been identified in the clinical trials among 300 plant species belonging to 79 families with traditional use for skin problems in Turkey. Main body Natural sources are very important to treat diseases for thousands of years. The ethnopharmacological research of natural products ranges from the collection of biogenic samples such as plants to preclinical and clinical studies with the aim of developing drug templates or new drugs. In the ethnopharmacological approach, it is aimed to reach the result based on the traditional and modern knowledge about natural resources. The biggest advantage of this approach is synthesizing new and old information. After the plant or natural compound is determined, other processes work similarly with conventional drugs. Methods Ethnobotanical papers, thesis and projects in Istanbul University Faculty of Pharmacy Department of Pharmaceutical Botany and databases (PubMed and Google Scholar) have been sought and results were synthesized. Results Most of the clinical uses of herbs have been seen similar to their traditional uses. On the other hand, there are some plants on which their clinical uses differ from the traditional uses such as Borago officinalis, Calendula officinalis or Euphorbia peplus. When the frequency of traditional uses of herbs are compared, Plantago species, Plantago major and Plantago lanceolata are the most used taxa in Turkey, secondly, Hypericum perforatum comes. However, Plantago species are not of much interest in clinical trials. It is seen that most of the plants in the clinical research are tried for wound healing occuring due to different origins such as cancer, surgery and injury. Side effects were observed only during the application of Allium cepa, Cydonia oblonga and H. perforatum. Conclusions When clinical trials are evaluated in terms of efficacy and overall results, significant differences and effective results are seen in treatment groups given herbs in comparison with placebo or control groups.
Article
Astaxanthin (3,3´-dihydroxy-β,β-carotene-4,4´-dione) acts as a protective agent against oxidative damage to cells and is widely used in various industries. In this study, we profiled fatty acids in the astaxanthin-producing heterobasidomycete Xanthophyllomyces dendrorhous. Our analysis revealed that X. dendrorhous can produce α-linolenic acid (C18:3ω3) in its cells. To identify plant oils with positive effects on X. dendrorhous, we screened various oils and tested for coproduction of astaxanthin and fatty acids in the yeast. Interestingly, culturing X. dendrorhous with 0.01% (w/v) meadowfoam oil led to a three-fold increase in the growth of the yeast. Due to this increased growth, X. dendrorhous produced more total fatty acids (2.7-fold increase) and astaxanthin (1.4-fold increase) than were produced without oil supplementation. However, fatty acid composition did not change substantially under supplemented conditions. Thus, X. dendrorhous can coproduce industrially valuable astaxanthin and fatty acids, and meadowfoam oil can serve as a promoting factor for this coproduction.
Chapter
Dietary components, olive oil and its fractions, are capable to effect on immune network and their mechanisms. Olive oil is a principal source of dietary lipids and polyphenols in the Mediterranean diet, which is especially relevant in the case of extra-virgin olive oil (VOO) and also in VOO. They can effect cytokine production, signaling pathways, and overall health status. This chapter summarizes the key works of olive and olive oil fractions on immune system and several immune-mediated diseases.
Article
Atopic dermatitis (AD) is the long-lasting chronic inflammatory skin condition associated with cutaneous hyper-reactivity and triggered by environmental factors. The attributes of AD include dry skin, pruritus, lichenification and frequent eczematous abrasions. This has a strong heritable aspect and typically occurs with asthma and allergic rhinitis. The complex pathological mechanism behind AD etiology is epidermal barrier destruction resulting in the lack of filaggrin protein that can induce inflammation and T-cell infiltration. T-helper 2 cell-mediated pathways also bear the responsibility of damage to the epidermal barrier. Certain causative factors for AD include microbial imbalance of skin microbiota, immunoglobulin-E-induced sensitization and neuro-inflammation. Numerous beneficial topical and oral treatments have been available to patients and there are even more drugs in the pipeline for the treatment of AD. Topical moisturizers, corticosteroids, anti-inflammatory agents such as calcineurin inhibitors, phototherapy, cAMP-specific 3, 5 half-cyclic phosphodiesterase 4 inhibitors and systemic immunosuppressants are widely available for AD treatments. Different positions and pathways inside the immune system including JAK-STAT, phosphodiesterase 4, aryl hydrocarbon receptor and T-helper 2 cytokines are targeted by above-mentioned drug treatments. Instead of the severe side effects of topical steroids and oral antihistamines, herbal plants and their derived phytoconstituents are commonly used for the treatment of AD. A clear understanding of AD's cellular and molecular pathogenesis through substantial advancement in genetics, skin immunology and psychological factors resulted in advancement of AD management. Therefore, the review highlights the recent advancements in the understanding of clinical features, etiology, pathogenesis, treatment and management and non-adherence to AD treatment.
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Chronic inflammation is a critical factor in the pathogenesis of many inflammatory disease states including cardiovascular disease, cancer, diabetes, degenerative joint diseases and neurodegenerative diseases. Chronic inflammatory states are poorly understood, however it is known that dietary habits can evoke or attenuate inflammatory responses. Popular methods to deal with inflammation and its associated symptoms involve the use of non steroidal anti-inflammatory drugs, however the use of these drugs are associated with severe side effects. Therefore, investigations concerned with natural methods of inflammatory control are warranted. A traditional Mediterranean diet has been shown to confer some protection against the pathology of chronic diseases through the attenuation of pro-inflammatory mediators and this has been partially attributed to the high intake of virgin olive oil accompanying this dietary regime. Virgin olive oil contains numerous phenolic compounds that exert potent anti-inflammatory actions. Of interest to this paper is the recently discovered phenolic compound oleocanthal. Oleocanthal is contained in virgin olive oil and possesses similar anti-inflammatory properties to ibuprofen. This pharmacological similarity has provoked interest in oleocanthal and the few studies conducted thus far have verified its anti-inflammatory and potential therapeutic actions. A review of the health benefits of the Mediterranean diet and anti-inflammatory properties of virgin olive oil is presented with the additional emphasis on the pharmacological and anti-inflammatory properties of the phenolic compound oleocanthal.
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Nutritional supplementation with omega-6 essential fatty acids (omega-6 EFAs) is of potential interest in the treatment of atopic dermatitis. EFAs play a vital role in skin structure and physiology. EFA deficiency replicates the symptoms of atopic dermatitis, and patients with atopic dermatitis have been reported to have imbalances in EFA levels. Although direct proof is lacking, it has been hypothesized that patients with atopic dermatitis have impaired activity of the delta-6 desaturase enzyme, affecting metabolism of linoleic acid to gamma-linolenic acid (GLA). However, to date, studies of EFA supplementation in atopic dermatitis, most commonly using evening primrose oil, have produced conflicting results. Borage oil is of interest because it contains two to three times more GLA than evening primrose oil. This review identified 12 clinical trials of oral or topical borage oil for treatment of atopic dermatitis and one preventive trial. All studies were controlled and most were randomized and double-blind, but many were small and had other methodological limitations. The results of studies of borage oil for the treatment of atopic dermatitis were highly variable, with the effect reported to be significant in five studies, insignificant in five studies, and mixed in two studies. Borage oil given to at-risk neonates did not prevent development of atopic dermatitis. However, the majority of studies showed at least a small degree of efficacy or were not able to exclude the possibility that the oil produces a small benefit. Overall, the data suggest that nutritional supplementation with borage oil is unlikely to have a major clinical effect but may be useful in some individual patients with less severe atopic dermatitis who are seeking an alternative treatment. Which patients are likely to respond cannot yet be identified. Borage oil is well tolerated in the short term but no long-term tolerability data are available.
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Atopic dermatitis (AD) is a multifactorial, heterogenous disease that arises as a result of the interaction between both environmental and genetic factors. Changes in at least three groups of genes encoding structural proteins, epidermal proteases, and protease inhibitors predispose to a defective epidermal barrier and increase the risk of developing AD. Loss-of-function mutations found within the FLG gene encoding the structural protein, filaggrin, represent the most significant genetic factor predisposing to AD identified to date. Enhanced protease activity and decreased synthesis of the lipid lamellae lead to exacerbated breakdown of the epidermal barrier. Environmental factors, including the use of soap and detergents, exacerbate epidermal barrier breakdown, attributed to the elevation of stratum corneum pH. A sustained increase in pH enhances the activity of degradatory proteases and decreases the activity of the lipid synthesis enzymes. The strong association between both genetic barrier defects and environmental insults to the barrier with AD suggests that epidermal barrier dysfunction is a primary event in the development of this disease. Our understanding of gene-environment interactions should lead to a better use of some topical products, avoidance of others, and the increased use and development of products that can repair the skin barrier.
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Atopic dermatitis (AD) skin is dry and readily colonized by Staphylococcus aureus (SA). Coconut and olive oils are traditionally used to moisturize and treat skin infections. To compare virgin coconut oil (VCO) and virgin olive oil (VOO) in moisturizing dryness and removing SA from colonized AD skin. This was a double-blind controlled trial in two outpatient dermatology clinics with adult AD patients who were diagnosed by history, pattern, evolution, and skin lesions and who were randomized to apply VCO or VOO twice daily at two noninfected sites. SA cultures, photography, and objective-SCORAD severity index (O-SSI) scoring were done at baseline and after 4 weeks. Twenty-six subjects each received VCO or VOO. Of those on VCO, 20 were positive for SA colonies at baseline versus 12 on VOO. Post intervention, only 1 (5%) VCO subject remained positive versus 6 (50%) of those on VOO. Relative risk for VCO was 0.10, significantly superior to that for VOO (10:1, p = .0028; 95% CI, 0.01-0.73); thus, the number needed to treat was 2.2. For the O-SSI, the difference was not significant at baseline (p = .15) but was significantly different post treatment (p = .004); this was reduced for both oils (p < .005) but was greater with VCO. VCO and monolaurin's O-SSI reduction and in vitro broad-spectrum activity against SA (given clinical validity here), fungi, and viruses may be useful in the proactive treatment of AD colonization.
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Members of the superfamily of nuclear hormone receptors which are obligate heterodimeric partners of the retinoid X receptor may be important in epidermal development. Here, we examined the effects of activators of the receptors for vitamin D3 and retinoids, and of the peroxisome proliferator activated receptors (PPARs) and the farnesoid X-activated receptor (FXR), on the development of the fetal epidermal barrier in vitro. Skin explants from gestational day 17 rats (term is 22 d) are unstratified and lack a stratum corneum (SC). After incubation in hormone-free media for 3-4 d, a multilayered SC replete with mature lamellar membranes in the interstices and a functionally competent barrier appear. 9-cis or all-trans retinoic acid, 1,25 dihydroxyvitamin D3, or the PPARgamma ligands prostaglandin J2 or troglitazone did not affect the development of barrier function or epidermal morphology. In contrast, activators of the PPARalpha, oleic acid, linoleic acid, and clofibrate, accelerated epidermal development, resulting in mature lamellar membranes, a multilayered SC, and a competent barrier after 2 d of incubation. The FXR activators, all-trans farnesol and juvenile hormone III, also accelerated epidermal barrier development. Activities of beta-glucocerebrosidase and steroid sulfatase, enzymes previously linked to barrier maturation, also increased after treatment with PPARalpha and FXR activators. In contrast, isoprenoids, such as nerolidol, cis-farnesol, or geranylgeraniol, or metabolites in the cholesterol pathway, such as mevalonate, squalene, or 25-hydroxycholesterol, did not alter barrier development. Finally, additive effects were observed in explants incubated with clofibrate and farnesol together in suboptimal concentrations which alone did not affect barrier development. These data indicate a putative physiologic role for PPARalpha and FXR in epidermal barrier development.
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Xerosis is a common skin condition (1) characterized by dry, rough, scaly, and itchy skin, (2) associated with a defect in skin barrier function, and (3) treated with moisturizers. People in the tropics have effectively used coconut oil as a traditional moisturizer for centuries. Recently, the oil also has been shown to have skin antiseptic effects. A moisturizer with antiseptic effects has value, but there are no clinical studies to document the efficacy and safety of coconut oil as a skin moisturizer. This study aimed to determine the effectivity and safety of virgin coconut oil compared with mineral oil as a therapeutic moisturizer for mild to moderate xerosis. A randomized double-blind controlled clinical trial was conducted on mild to moderate xerosis in 34 patients with negative patch-test reactions to the test products. These patients were randomized to apply either coconut oil or mineral oil on the legs twice a day for 2 weeks. Quantitative outcome parameters for effectivity were measured at baseline and on each visit with a Corneometer CM825 to measure skin hydration and a Sebumeter SM 810 to measure skin lipids. For safety, transepidermal water loss (TEWL) was measured with a Tewameter TM210, and skin surface hydrogen ion concentration (pH) was measured with a Skin pH Meter PH900. Patients and the investigator separately evaluated, at baseline and at each weekly visit, skin symptoms of dryness, scaling, roughness, and pruritus by using a visual analogue scale and grading of xerosis. Coconut oil and mineral oil have comparable effects. Both oils showed effectivity through significant improvement in skin hydration and increase in skin surface lipid levels. Safety was demonstrated through no significant difference in TEWL and skin pH. Subjective grading of xerosis by the investigators and visual analogue scales used by the patients showed a general trend toward better (though not statistically evident) improvement with coconut oil than with mineral oil. Safety for both was further demonstrated by negative patch-test results prior to the study and by the absence of adverse reactions during the study. Coconut oil is as effective and safe as mineral oil when used as a moisturizer.
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Infections and complications of prematurity are main causes of neonatal mortality. Very low birthweight premature infants have compromised skin barrier function, and are at especially high risk for serious infections and mortality. Our aim was to ascertain whether topical application of emollients to enhance skin barrier function would prevent nosocomial infections in this population. We randomly assigned infants born before week 33 of gestation after admission to Dhaka Shishu Hospital, Bangladesh, to daily massage with sunflower seed oil (n=159) or Aquaphor (petrolatum, mineral oil, mineral wax, lanolin alcohol; n=157). We then compared incidence of nosocomial infections among infants in these two groups with an untreated control group (n=181) by an intention-to-treat analysis. 20 patients in the control group, and 22 in each of the treatment groups left the hospital early, but were included in the final analysis. Overall, infants treated with sunflower seed oil were 41% less likely to develop nosocomial infections than controls (adjusted incidence rate ratio [IRR] 0.59, 95% CI 0.37-0.96, p=0.032). Aquaphor did not significantly reduce the risk of infection (0.60, 0.35-1.03, p=0.065). No adverse events were seen. Our findings confirm that skin application of sunflower seed oil provides protection against nosocomial infections in preterm very low birthweight infants. The low cost, availability, simplicity, and effect of treatment make it an important intervention for very low birthweight infants admitted to hospital in developing countries.
Article
Prolonged exposure of human epidermis to excess endogenous or exogenous glucocorticoids can result in well-recognized cutaneous abnormalities. Here, we determined whether short-term glucocorticoid treatment would also display adverse effects, specifically on two key epidermal functions, permeability barrier homeostasis and stratum corneum integrity and cohesion, and the basis for such changes. In humans 3 d of treatment with a potent, commonly employed topical glucocorticoid (clobetasol), applied topically, produced a deterioration in barrier homeostasis, characterized by delayed barrier recovery and abnormal stratum corneum integrity (rate of barrier disruption with tape strippings) and stratum corneum cohesion (mug protein removed per stripping). Short-term systemic and topical glucocorticoid produced similar functional defects in mice, where the basis for these abnormalities was explored further. Both the production and secretion of lamellar bodies were profoundly decreased in topical glucocorticoid-treated mice resulting in decreased extracellular lamellar bilayers. These structural changes, in turn, were attributable to a profound global inhibition of lipid synthesis, demonstrated both in epidermis and in cultured human keratinocytes. The basis for the abnormality in stratum corneum integrity and cohesion was a diminution in the density of corneodesmosomes in the lower stratum corneum. We next performed topical replacement studies to determine whether lipid deficiency accounts for the glucocorticoid-induced functional abnormalities. The abnormalities in both permeability barrier homeostasis and stratum corneum integrity were corrected by topical applications of an equimolar distribution of free fatty acids, cholesterol, and ceramides, indicating that glucocorticoid-induced inhibition of epidermal lipid synthesis accounts for the derangements in both cutaneous barrier function and stratum corneum integrity/cohesion. These studies indicate that even short-term exposure to potent glucocorticosteroids can exert profound negative effects on cutaneous structure and function. Finally, topical replenishment with epidermal physiologic lipids could represent a potential method to reduce the adverse cutaneous effects of both topical glucocorticoid treatment and Cushing's syndrome.
Article
This report describes 2 female patients having contact dermatitis due to mustard khal - the residue of mustard seeds after the oil has been extracted out. The dermatitis was caused by mixing mustard khal with the cattle feed and was occurring on the hands and forearms, though the face, ear-lobules and neck were also involved because of the practice of applying mustard oil on the hair. Patch tests were positive with the mustard khal and its fractionation products in both the patients and with mustard oil in one patient.
Article
Olive oil is commonly recommended by health professionals to new parents for use in the prevention and treatment of the term baby's dry skin, and for baby massage. There is no evidence to support this practice. The use of olive oil may be harmful to skin, affecting skin barrier function. This effect may be a contributory factor in the prevalence of childhood conditions such as atopic eczema. This paper discusses a national online audit of UK maternity hospitals (n = 67) and neonatal units (n = 33) performed between November 2010 and January 2011. Our findings confirm that oil use on babies' skin is common practice. As the direct cost to the NHS for treatment of atopic eczema is high, it is imperative that further research in this area is performed, preferably in the form of a randomized controlled trial. Health professionals will then be in a position to provide accurate information to parents with regard to oil in baby skin care regimens.
Article
This comprehensive account of the genetic and environmental factors that cause atopic dermatitis reconciles two hypotheses concerning the origin of the disease - IgE-mediated sensitization, or an intrinsic defect in epithelial cells that causes dysfunction of the skin barrier - with evidence that both mechanisms contribute. Clinical implications are discussed.
Article
Background: Over the last decade, health professionals have debated the relative merits and potential harms of various neonatal bathing practices. Two schools of thought exist - those that support the use of water alone, and those who believe that bathing products offer some benefit. However, there is a dearth of empirical evidence on which to inform practice or advise new parents. Objective: The purposes of this study were two-fold: first, to gain insight into current practices and beliefs related to newborn bathing, and secondly, to assess the feasibility of conducting a randomised controlled trial (RCT) of wash products versus water alone. Design: A qualitative study was conducted using in-depth interviews. The authors purposively sampled and interviewed 20 midwives, ten health visitors and 26 women. For some of the latter group (n=22), data were collected longitudinally. Data were analysed thematically. Setting: A large teaching hospital in the north west of England. Results: The overarching theme was 'informed uncertainty'. Three sub-themes were also identified, 'mirage of evidence', 'toeing the party line' and 'influential marketing'. Conclusion: There is confusion around the evidence base of newborn bathing practices. As a consequence, women and health professionals draw on tradition, experience and opinion to inform practice. There was some nervousness around industry-funded trials, nevertheless, there was general agreement that a robust, investigator-led RCT of a baby wash product versus water alone was required.
Article
Coconut oil, a traditional moisturizer used for centuries by people in the tropics, does not have any clinical studies documenting its effectivity and safety. This study aims to determine effectivity and safety of coconut oil compared to mineral oil as moisturizer for mild to moderate xerosis. A review board-approved randomized double-blind controlled trial was conducted in 34 patients after negative patch-testing. Patients applied either coconut or mineral oil twice a day for two weeks. Quantitative outcomes for effectivity, measured at baseline and each weekly visit, were skin hydration (Corneometer CM825®) and skin lipids (Sebumeter SM810®); for safety, transepidermal water loss [TEWL](Tewameter TM210®) and skin surface pH (Skin pH meter PH900®). Patients and investigator evaluated symptoms of dryness, scaling, roughness, and pruritus using visual analogue scales (VAS) and grading of xerosis. Both groups showed significant improvement in skin hydration and increased skin surface lipid levels. TEWL and Skin pH were not affected. Objective instrumental determinations showed no significant difference between both groups. Patient and investigator subjective grading of xerosis and VAS showed general trend toward better, though not statistically evident, with coconut over mineral oil. Coconut oil is as effective and safe as mineral oil as a moisturizer.
Article
The skin barrier function can be evaluated by measuring the rate of transepidermal water loss (TEWL). This technique can also be used to elucidate the effect of enhancers on the skin barrier. In this in vivo study the effect of oleic acid in propylene glycol (OA/PG) has been investigated on 10 human volunteers of both sexes (age: 20–40 years). A 3-h and a 24-h occlusion of 0.16 M OA/PG resulted in a 2-fold increase in TEWL, whereas PG alone only increased TEWL with a ratio of 1.1. An optimal enhancement of TEWL has thus been achieved from the synergistic working of OA and PG. Furthermore, the enhancing effect lasted long: for a 3-h and a 24-h application, the TEWL increase could be monitored up to 25 and 72 h, respectively. The results indicate that OA remains inside the stratum corneum and is able to maintain its effect for a relatively long, yet limited, period of time. Another in vivo technique, attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR) has been employed to follow the effect at a molecular scale. Following the absorbances at 1710 and 1740 cm−1, representing the carboxyl group of the free acid and of the ester, respectively, it was observed that the absorbance ratio of both wavenumbers is levelled off to that of an untreated condition already 3 h after the removal of OA/PG application system. These results may indicate either the migration of OA into lower cell layers or lateral spreading within the stratum corneum. Comparing the enhancement ratios from TEWL measurements of the OA/PG applied sites to the untreated sites with the ratio of absorbance at 1710 and 1740 cm−1 in time, there is a congruency with the disappearance of free acid in the uppermost layers of SC and the stabilization of the increased TEWL value (`steady-state' water diffusion). This suggests that the barrier perturbation by OA `outlives' its presence in the superficial cell layers in the free acidic form.
Article
Functional and structural skin adaptation is a dynamic process which starts immediately after birth in humans and in mammalian skin in general. This adjustment to the extrauterine dry environment is accomplished in the first year of postnatal life of humans. To assess the dynamic changes in vivo after birth in the molecular composition and skin physiology parameters compared with older children and adults. The molecular composition of the stratum corneum (SC) and the water profile were investigated noninvasively by in vivo Raman confocal microscopy as a function of depth. Functional parameters including transepidermal water loss (characterizing epidermal permeability barrier), capacitance (as an indirect parameter for SC hydration) and skin surface pH were assessed noninvasively. The measurements were performed in 108 subjects divided into six age groups: full-term newborns (1-15 days), babies aged 5-6 weeks, babies aged 6±1 months, children aged 1-2 years, children aged 4-5 years and adults aged 20-35 years. We showed that skin acidification is still under development during the first weeks of life. While the basal epidermal barrier is competent immediately after birth, the SC is less hydrated in the first 2 weeks of postnatal life. Similar continuous decreasing water content towards the surface for all age groups was observed, whereas this gradient was lower for the newborns. Dynamic changes in the amounts of the natural moisturizing factor constituents were revealed in the period of infancy. We demonstrated the relation of formation of an acidic pH as well as underlying mechanisms in the induction of a fully hydrated SC over the first weeks of human life as a dynamic functional adaptation.
Article
The emollient aqueous cream BP is frequently used for the treatment of atopic dermatitis (AD), yet it is associated with a high rate of adverse cutaneous reactions. It contains the harsh anionic surfactant sodium lauryl sulphate, a known negative environmental factor associated with the exacerbation of AD. To investigate the effect of aqueous cream BP on stratum corneum (SC) integrity and skin barrier function in volunteers with a predisposition to a defective skin barrier. Thirteen volunteers with a previous history of AD (no symptoms for 6 months) applied aqueous cream BP twice daily to the volar side of one forearm for 4 weeks. The other forearm was left untreated as a control. Permeability barrier function and SC integrity were determined before and after treatment by measuring transepidermal water loss (TEWL) in conjunction with tape-stripping. For comparison, 13 volunteers with current AD were recruited for assessment, without treatment, of SC integrity and skin barrier function at unaffected sites. Topical application of aqueous cream BP resulted in significant elevation of baseline TEWL and a concomitant decrease in SC integrity. Measurements made after no treatment in volunteers with current AD, at unaffected sites, suggest that application of aqueous cream BP negatively affects the skin barrier towards the damaged state associated with onset of flares of the disease. Aqueous cream BP used as a leave-on emollient caused severe damage to the skin barrier in volunteers with a previous history of AD. Aqueous cream BP should not be used as a leave-on emollient in patients with AD.
Article
Infant massage was first introduced in China in 2nd century BC. Massaging the newborn has been a tradition in India and other Asian countries since time immemorial. Various oil-based preparations have been used depending on the regional availability. There has been a recent surge in this ancient art particularly as a therapy among parents and professionals in the Western world. Evidence exists supporting the benefits of touch and massage therapy. We reviewed the literature to look at the various techniques of providing massage, its benefits, possible mechanism of action and adverse effects. The review suggests that massage has several positive effects in terms of weight gain, better sleep-wake pattern, enhanced neuromotor development, better emotional bonding, reduced rates of nosocomial infection and thereby, reduced mortality in the hospitalized patients. Many studies have described the technique and frequency of this procedure. Massage was found to be more useful when some kind of lubricant oil was used. Harmful effects like physical injury and increased risk of infection were encountered when performed inappropriately. The review also discusses the different hypotheses put forward regarding the mechanism of action. As of now there are very few studies describing the long term impact of neonatal massage.
Article
Infant skin is often presented as the cosmetic ideal for adults. However, compared to adult skin it seems to be more prone to develop certain pathological conditions, such as atopic dermatitis and irritant contact dermatitis. Therefore, understanding the physiology of healthy infant skin as a point of reference is of interest both from the cosmetic as well as from the clinical point of view. Clinical research on healthy infants is, however, limited because of ethical considerations of using invasive methods and therefore until recently data has been scarce. Technical innovations and the availability of non-invasive in vivo techniques, such as evaporimetry, electrical impedance measurement, in vivo video and confocal microscopy, and in vivo fibre-optic based spectroscopy, opened up the field of in vivo infant skin physiology research. Studies incorporating such methods have demonstrated that compared to adult, infant skin continues to develop during the first years of life. Specifically, infant skin appears to have thinner epidermis and stratum corneum (SC) as well as smaller corneocytes at least until the second year of life. The water-handling properties are not fully developed before the end of the first year and infant SC contains more water and less amounts of natural moisturizing factors. Such findings re-evaluate the old notions that skin is fully matured at birth. Armed with this knowledge, we are in a position not only to better understand infant dermatological conditions but also to design better skin care products respecting the distinct qualities of infant skin.
Article
As skin barrier modulating compounds, fatty acids are frequently used in formulations for transdermal or topical delivery. In this study the effects of oleic acid on keratinocytes in vitro was compared with its in vice skin irritancy in humans. Dose- and time-dependent effects of oleic acid were examined in submerged human keratinocyte cultures,in reconstructed human epidermis (RE-DED), and in excised human skin, using alterations in morphology and changes in interleukin-1α mRNA levels as endpoints. In vitro results were compared with responses of living human skin after topical application of oleic acid, using non-invasive bioengineering methods. Direct interaction of oleic acid and submerged keratinocyte cultures resulted in cell toxicity at very low concentrations of the fatty acid. By contrast, when oleic acid was applied topically on RE-DED or on excised skin, no alterations in morphology were observed. Modulation of stratum corneum thickness indicated a key role of the stratum corneum barrier in the control of oleic acid-induced toxicity. In agreement with these findings, no epidermal tissue damage was seen in vivo, whereas oleic acid induced a mild but clearly visible skin irritation and inflammatory cells were present in the upper dermal blood vessels. Small amounts of oleic acid induced IL-1α mRNA expression in submerged keratinocyte cultures, whereas in RE-DED and in excised skin, IL-1α mRNA levels were increased only when the concentration applied topically was at least. two orders of magnitude higher. It is concluded that minute amounts of oleic acid are sufficient to cause local (i.e. inside the viable epidermis) modulation of cytokine production. These concentrations do not affect morphology but induce skin irritation in vitro. To achieve comparable effects in the skin, much higher topical doses are needed than expected according to the locally required levels, owing to the rate-limiting transport of the fatty acid across the stratum corneum barrier.
Article
This study investigated some pharmacological properties of virgin coconut oil (VCO), the natural pure oil from coconut [Cocos nucifera Linn (Palmae)] milk, which was prepared without using chemical or high-heat treatment. The anti-inflammatory, analgesic, and antipyretic effects of VCO were assessed. In acute inflammatory models, VCO showed moderate anti-inflammatory effects on ethyl phenylpropiolate-induced ear edema in rats, and carrageenin- and arachidonic acid-induced paw edema. VCO exhibited an inhibitory effect on chronic inflammation by reducing the transudative weight, granuloma formation, and serum alkaline phosphatase activity. VCO also showed a moderate analgesic effect on the acetic acid-induced writhing response as well as an antipyretic effect in yeast-induced hyperthermia. The results obtained suggest anti-inflammatory, analgesic, and antipyretic properties of VCO.
Article
The skin is the largest organ of the human body and its functions include protection, thermoregulation sensation and secretion. Significant advances in our understanding of how the morphology and physiology of the skin contribute to the skin's barrier role have been achieved in recent years. The aim of this review is to summarize the principal approaches which have been used to assess variation in skin barrier function with anatomic site, age, gender, and ethnicity. The methods discussed include trans-epidermal water loss (TEWL) measurement, assessment of corneocyte size, response to vasoactive compounds and attenuated total reflectance Fourier transform infrared (ATR-FTIR) interrogation of skin. The utility of the various methods is considered and the most important findings in the literature to date are highlighted.
Article
For millennia, sunflower seed oil has been used in folk medicine for both skin care and the treatment of skin disorders. In its natural state, the oil contains high levels of essential fatty acids, particularly linoleic acid, which has skin barrier-enhancing properties. A sunflower oleodistillate (SOD), which is produced through a molecular distillation process without the use of solvents, has been shown to increase the epidermal key lipid synthesis and to reduce inflammation in vitro and in animal models. It has also been shown to activate peroxisome proliferative-activated receptor-alpha (PPAR-alpha) in vitro. As PPAR-alpha agonists have been shown to stimulate keratinocyte differentiation, improve barrier function, and enhance lipid metabolism in the skin, it has been suggested that SOD might also be efficacious in atopic dermatitis (AD). An initial clinical evaluation of the care effect of a 2% SOD emulsion in 20 adult volunteers with atopic skin revealed the moisturizing properties of SOD. Finally, a strong steroid-sparing effect and a positive effect on quality-of-life parameters were clearly demonstrated for the 2% SOD cream in studies in infants and babies with AD.
Article
FWHM, full width at 50% peak height; HEX, hexagonal; LIQ, liquid-crystalline; OR, orthorhombic; SC, stratum corneum; TEWL, transepidermal water loss
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Standard recommendations for skin care for patients with atopic dermatitis stress the importance of skin hydration and the application of moisturizers. However, objective data to guide recommendations regarding the optimal practice methods of bathing and emollient application are scarce. This study quantified cutaneous hydration status after various combination bathing and moisturizing regimens. Four bathing/moisturizer regimens were evaluated in 10 subjects, five pediatric subjects with atopic dermatitis and five subjects with healthy skin. The regimens consisted of bathing alone without emollient application, bathing and immediate emollient application, bathing and delayed application, and emollient application alone. Each regimen was evaluated in all subjects, utilizing a crossover design. Skin hydration was assessed with standard capacitance measurements. In atopic dermatitis subjects, emollient alone yielded a significantly (p < 0.05) greater mean hydration over 90 minutes (206.2% baseline hydration) than bathing with immediate emollient (141.6%), bathing and delayed emollient (141%), and bathing alone (91.4%). The combination bathing and emollient application regimens demonstrated hydration values at 90 minutes not significantly greater than baseline. Atopic dermatitis subjects had a decreased mean hydration benefit compared with normal skin subjects. Bathing without moisturizer may compromise skin hydration. Bathing followed by moisturizer application provides modest hydration benefits, though less than that of simply applying moisturizer alone.
Article
Development of the skin barrier continues up to 12 months after birth; therefore, care must be taken when cleansing and bathing infants' skin. Available guidelines for skin care in newborns are, however, limited. In 2007, the 1st European Round Table meeting on 'Best Practice for Infant Cleansing' was held, at which a panel of expert dermatologists and paediatricians from across Europe aimed to provide a consensus on infant bathing and cleansing. Based on discussions at the meeting and a comprehensive literature review, the panel developed a series of recommendations relating to several aspects of infant skin care, including initial and routine bathing, safety while bathing, and post-bathing procedures. The panel also focused on the use of liquid cleansers in bathing, particularly relating to the benefits of liquid cleansers over water alone, and the criteria that should be used when choosing an appropriate liquid cleanser for infants. Alkaline soaps have numerous disadvantages compared with liquid cleansers, with effects on skin pH and lipid content, as well as causing skin drying and irritation. Liquid cleansers used in newborns should have documented evidence of their mildness on skin and eyes, and those containing an emollient may have further benefits. Finally, the panel discussed seasonal differences in skin care, and issues relating to infants at high risk of atopic dermatitis. The panel further discussed the need of clinical studies to investigate the impact of liquid cleansers on skin physiology parameters on newborns' and infants' skin. Bathing is generally superior to washing, provided basic safety procedures are followed, and has psychological benefits for the infant and parents. When bathing infants with a liquid cleanser, a mild one not altering the normal pH of the skin surface or causing irritation to skin or eyes should be chosen.
Article
Atopic dermatitis (AD) is a chronic inflammatory disease associated with changes in stratum corneum (SC) structure and function. The breakdown of epidermal barrier function in AD is associated with changes in corneocyte size and maturation, desquamation, lipid profiles, and some protease activities. The purpose of this study was: (i) to examine physiological changes in lesional (L) skin of acute eczematous AD, compared with nonlesional (NL) AD skin and healthy (H) skin, using sequential tewametry and SC protein analysis to estimate SC thickness; and (ii) to assess which serine proteases might be involved in pathogenesis. Six subjects with H skin, six AD patients with NL skin and six AD patients with mild to moderate eczema (L skin) were enrolled. Skin was assessed using several noninvasive techniques but SC thickness was estimated using tewametry and SC protein content of D-Squame strippings. SC integrity was determined by sequential tape stripping (D-Squame) and infrared densitometry. Kallikreins, plasmin, urokinase and leucocyte elastase protease activities together with a novel SC tryptase-like enzyme activity were quantified. Transepidermal water loss (TEWL) levels after D-Squame stripping were elevated in L compared with NL and H skin at all sampling points (P < 0.05). Conversely, the amount of SC removed by sequential tape stripping was decreased in L skin, indicating increased intracorneocyte cohesion (P < 0.05). By correlating 1/TEWL values and SC removed as an estimate of SC thickness, a significantly thinner SC was observed in L compared with NL and H skin (P < 0.05). Elevated extractable serine protease activity was measured in AD skin in the order: SC tryptase-like enzyme (45x), plasmin (30x), urokinase (7.1x), trypsin-like kallikreins (5.8x) and chymotrypsin-like kallikreins (3.9x). Leucocyte elastase activity was not detected in H and NL skin but was observed in AD SC samples (L skin). All enzymes were elevated in the deeper layers of L SC compared with NL and H SC samples. All consistently elevated SC protease activities were significantly correlated with the bioinstrumental data. We report increased serine protease activities in acute eczematous AD, especially in deeper layers of the SC, including SC tryptase-like enzyme, plasmin, urokinase and leucocyte elastase activities. These elevations in protease activities were associated with impaired barrier function, irritation, and reduced skin capacitance. Increased SC cohesion was apparent despite elevated TEWL during tape stripping, which would indicate reduced SC thickness in acute eczematous lesions of AD. Indeed, this was observed using an estimate of SC thickness.
Article
Preterm newborns admitted to the Neonatal Intensive Care Unit are deprived of sensory stimulation. Tactile/kinaesthetic stimulation results in weight gain. Studies involving the cutaneous application of vegetable oils have shown improvement in somatic growth and on skin barrier function. To assess the neurodevelopmental and biological benefits of the simultaneous use of multimodal stimulation (SMS) and the cutaneous application of vegetable oils. Setting Tertiary referral centre serving the Poitou-Charentes region of France. Randomized controlled trial of 49 low-risk preterm infants, born at 31- to 34-week gestation. Each infant was randomly assigned to one of three treatment groups, Sensori-Tonico-Motor (STM) touch for 10 days with either: sweet almond oil, ISIO4 blended oil, or placebo - normal saline, or to a control group who did not receive any intervention. The primary outcome was weight gain. Secondary outcomes were linear growth, neurological maturation, psychomotor development and number of days of admission. Analysis was by intention-to-treat. The group who received STM with ISIO4 oil demonstrated enhanced weight gain (+57%, 95% CI 37-76) compared with controls (P = 0.030). All STM groups showed shorter admission times (mean reduction 15 days, 95% CI 23-50 days hospitalised, P = 0.005), and an increase in body length (P = 0.030). Both groups of oil massaged babies (almond and ISIO4) showed an increased neurological score (P = 0.001) compared to controls. The infants receiving ISIO4 oil had an associated increase in psychomotor scores (P = 0.028), time spent in quiet wakefulness (P = 0.036), improved orientation (P = 0.036), and enhanced development of the oculomotor (P = 0.012) and sensorimotor (P = 0.003) systems. An additional benefit seen was improved moisturization (P = 0.001), and quicker recovery of dermatological conditions. No adverse dermatological events were observed. The combination of STM and cutaneous application of oils to healthy preterm babies resulted in enhanced weight gain and neurological development, and a shorter stay in hospital.
Article
Unsaturated fatty acids from sebum affect calcium dynamics in epidermal keratinocytes, disrupt the barrier function and induce abnormal keratinization. However, the mechanisms of these effects have not been clarified. To investigate the function of unsaturated fatty acids in epidermis. Antagonists of calcium channel receptors were applied to mouse skin together with oleic acid. Measurements were made of transepidermal water loss (TEWL), and hyperproliferation was assessed. The effects of the antagonists on calcium influx into cultured normal human keratinocytes and on cytokine production were also evaluated. N-methyl-d-aspartate (NMDA) receptor antagonists such as MK801 and D-AP5 specifically inhibited the increase in TEWL caused by oleic acid, and suppressed keratinocyte hyperproliferation. These compounds also inhibited the increase in the intracellular concentration of calcium ions induced by oleic acid. MK801 suppressed the production of interleukin-1alpha by keratinocytes induced by oleic acid. Unsaturated fatty acids such as oleic acid might function via NMDA receptors.
Article
Atopic dermatitis is an inflammatory skin disease characterized by dryness and itch of the skin. In this study, we measured the phospholipid content and the fatty acid pattern of lesional and lesion-free epidermal keratome biopsies on 15 patients. For comparison, epidermal biopsies were obtained from healthy individuals undergoing plastic surgery. The phospholipid content of atopic epidermis was nearly twice as high as in healthy epidermis. Monounsaturated fatty acids in the phosphoglycerides were significantly increased (p less than 0.001) and n-6 fatty acids were significantly decreased (p less than 0.001) in lesional atopic epidermis compared to lesion-free epidermis. The content of esterified arachidonic acid in phosphatidylcholine from lesional epidermis was only 49% of that found in healthy epidermis (p less than 0.001). The content of free arachidonic acid was 47% higher (p less than 0.05), whereas the content of free long-chain saturated fatty acids was decreased by 29% (p less than 0.01), in lesional compared to lesion-free atopic epidermis. The disease severity, calculated as an arbitrary index, correlated inversely with the n-6 fatty acid content of lesion-free atopic epidermis (r = -0.89, p less than 0.001). Our findings suggest that atopic epidermis is characterized by an increased activity of phospholipase A2 and an incomplete transformation of phospholipids into other lipid classes.
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This report reviews individual-related variables, environment-related variables and instrument-related variables, with a focus on the Evaporimeter EP1 (ServoMed). Start-up and use is described, and guidelines for good laboratory practice given.
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Summary Moisturizers are used daily by many people to alleviate symptoms of dry skin. All of them contain lipids. It has been suggested that topically applied lipids may interfere with the structure and function of the permeability barrier. The influence of a single application of nine different lipids on normal skin and skin irritated by sodium lauryl sulphate (SLS) was studied in 21 healthy subjects. Parameters assessed were visible signs of irritation, and objectively measured cutaneous blood flow and transepidermal water loss (TEWL). The substances tested were hydrocortisone, petrolatum, fish oil, borage oil, sunflower seed oil, canola oil, shea butter, and fractions of unsaponifiable lipids from canola oil and shea butter. Water was included as a control. On normal skin, no significant differences in the effects of the test substances were found, whereas significant differences were observed when they were applied to SLS-irritated skin. The visible signs of SLS-induced irritation were significantly less pronounced after treatment with the sterol-enriched fraction from canola oil than after treatment with water. This fraction, and hydrocortiso