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The Winter Season Affects More Severely the Facial Skin than the Forearm Skin: Comparative Biophysical Studies Conducted in the Same Japanese Females in Later Summer and Winter
Abstract
Skin disorders such as atopic dermatitis, psoriasis and senile xerosis show a tendency to exacerbate in winter. We investigated the seasonal influence on the functional parameters of the skin in healthy female volunteers of different age groups. Biophysical noninvasive measurements, including transepidermal water loss (TEWL) as a parameter for the barrier function of the stratum corneum (SC), high-frequency conductance as a parameter for the hydration state of the SC, temperature, color and casual surface lipid levels, were conducted during the later summer and winter months in 39 healthy adult Japanese females ranging in age from 24 to 78 years. The measurements were made on the cheek, the exposed area, and flexor forearm, the semicovered area, in the same climate-controlled chamber. The barrier function of the SC was found to be significantly impaired in winter both on the cheek and flexor forearm. This difference between summer and winter was much larger on the cheek than on the forearm. The hydration state of the SC was significantly lower in winter on the flexor forearm, whereas no such seasonal change was apparent on the cheek where sebum levels did not show any seasonal change. We measured the corneocyte size in 24 out of the 39 subjects to estimate a seasonal change of the turnover rate of the SC. It tended to be smaller only on the exposed cheek skin, suggesting an enhanced turnover of the SC in winter, whereas it was somewhat larger on the semicovered flexor forearm. The skin surface temperature and redness were also significantly higher on the cheek in winter. We think that subclinical inflammation resulted in the enhanced turnover rate of the SC associated with elevated TEWL levels observed on the face in winter. In conclusion, the obtained data suggest that the exposed facial skin becomes more irritable under the influence of the dry and cold environment of winter even in healthy individuals where the barrier function of the SC is relatively poor as compared to the skin of other areas.
... The changes in temperature and humidity for each season according to the Japan Meteorological Agency are shown in Figure 1a [8]. Owing to these climatic changes, in Japan, the water content of the skin s stratum corneum in healthy subjects has been reported to decrease significantly in winter compared to that in summer [9]. Furthermore, atopic dermatitis symptoms are worse during winter [10]. ...
... The changes in temperature and humidity for each season according to the Japan Meteorological Agency are shown in Figure 1a [8]. Owing to these climatic changes, in Japan, the water content of the skin′s stratum corneum in healthy subjects has been reported to decrease significantly in winter compared to that in summer [9]. Furthermore, atopic dermatitis symptoms are worse during winter [10]. ...
Background and Objectives: Seasonal climatic changes may affect the development of the rash that is characteristic of treatment with anti-epidermal growth factor receptor (EGFR) antibodies. We evaluated the association between seasons and rash incidence among patients with cancer. Materials and Methods: Data from patients with colorectal or head and neck cancer treated with cetuximab or panitumumab during summer (S group; n = 34) or winter (W group; n = 37) between June 2014 and February 2019 were collected to retrospectively examine patient characteristics and rash incidence ≤ 8 weeks after treatment initiation. Results: Rashes were observed in 73.5% (n = 25) and 78.4% (n = 29) and grade 3 rashes were observed in 17.6% (n = 6) and 2.7% (n = 1) of the patients in the S and W groups, respectively. The incidence of grade ≥ 2 rashes in males in the S group was higher than that in the rest of the patient groups (p < 0.01). Conclusions: The higher incidence of skin rashes in males during summer might be attributed to the effects of ultraviolet light, lack of skincare, male hormones, and secretion of anti-EGFR antibodies in sweat. These findings highlight the need for research on preventive measures for such rashes.
... The reason why almost 90% of the infants with the Koch-like phenomenon with IGRA tests results available were IGRA negative is that they may have been infected with NTM, such as M. marinum [17] and M. avium, [18] as some authors previously reported, rather than M. tuberculosis. The reason why the number of Koch-like phenomenon reports increased in winter is that skin reactivity in general increases in dry and cold weather conditions in winter in Japan; [26][27][28][29] however, other mechanisms may need to be explored. ...
Background:
The epidemiology of infants who exhibited the Koch-like phenomenon after Bacillus Calmette-Guérin vaccination and who subsequently tested positive in interferon-γ release assay (IGRA) was compared to that of those who tested negative. The reports of pediatricians on the phenomenon to the health authorities of Japan were retrieved and analyzed.
Methods:
In 2013-2019, 790 infants with such events were reported with IGRA test results available, of whom 81 (10.3%) tested positive and 709 (89.7%) negative.
Results:
The infants who were IGRA positive did not show an increasing trend (P = 0.06, P = 0.60), whereas those who were IGRA negative showed a significantly increasing trend (P = 0.42, P = 0.0002). The infants who were IGRA positive did not exhibit seasonality, whereas those who were IGRA negative had a higher number of cases in winter than in summer. The rates of infants who were IGRA positive per 10 million live births showed a significant correlation with the tuberculosis (TB) notification rates by prefecture (P = 0.41, P = 0.004), whereas those who were IGRA negative did not (P = 0.04, P = 0.78).
Conclusion:
The IGRA-positive infants were distributed quite differently from those who were IGRA negative and appeared more likely to be infected with TB. Reports of pediatricians on the Koch-like phenomenon should continuously be collected as the reports reflect a risk of TB infection including TB outbreaks among infants in Japan. The reports should include IGRA test results as IGRA is more specific than tuberculin skin testing. Infants with IGRA-positive results should be followed up for 2-3 years to determine their final outcomes.
... TEWL was higher at the back of infants and younger children, probably because of heat and friction from longer durations of nighttime or afternoon sleep. Cheek TEWL was higher in winter than in summer, similar to that in women [10]. TEWL at the forehead, anterior neck, and cubital fossa of infants and children was higher in summer than in winter. ...
Introduction There is little information regarding skin conditions in infants and children, especially with respect to age, anatomical sites, and seasonal variations. This study aimed to compare the physiological skin characteristics of infants and children with those of women. Methods This study involved skin measurements and a questionnaire-based survey assessing healthy infants and children aged one month to six years and four months (37 males and 48 females) and 15 healthy women in their twenties in the summer, and healthy infants and children aged two months to six years and seven months (34 males and 45 females) and 15 healthy women in their twenties in the winter. The physiological characteristics of the skin of infants and children were surveyed by age. We excluded infants and children with allergic symptoms at the time of measurement. There were 11 subjects with a history of atopic dermatitis. Results Compared with women, infants and children had lower stratum corneum water content and higher transepidermal water loss (TEWL) at most sites. Minimal sebum secretion was observed throughout the body in infants and children aged ≥1 year. The skin surface pH of infants and children was low throughout the body. The questionnaire revealed that skin issues were most common at the anterior neck and cubital fossa, where TEWL was markedly high. These results suggest that barrier function is less developed in the skin of infants and children than in the skin of women. Conclusions The physiological characteristics of skin varied depending on age, anatomical site, and season; hence, skincare guidance must be provided according to these factors.
... At the same time, the skin of the face is continuously exposed to environmental challenges (e.g., cold/hot weather, pollution, UV rays) [2,4]. This makes the skin on the face particularly prone to dryness [5]. ...
Three novel face creams containing dexpanthenol with different lipid contents were developed for dry skin sufferers: a day face cream (DFC), a day face cream with sun protection (DFC-SPF), and a night face cream (NFC). Three identically designed studies (N = 42–44 each) were conducted with healthy adults of three ethnicities (African, Asian, Caucasian) with dry/sensitive skin. Effects on stratum corneum (SC) hydration, SC lipid content, and skin elasticity were quantified by established noninvasive methods during the 4-week studies. After single and repeated once-daily applications of the face creams, facial hydration significantly increased from baseline. On day 28, the mean increments in skin hydration amounted to 27%, 26%, and 27% (p < 0.0001 each) for DFC, DFC-SPF, and NFC, respectively. Favorable effects of DFC, DFC-SPF, and NFC on facial moisturization were observed in all three ethnic groups. The enhancements in SC hydration were not paralleled by improvements in skin elasticity parameters but lipid analyses showed significant increases in SC cholesterol, SC free fatty acid, and/or SC ceramide levels. All three face creams were well tolerated and achieved a high product satisfaction and acceptability by study participants. Our findings support the once-daily use of the face creams in adults of different ethnicities with dry and sensitive skin.
Introduction:
During the COVID-19 pandemic healthcare workers (HCWs) have used respiratory protective equipment for prolonged periods, which has been associated with detrimental effects on the underlying skin. The present study aims to evaluate changes in the main cells (corneocytes) of the stratum corneum (SC) following prolonged and consecutive use of respirators.
Methods:
17 HCWs who wore respirators daily during routine hospital practice were recruited to a longitudinal cohort study. Corneocytes were collected via tape stripping from a negative control site (area outside the respirator) and from the cheek which was in contact with the device. Corneocytes were sampled on three occasions and analysed for the level of positive-involucrin cornified envelopes (CEs) and the amount of desmoglein-1 (Dsg1), as indirect measurements of immature CEs and corneodesmosomes (CDs), respectively. These were compared to biophysical measurements (Transepidermal water loss, TEWL, and SC hydration) at the same investigation sites.
Results:
A large degree of inter-subject variability was observed, with maximum coefficients of variation of 43% and 30% for the level of immature CEs and Dsg1, respectively. Although it was observed that there was not an effect of prolonged respirator usage on the properties of corneocytes, the level of CDs was greater at the cheek than the negative control site (p < 0.05). Furthermore, low levels of immature CEs correlated with greater TEWL values after prolonged respirator application (p < 0.01). It was also noted that a smaller proportion of immature CEs and CDs was associated with a reduced incidence of self-reported skin adverse reactions (p < 0.001).
Conclusions:
This is the first study that investigated changes in corneocyte properties in the context of prolonged mechanical loading following respirator application. Although differences were not recorded over time, the levels of CDs and immature CEs were consistently higher in the loaded cheek compared to the negative control site and were positively correlated with a greater number of self-reported skin adverse reactions. Further studies are required to evaluate the role of corneocyte characteristics in the evaluation of both healthy and damaged skin sites.
Purpose: Despite the wide breadth of research, much disparity exists in transepidermal water loss (TEWL) research data—possibly due to uncontrolled experimental variables. We determined whether such experimental variables significantly impact TEWL studies and cause this disparity. Methods and Materials: An initial literature search regarding TEWL was performed to determine potential confounding variables. A subsequent search procured relevant and representative studies investigating the impact of these variables on TEWL. Results: Variables, such as age, anatomic site, and temperature, impact TEWL and should be controlled for in TEWL studies. Other variables, such as smoking and menstrual cycle, have inconclusive results or do not provide sufficient data breadth to make a conclusion regarding its effect, if such an effect exists, on TEWL metrics. Therefore, these variables require further research to determine their potential impact on TEWL. Conclusion: Matching for as many experimental variables as possible may reduce the disparity in TEWL data/conclusions.KeywordsTransepidermal water lossExperimental variablesStratum corneumSkinEvaporimeter
Type I keratin 9 encoded by the KRT9 gene serves an important special function either in the mature palmar and plantar skin tissue. The changes in skin conditions and thickening of the outer layer of the skin may be affected by environmental variables. A missense mutation rs209302038 (NC_037346.1: g.41782870 G > A) was detected in KRT9, which changing the isoleucine into valine. This study aimed to identify the frequency of allele in this locus in Chinese indigenous cattle, and analyze the connection with heat stress. Our results indicated that the frequency of allele A gradually decreases from south to north, while the frequency of G allele showed the opposite pattern. Further analysis of the association of the different genotypes with three climate factors, which showed that the genotypes (GG, GA, AA) were significantly related to climatic conditions (p < 0.01). Therefore, we speculated that the mutation of the rs209302038 in Chinese indigenous cattle might be a genetic marker to detect heat stress.
This is the English version of guidelines for the management of asteatosis 2021 in Japan. Asteatosis is a synonym of xerosis found in a wide range of diseases that induce dry skin through impaired functions of either water retention of the stratum corneum or skin covering with acid mantle. Patients with asteatosis may be accompanied by pruritus. Moisturizers are the first-line treatment for asteatosis and their adequate use must be recommended. The main purpose of the present guidelines is to define skin symptoms requiring treatment with moisturizers for medical use in patients with asteatosis. If the deterioration of marked scaling or scratch marks is predicted, therapeutic intervention with moisturizers for medical use should be considered even in the absence of pruritus. Regarding six important points requiring decision-making in clinical practice (clinical questions), we evaluated the balance between the benefits and harm of medical interventions in reference to previous reports of clinical research, and presented the recommendation grades and evidence levels to optimize the patient outcome by medical interventions.
In this study, the effect of one cycle of winter to summer seasonal transition on the mechanical and physical properties of skin was investigated in vivo. Fourteen healthy skin volunteers aged between 22 and 42 years were studied at the volar lower and upper arms. The findings indicate a 22.15% and 34.29% decrease in trans-epidermal water loss (TEWL) and the average epidermal roughness (AER), respectively. Also, improved skin properties were observed such as a 25.48% rise in average epidermal hydration (AEH), 22.59% in skin thickness, 38.64% and 21.92% in melanin and redness, respectively, as well as an 8.25% rise in its firmness and 23.14% in elasticity when strained with uniaxial deformations. An inverse correlation was established between TEWL and AEH with a linear relationship between stratum corneum roughness versus TEWL as well as thickness and hydration. Also, the skin firmness exhibited a direct proportionality with TEWL and an inverse correlation with skin hydration where these relationships were stronger in summer than in winter. Furthermore, time-dependent results demonstrated three-staged elastic, viscoelastic and creep deformations with high, moderate and low strain rates respectively at both anatomical locations. The winter season displayed lower skin firmness and elasticity of 0.37 mm and 0.04 mm compared to 0.40 mm and 0.06 mm in summer accordingly. Anatomically, the two arm regions displayed different results with the upper arm having more consistent results than the lower arm. These results will find relevance in sensor skins and exoskeletons in Medicare, robotic and military technologies as well as innovations in cosmetics and dermatology.
Background
The effects of seasonal factors on sensitive skin (SS) have been reported intensively, but the mechanisms still remain poorly understood.
Objective
To investigate the effects of seasonal factors on SS, by comparing the physiological changes in the healthy skin and different subgroups of SS with seasonal variation.
Methods
Through a questionnaire survey, lactic acid sting test, and capsaicin test, qualified subjects were classified into four groups: healthy skin, only lactic acid sting test positive (LAST(+)/CAT(−)), only capsaicin test positive (LAST(−)/CAT(+)), and both positive (LAST(+)/CAT(+)). Skin physiological parameters were measured in winter and summer.
Results
A total of 140 subjects completed the study. Significant differences were found in transepidermal water loss (TEWL), skin pH, and cutaneous blood flow (CBF) between winter and summer in the four groups. There were significant differences in stratum corneum hydration (SCH) of the LAST(+)/CAP(−) and LAST(+)/CAP(+) groups, current perception threshold (CPT) at 250 Hz of the LAST(+)/CAT(+) group, and epidermal density of the healthy skin group between the two seasons. Sum of the scores of sting (SSS) showed a close correlation with TEWL, SCH, pH, CPT at 250 Hz, and epidermal density. Sum of the scores of burning (SSB) showed a strong correlation with TEWL, pH, CPT at 250 Hz and 5 Hz, and epidermal density.
Conclusions
Seasonal variation influences the skin barrier function of different types of sensitive skin at different levels. We therefore strongly suggest that, with seasonal variation, different treatments will be undertaken for different subgroups of sensitive skin.
Using noninvasive measurement techniques, parameters representing skin characteristics were measured in a total of 117 Japanese females ranging in age from 3 to 65 years. The parameters measured were sebum secretion rate, transepidermal water loss, skin surface conductance, skin color, skin surface temperature, corneocyte surface area, and skin surface microtopography. Measurements were taken twice for each subject, once in the summer (July) and again in the winter (December). Polynomial regression analysis was used to quantitatively assess age-related trends associated with changes in shin parameters. Also, to evaluate the progression of the aging phenomena in adults (i.e., physiological aging), multiple regression analysis was carried out with age as the criterion variable and the above parameters as predictor variables.The results of these analyses established the following facts: Most physiological skin parameters undergo changes that can be characterized by curves which attain peak values during the third decade of life, whereas morphological parameters tend to vary linearly with age. Until the third dacade of life, the physiological functions of female skin remain in the developmental phase and are extremely prone to fluctuations. However, during the third decade, the physiological development of the skin reaches a stage of completion and becomes comparatively stable, and thereafter commences a gradual transition to senescence concomitant with chronological aging. The degree of skin aging can be estimated by a quantiative assessment of age-related physiological phenomena and a comprehensive analysis of the relevant data.
The problems of non-immunologic contact urticarogens are addressed from various points of view. A new test for evaluating substances which may cause non-immunologic contact urticaria in humans the NICU test, is introduced. Characterustue data of widely known contact utticariogens are given.
This study quantified irritant susceptibility and blood vessel reactivity in normal women over the course of the menstrual cycle. Such alterations were studied by observing vasodilation from topical application of methyl nicotinate (MN) on the following days of the menstrual cycle: (i) the day of putative maximal estrogen secretion; (ii) the day of maximal progesterone secretion; (iii) the day of minimal estrogen/progesterone secretion. These responses were evidenced by changes in the following dose response characteristics: the initial response (IR), the peak response (PR) and the area under the curve (AUC). Baseline laser Doppler velocimetry (LDV) blood flow values and transepidermal water loss (TEWL) values on normal skin were also obtained. No significant differences existed for any of the dose-response characteristics (IR, PR, AUC) when the values for the 3 testing days were compared to one another. Significant differences did exist for baseline TEWL values when comparing the day of maximal estrogen secretion to the day of minimal estrogen/progesterone secretion. TEWL was higher on the day of minimal estrogen/progesterone secretion as compared to the day of maximal estrogen secretion on both back (p = 0.037) and forearm (p = 0.021) sites, suggesting that the skin barrier function is less complete on the days just prior to the onset of the menses as compared to the days just prior to ovulation. Significant differences in baseline blood flow also existed for the day of maximal estrogen secretion as compared to the day of maximal progesterone secretion, with higher baseline blood flow recorded on the day of maximal progesterone secretion on both the back (p = 0.021) and forearm (p = 0.009) sites.
The hypothesis was tested that a cyclic variation exists in skin reactivity to irritant stimuli. Twenty-nine healthy women with regular menstrual cycles were challenged with sodium lauryl sulfate as an irritant patch test at day 1 and at days 9 through 11 of the menstrual cycle. The skin response to the applied irritant stimulus was evaluated by visual scoring and also quantified by measurements of transepidermal water loss, edema formation, and blood flow in the skin. The skin response to challenge with sodium lauryl sulfate was found to be significantly stronger at day 1 than at days 9 through 11 in the menstrual cycle as evaluated by visual scoring (p less than 0.05) as well as by measurement of transepidermal water loss (p less than 0.05) and edema formation (p less than 0.005).
In order to investigate a possible seasonal variation in the skin response to irritants, 17 healthy volunteers were patch tested with sodium lauryl sulphate (SLS) and nonanoic acid in the winter and summer. The response to these irritants was quantified by visual scoring, measurement of transepidermal water loss, measurement of electrical conductance indicating the hydration state of the superficial epidermis, measurement of blood flow by laser Doppler and measurement of oedema by ultrasound A-scan. Significantly stronger reactions to SLS were found during the winter than the summer as indicated by visual scoring and by measurements of transepidermal water loss, whereas no significant seasonal variation was found in the response to nonanoic acid. A decreased hydration state of the epidermis of unexposed skin was found during the winter, and we believe this to be responsible for the increased susceptibility to SLS during this season.
Transepidermal water loss (TEWL) was measured as a function of skin temperature, using human cadaver skin in modified skin diffusion chambers. A formula was derived to allow conversion of TEWL at any skin temperature to a standard reference temperature. This formula permits more accurate comparison of TEWL within and between subjects.
The wealing response of human skin to dimethyl sulphoxide (DMSO) has been quantified. Concentrations of 90%, 95%, and 100% were applied for 5 min to circular areas 8 mm in diameter. Wealing was scored on a five-point scale after 10 min.
Marked individual variations were found. Wealing was strongly influenced by body region and was dose-dependent. The intensity of the reaction paralleled that to other irritants and was dependent mainly on thickness and integrity of the horny layer. The DMSO test is a simple, quick way to assess the barrier function of the stratum corneum.