A randomized half-body, double blind, controlled trial on the effects of a pH-modified moisturizer vs. standard moisturizer in mild to moderate atopic dermatitis,

Abstract Background: Higher skin pH in atopic dermatitis contributes to impaired epidermal barrier. A moisturizer compatible with physiological pH could improve atopic dermatitis. Objective: To determine the effect of a physiologically compatible pH moisturizer in atopic dermatitis. Methods: A randomized half body, double blind, controlled trial involving patients with stable atopic dermatitis was performed. pH-modified moisturizer and standard moisturizer were applied to half body for 6 weeks. Results: A total of 6 (16.7%) males and 30 (83.3%) females participated. Skin pH reductions from week 0, week 2 and 6 were significant at the forearms (5.315 [0.98] to 4.85 [0.54] to 5.04 [0.78], p = 0.02) and abdomen (5.25 [1.01], 4.82 [0.64], 5.01 [0.59], p = 0.00) but not at the shins (5.01 [0.80], 4.76 [0.49], 4.85 [0.79], p = 0.09) with pH-modified moisturizer. Transepidermal water loss (TEWL) at the forearms decreased (4.60 [2.55] to 3.70 [3.10] to 3.00 [3.55], p = 0.00), abdomen (3.90 [2.90] to 2.40 [3.45] to 2.70 [2.25], p = 0.046). SCORAD improved from 14.1 ± 12.75 to 10.5 ± 13.25 to 7 ± 12.25, p = 0.00. In standard moisturizer group, pH reductions were significant at the forearms (5.29 [0.94] to 4.84 [0.55] to 5.02 [0.70], p = 0.00) and abdomen (5.25 [1.09], 4.91 [0.63], 5.12 [0.66], p = 0.00). TEWL at the forearm were (4.80 [2.95], 4.10 [2.15], 4.60 [3.40], p = 0.67), shins (3.80 [1.40], 3.50 [2.35], 4.00 [2.50], p = 0.91) and abdomen (3.70 [2.45], 4.10 [3.60], 3.40 [2.95], p = 0.80). SCORAD improved from 14.2 ± 9.1 to 10.9 ± 10.65 to 10.5 ± 11, p = 0.00. Reduction in pH was observed with both moisturizers while TEWL significantly improved with pH-modified moisturizer. pH-modified moisturizer resulted in greater pH, TEWL and SCORAD improvements however the differences were not significant from standard moisturizer. Study limitation: Skin hydration was not evaluated. Conclusion: Moisturization is beneficial for atopic dermatitis; use of physiologically compatible pH moisturizer is promising.

Diseño y evaluación in vivo de fórmulas para acné basadas en aceites esenciales de naranja (Citrus sinensis), albahaca (Ocimum basilicum L) y ácido acético / Effectiveness of antimicrobial formulations for acne based on orange (Citrus sinensis) and sweet basil (Ocimum basilicum L) essential oils

Introducción. Actualmente, la resistencia a los antimicrobianos de las cepas bacterianas involucradas en el desarrollo del acné es una realidad y se hace necesario buscar alternativas terapéuticas para su tratamiento. Objetivos. Diseñar fórmulas en gel a base de aceites esenciales y ácido acético, y evaluar su efectividad en pacientes voluntarios afectados por acné. Materiales y métodos. Se trata de un estudio experimental simple enmascarado de tres fórmulas en gel sobre cuatro grupos de siete pacientes. Los tratamientos antibacterianos (aceites esenciales), queratolíticos y mixtos (ácido acético), se aplicaron diariamente por espacio de ocho semanas. Se hicieron controles semanales para evaluar la evolución de los pacientes. Resultados. Todos los grupos reportaron mejoría (desaparición de las lesiones) de la condición del acné, la cual osciló entre 43 y 75 %, con leves efectos secundarios transitorios relacionados con la aplicación de los tratamientos utilizados. Conclusiones. Las fórmulas estudiadas mostraron ser estables química y físicamente durante la aplicación de los tratamientos, lo cual se demostró mediante análisis de cromatografía de gases, en la cual no se evidenció ningún cambio en los perfiles de composición de los aceites esenciales ni en el del ácido acético. Los resultados se catalogaron entre buenos y excelentes, en particular, el del ácido acético, que logró mejorías superiores al 75 %, dada su actividad mixta antiséptica y queratolítica. Los efectos secundarios (ardor y enrojecimiento) desaparecieron a los pocos minutos de realizada la aplicación y no impidieron el cumplimiento de los tratamientos.

Introduction. Currently, the antimicrobial resistance has developed in bacterial strains involved in the development of acne. Therefore, alternatives to antibiotic treatment have become necessary. Objectives. Gel formulations were designed based on essential oils and acetic acid, and their effectiveness was evaluated in patients affected by acne. Materials and methods. Masked simple experimental study of three gel formulations on 28 volunteer patients, separated in four groups of seven patients. Treatments were applied daily for eight weeks and consisted of (1) antibacterial (essential oils), (2) keratolytic medication (3) essential oils mixed with acetic acetic, and (4) kerolytic medication with acetic acid. Weekly checks were conducted to evaluate patient improvement. Results. All groups reported an improvement of the acne condition, which ranged between 43% and 75% clearance of lesions. Evidence of treatment disappeared within minutes, showing little discomfort or side effects after application. Conclusions. The essential oil formulations were chemically and physically stable during application of treatments. This was demonstrated by gas chromatography, where no evidence no change neither the composition profiles of essential oils nor in acetic acid. The results were ranked good to excellent, particularly for the acetic acid mixture, which achieved improvements of 75%. This appeared to be a result of their joint antiseptic and keratolytic activity. Side effects (burning and redness) disappeared within a few minutes of completing the application, therefore, did not interfere with adherence to treatment.