Sunscreen lotions in the dermatological prescription: review of concepts and controversies

Abstract The skin is regularly exposed to several environmental aggressions, including solar radiation, whose biological effects can induce sunburn, dyschromia, skin aging and cancer. Among the photoprotection measures, sunscreens comprise a relevant part of the strategy aimed to prevent solar radiation damage and, for effective action, the patient must adhere to the product use and the latter, in turn, must follow technical parameters to promote adequate protection. This review article brings together the most current and relevant concepts about photoprotection for dermatological use, including the challenges for their formulation, the risks of certain photoprotective active substances for individual and environmental safety and the importance of stringency in determining the product efficacy, considering the regulatory aspects, highlighting relevant differences between Brazil and other countries. Thus, when assessing a sunscreen, not only the visual aspects and sensory perception will be immediately evaluated, but also the quality and suitability of the vehicle, the chemical composition of the formulation, the environmental risks, the photostability of the screening system, and the measurement of its protection spectrum. Technical knowledge of sunscreens can help dermatologists in this important role of educating patients about the best photoprotective strategies in each situation.

Sunscreen lotions in the dermatological prescription: review of concepts and controversies.

The skin is regularly exposed to several environmental aggressions, including solar radiation, whose biological effects can induce sunburn, dyschromia, skin aging and cancer. Among the photoprotection measures, sunscreens comprise a relevant part of the strategy aimed to prevent solar radiation damage and, for effective action, the patient must adhere to the product use and the latter, in turn, must follow technical parameters to promote adequate protection. This review article brings together the most current and relevant concepts about photoprotection for dermatological use, including the challenges for their formulation, the risks of certain photoprotective active substances for individual and environmental safety and the importance of stringency in determining the product efficacy, considering the regulatory aspects, highlighting relevant differences between Brazil and other countries. Thus, when assessing a sunscreen, not only the visual aspects and sensory perception will be immediately evaluated, but also the quality and suitability of the vehicle, the chemical composition of the formulation, the environmental risks, the photostability of the screening system, and the measurement of its protection spectrum. Technical knowledge of sunscreens can help dermatologists in this important role of educating patients about the best photoprotective strategies in each situation.

Eficácia de uma nova geração de xampus no controle da dermatite seborreica do couro cabeludo / Efficacy of a new generation of shampoos in controlling seborrheic dermatitis of the scalp

Introdução: A dermatite seborreica é uma doença inflamatória crônica sobre áreas com maior concentração de glândulas sebáceas, com participação de fungos do gênero Malassezia sp. Objetivo: Avaliar a eficácia do tratamento da dermatite seborreica moderada a intensa com o uso de duas formulações de xampu em monoterapia. Métodos: Pacientes portadores de dermatite seborreica de couro cabeludo moderada à intensa, com cabelos processados quimicamente ou não, foram agrupados de acordo com o grau da afecção e usaram uma das duas versões de xampus em monoterapia, por quatro semanas. Também foi avaliada a ocorrência de recidivas após a suspensão do tratamento. Resultados: Houve redução significativa (p<0,05) da oleosidade desde a primeira aplicação. Os demais sinais (eritema e descamação) apresentaram melhora significativa para ambos os tratamentos. Também foi relatada uma melhora significativa do prurido, eritema e descamação pelos participantes. O efeito sobre os fios foi considerado positivo com ambos os tratamentos. Após uma semana da suspensão, o índice de recidivas foi considerado não significativo (p<0,05). Conclusões: As duas versões de xampus foram capazes de promover um controle efetivo da dermatite seborreica moderada à intensa. Essas formulações demonstraram também não agredirem os fios, mesmo quando processados, fato considerado fundamental para a adesão ao tratamento.

Introduction: Seborrheic dermatitis is a chronic inflammatory disease in areas with a higher concentration of sebaceous glands and the participation of the fungi of the genus Malassezia sp. Objective: To assess the effectiveness of treating moderate to severe seborrheic dermatitis using two shampoo formulations in monotherapy. Methods: Patients with moderate to severe seborrheic dermatitis of the scalp, with or without chemically processed hair, were grouped according to the degree of affection and used one of two versions of shampoo monotherapy for four weeks. Relapse after treatment cessation was also evaluated. Results: There was a significant reduction (p <0.05) of oiliness since the first application. The other signs (erythema and peeling) showed significant improvement for both treatments. Participants also reported a considerable improvement in pruritus, erythema, and peeling. The effect on the hair strands was considered positive with both procedures. After one week of suspension, the relapse rate was considered non-significant (p <0.05). Conclusions: Both versions of shampoos were able to promote effective control of moderate to severe seborrheic dermatitis. These formulations also demonstrated not to harm the hair strands, even when chemically processed, a fundamental fact to treatment adherence.

Topical effects of SCA® (Cryptomphalus aspersa secretion) associated with regenerative and antioxidant ingredients on aged skin: evaluation by confocal and clinical microscopy.

PURPOSE: This was an open-label, single-center clinical study to evaluate a topical association of SCA® (Cryptomphalus aspersa secretion) with regenerative and antioxidant ingredients, according to the type and area of the face, on the improvement of signs of skin aging. PATIENTS AND METHODS: One hundred and twenty female participants aged between 40 and 65 years, with facial aging complaints (presence of static, dynamics wrinkles, loss of elasticity, and skin firmness) were randomized into two groups according to the type of skin: normal-oily and normal-dry, and 40 participants were randomized for evaluation of the periocular area (with the presence of wrinkles, expression lines, and dark circles) with both types of skin. The groups received serum for normal-oily skin, a cream for normal-dry skin, and a cream for periocular and eyelid skin (eye area). All the participants were evaluated by a dermatologist and submitted to hydration evaluation by corneometry, elasticity and firmness measures complementarily, and images were collected in confocal reflectance microscopy. RESULTS: Topical skin treatment with the association of SCA with antioxidant ingredients (green coffee oil, olive oil, ectoine, hyaluronic acid, and peptides) was able to promote significant clinical and subjective improvement of all signs of skin aging. This improvement was presented at the epidermal level, with improved hydration levels measured by corneometry and epidermal thickness, and at the dermal level, with improvement of the firmness and elasticity parameters, measured by cutometry, from 45 days of use. CONCLUSION: All the evaluated topical formulations seemed to be an effective alternative for the progressive treatment of signs of skin aging, since they demonstrate a real improvement of dermal-epidermal structure and function with high safety margin for long-term use.

Efeito de um suplemento nutricional na proteção contra os danos decorrentes da poluição em queratinócitos: comprovação in vitro / Effect of a nutritional supplement in the protection against keratinocyte damage due to pollution: in vitro confirmation

Introdução: A interação da pele com poluentes atmosféricos tem demonstrado efeitos na barreira cutânea, assim como o desencadeamento de processos oxidativos relacionados ao envelhecimento prematuro da pele. O receptor de aril hidrocarbonetos (ArH) é proteína de transcrição que interage com os xenobióticos, regulando a transcrição de genes envolvidos com estresse oxidativo, inflamação, imunossupressão e pigmentação, além de levar a processos relacionados ao envelhecimento e carcinogênese. Objetivo: Avaliar a eficácia antipoluente de uma associação antioxidante na prevenção da translocação nuclear do receptor AhR Métodos: Um modelo in vitro (cultura de queratinócitos) foi exposto à fumaça de cigarro, e a presença de AhR foi medida por ensaio Elisa-sanduíche. Resultados: A cultura tratada demonstrou inibição da translocação nuclear do AhR em todas as concentrações avaliadas: aumentos de ArH de 75,38%; 59,88% e 117,79% são observados nas concentrações de 0,316; 0,100 e 0,0316mg/ml, respectivamente. Conclusão: Os resultados sugerem a capacidade da formulação avaliada em prevenir a ativação de genes responsáveis pelos efeitos nocivos da fumaça de cigarro.

Introduction: The interaction between the skin and air pollutants has demonstrated effects in the cutaneous barrier, as well as triggering oxidative processes related to premature ageing of the skin. The aryl hydrocarbon receptor (ArH) is a transcription protein that interacts with xenobiotics, regulating the transcription of genes involved with oxidative stress, inflammation, immunosuppression and pigmentation, besides leading to processes related to ageing and carcinogenesis. Objective: Evaluate the anti-pollution efficacy of an antioxidant association for the prevention of the nuclear translocation of the AhR receptor. Methods: A in vitro model (keratinocyte culture) was exposed to cigarette smoke and the presence of AhR was measured through sanduwich ELISA assay. Results: The treated culture demonstrated inhibition of the nuclear translocation of AhR in all concentrations evaluated: ArH increase of 75.38%; 59.88% and 117.79% are seen with the concentrations of 0.316; 0.100 and 0.0316mg / mL, respectively. Conclusion: The results suggest the ability of the formulation analyzed in preventing the activation of genes responsible for the damaging effects of cigarette smoke.

Beyond photoaging: additional factors involved in the process of skin aging.

Studies assessing the impact of extrinsic factors on skin aging have increased during the last with the increase in life expectancy. Although most of the studies are about the sun radiation impact, many factors should be considered in elderly people, beyond environmental conditions. Lifestyle factors, like diet, sleeping, smoking, should be analyzed carefully, as common age-related conditions (menopause, diabetes, pulmonary diseases, etc.). All these factors could accelerate the natural decline of skin structure and functions, possibly affecting the responses to treatments and drugs. This review demonstrates that growing evidence regarding environmental factors that are associated with lifestyle and comorbidities deserve greater attention from researchers and dermatologists and may require new approaches in the management of skin aging.

Comparative evaluation between two nutritional supplements in the improvement of telogen effluvium.

PURPOSE: Telogen effluvium (TE) is defined as a diffuse hair loss characterized by shortening of the anagen phase and precipitation of the telogen phase, with a consequent reduction of total hair volume. Nutritional supplementation is indicated under conditions in which TE is related to dietary disorders. The aim of this clinical study was to compare the efficacy of two different supplements in monotherapy for TE. PATIENTS AND METHODS: Female adult patients were randomized to receive two oral nutritional supplements (group 1: a supplement composed of zinc, biotin, iron, vitamins A, C, E, and B complex, folic acid, magnesium, and amino acids of keratin and collagen and group 2: calcium pantothenate cystine, thiamine nitrate, medicinal yeast, keratin, and aminobenzoic acid) to treat hair loss for 180 days. They were evaluated clinically and by digital trichoscopy. RESULTS: Clinical evaluation showed significant clinical improvement (P<0.05) for the evaluated parameters: hair loss, hair volume, density of hair (scalp cover), hair shine, hair strength, in 180 days. At 90 days evaluation, group 1 showed significant improvement for all parameters, while group 2 did not show any significant improvement for hair shine and hair strength. In the digital trichoscopy, there was a significant improvement only in group 1 (11.09%×7.76%) after 180 days. CONCLUSION: In idiopathic TE, the nutritional component should be suspected; the supplementation of an association of nutrients in recommended daily intake can lead to significant improvement of the condition from the first trimester of use. The use of an association with proven efficacy and a safety profile and posologic convenience facilitate its indication and patient adherence.

Improvement of dermal parameters in aged skin after oral use of a nutrient supplement.

PURPOSE: Skin aging is a progressive and degenerative process caused by a decrease in the physiological functions of the skin tissue. In addition, environmental factors as well as concomitant diseases and lifestyle (nutrition, sedentary lifestyle, smoking, etc) negatively impact the aging process. An association between oral administration of collagen peptides combined with vitamin C and extracts of Hibiscus sabdariffa and Aristotelia chilensis (Delphynol®) (Eximia Firmalize Age complex®) on dermal thickness was studied and the improvement in aging signs was evaluated. PATIENTS AND METHODS: Female adult patients received an oral nutritional supplement containing collagen peptides, vitamin C, H. sabdariffa, and A. chilensis (Delphynol) in a sachet and were instructed to consume 1 sachet diluted in 200 mL of water once daily for 12 weeks. They were evaluated clinically, by high frequency ultrasound and cutometry. RESULTS: There was a significant improvement of firmness and elasticity and an increase in dermal thickness by ultrasound after 3 months of use. CONCLUSION: The association of collagen peptides, vitamin C, H. sabdariffa and A. chilensis (Delphynol) could improve the signs of dermal skin aging.

Antioxidants in dermatology.

The skin cells continuously produce, through cellular respiration, metabolic processes or under external aggressions, highly reactive molecules oxidation products, generally called free radicals. These molecules are immediately neutralized by enzymatic and non-enzymatic systems in a physiological and dynamic balance. In situations where this balance is broken, various cellular structures, such as the cell membrane, nuclear or mitochondrial DNA may suffer structural modifications, triggering or worsening skin diseases. several substances with alleged antioxidant effects has been offered for topical or oral use, but little is known about their safety, possible associations and especially their mechanism of action. The management of topical and oral antioxidants can help dermatologist to intervene in the oxidative processes safely and effectively, since they know the mechanisms, limitations and potential risks of using these molecules as well as the potential benefits of available associations.

Antioxidants in dermatology

Abstract The skin cells continuously produce, through cellular respiration, metabolic processes or under external aggressions, highly reactive molecules oxidation products, generally called free radicals. These molecules are immediately neutralized by enzymatic and non-enzymatic systems in a physiological and dynamic balance. In situations where this balance is broken, various cellular structures, such as the cell membrane, nuclear or mitochondrial DNA may suffer structural modifications, triggering or worsening skin diseases. several substances with alleged antioxidant effects has been offered for topical or oral use, but little is known about their safety, possible associations and especially their mechanism of action. The management of topical and oral antioxidants can help dermatologist to intervene in the oxidative processes safely and effectively, since they know the mechanisms, limitations and potential risks of using these molecules as well as the potential benefits of available associations.

Efeito de suplementação nutricional no fortalecimento e crescimento das lâminas ungueais / Nutritional supplementation effect ON THE nail PLATE'S strength and growing

Introdução: "unhas quebradiças", ou que não crescem, constituem queixa relativamente frequente na prática dermatológica; entretanto, há poucos estudos sobre a influência nutricional nessa queixa Objetivo: avaliar a possível influência de suplemento nutricional na melhora da resistência da lâmina ungueal, bem como de seu crescimento Material e Métodos: 45 pacientes com queixas de unhas frágeis/quebradiças foram observadas durante 16 semanas, sob uso de suplemento nutricional contendo vitaminas e oligoelementos em ingestão diária recomendada com avaliações clínicas e subjetivas em oito, 12 e 16 semanas. Resultados: houve melhora nos parâmetros força, resistência, crescimento e integridade ungueais a partir de oito semanas, melhora que progride com o uso continuado do suplemento, permitindo afirmar que esse tratamento levou a perceptível melhora da qualidade da lâmina ungueal. Conclusões: O suplemento nutricional avaliado se mostrou seguro e eficaz na melhora de sinais de enfraquecimento ungueal, como perda da resistência e redução da velocidade de crescimento.

Introduction: Brittle nails or nails that do not grow are relatively frequent complaints in the dermatological practice, nonetheless there are few studies on how nutrition influences these symptoms. Objective: To evaluate the possible influence of nutritional supplementation for improving the nail plate's resistance and growth. Methods: Forty-five patients complaining of fragile/brittle nails were observed for 16 weeks under recommended daily intake of a nutritional supplement containing vitamins and trace elements, having undergone clinical and subjective evaluations in Weeks 8, 12 and 16. Results: There were improvements in the parameters strength, resistance, growth and nail integrity from Week 8, with further progress after continued use of the supplement, allowing the conclusion that this treatment led to noticeable improvement of the nail plate's quality. Conclusions: The nutritional supplement evaluated was safe and effective in improving the signs of nail weakening, including loss of resistance and reduction of growth rate.

Use of silicon for skin and hair care: an approach of chemical forms available and efficacy.

Silicon is the second most abundant element on Earth, and the third most abundant trace element in human body. It is present in water, plant and animal sources. On the skin, it is suggested that silicon is important for optimal collagen synthesis and activation of hydroxylating enzymes, improving skin strength and elasticity. Regarding hair benefits, it was suggested that a higher silicon content in the hair results in a lower rate of hair loss and increased brightness. For these beneficial effects, there is growing interest in scientific studies evaluating the efficacy and safety of using dietary supplements containing silicon. Its use aims at increasing blood levels of this element and improving the skin and its annexes appearance. There are different forms of silicon supplements available and the most important consideration to be made in order to select the best option is related to safety and bioavailability. Silicon supplements are widely used, though there is wide variation in silicon bioavailability, ranging from values below 1% up to values close to 50%, depending on the chemical form. Therefore, the aim of this study was to evaluate the scientific literature related to the different chemical forms of silicon supplements available and the limitations and recent progress in this field. According to reported studies, among the different chemical forms available, the orthosilicic acid (OSA) presents the higher bioavailability, whereas the others forms have absorption inversely proportional to the degree of polymerization. However, clinical studies evaluating safety and efficacy are still lacking.

Use of silicon for skin and hair care: an approach of chemical forms available and efficacy

Abstract Silicon is the second most abundant element on Earth, and the third most abundant trace element in human body. It is present in water, plant and animal sources. On the skin, it is suggested that silicon is important for optimal collagen synthesis and activation of hydroxylating enzymes, improving skin strength and elasticity. Regarding hair benefits, it was suggested that a higher silicon content in the hair results in a lower rate of hair loss and increased brightness. For these beneficial effects, there is growing interest in scientific studies evaluating the efficacy and safety of using dietary supplements containing silicon. Its use aims at increasing blood levels of this element and improving the skin and its annexes appearance. There are different forms of silicon supplements available and the most important consideration to be made in order to select the best option is related to safety and bioavailability. Silicon supplements are widely used, though there is wide variation in silicon bioavailability, ranging from values below 1% up to values close to 50%, depending on the chemical form. Therefore, the aim of this study was to evaluate the scientific literature related to the different chemical forms of silicon supplements available and the limitations and recent progress in this field. According to reported studies, among the different chemical forms available, the orthosilicic acid (OSA) presents the higher bioavailability, whereas the others forms have absorption inversely proportional to the degree of polymerization. However, clinical studies evaluating safety and efficacy are still lacking.

Skin barrier in rosacea.

Recent studies about the cutaneous barrier demonstrated consistent evidence that the stratum corneum is a metabolically active structure and also has adaptive functions, may play a regulatory role in the inflammatory response with activation of keratinocytes, angiogenesis and fibroplasia, whose intensity depends primarily on the intensity the stimulus. There are few studies investigating the abnormalities of the skin barrier in rosacea, but the existing data already show that there are changes resulting from inflammation, which can generate a vicious circle caused a prolongation of flare-ups and worsening of symptoms. This article aims to gather the most relevant literature data about the characteristics and effects of the state of the skin barrier in rosacea.

Skin barrier in rosacea

Abstract Recent studies about the cutaneous barrier demonstrated consistent evidence that the stratum corneum is a metabolically active structure and also has adaptive functions, may play a regulatory role in the inflammatory response with activation of keratinocytes, angiogenesis and fibroplasia, whose intensity depends primarily on the intensity the stimulus. There are few studies investigating the abnormalities of the skin barrier in rosacea, but the existing data already show that there are changes resulting from inflammation, which can generate a vicious circle caused a prolongation of flare-ups and worsening of symptoms. This article aims to gather the most relevant literature data about the characteristics and effects of the state of the skin barrier in rosacea.

Brazilian Consensus on Photoprotection

Brazil is a country of continental dimensions with a large heterogeneity of climates and massive mixing of the population. Almost the entire national territory is located between the Equator and the Tropic of Capricorn, and the Earth axial tilt to the south certainly makes Brazil one of the countries of the world with greater extent of land in proximity to the sun. The Brazilian coastline, where most of its population lives, is more than 8,500 km long. Due to geographic characteristics and cultural trends, Brazilians are among the peoples with the highest annual exposure to the sun. Epidemiological data show a continuing increase in the incidence of non-melanoma and melanoma skin cancers. Photoprotection can be understood as a set of measures aimed at reducing sun exposure and at preventing the development of acute and chronic actinic damage. Due to the peculiarities of Brazilian territory and culture, it would not be advisable to replicate the concepts of photoprotection from other developed countries, places with completely different climates and populations. Thus the Brazilian Society of Dermatology has developed the Brazilian Consensus on Photoprotection, the first official document on photoprotection developed in Brazil for Brazilians, with recommendations on matters involving photoprotection.

Brazilian consensus on photoprotection.

Brazil is a country of continental dimensions with a large heterogeneity of climates and massive mixing of the population. Almost the entire national territory is located between the Equator and the Tropic of Capricorn, and the Earth axial tilt to the south certainly makes Brazil one of the countries of the world with greater extent of land in proximity to the sun. The Brazilian coastline, where most of its population lives, is more than 8,500 km long. Due to geographic characteristics and cultural trends, Brazilians are among the peoples with the highest annual exposure to the sun. Epidemiological data show a continuing increase in the incidence of non-melanoma and melanoma skin cancers. Photoprotection can be understood as a set of measures aimed at reducing sun exposure and at preventing the development of acute and chronic actinic damage. Due to the peculiarities of Brazilian territory and culture, it would not be advisable to replicate the concepts of photoprotection from other developed countries, places with completely different climates and populations. Thus the Brazilian Society of Dermatology has developed the Brazilian Consensus on Photoprotection, the first official document on photoprotection developed in Brazil for Brazilians, with recommendations on matters involving photoprotection.

Uso de hialuronidase em complicações causadas por ácido hialurônico para volumização da face: relato de caso / The use of hyaluronidase in complications caused by hyaluronic acid for volumization of the face: a case report

O uso do ácido hialurônico (AH) injetável no preenchimento de rugas e volumização facial está consagrado na prática dermatológica. O manejo de suas complicações, embora raras, deve ser do conhecimento do dermatologista. No uso dos preenchedores de aplicação mais profunda, a formação de nódulos pode ocorrer, e a conduta é similar à utilizada para preenchedores mais superficiais e menos viscosos. O uso da cânula mais fina possivelmente reduz esse risco, sobretudo em áreas de derme mais fina.

The use of injectable hyaluronic acid (HA) in wrinkle filling and facial volumization is well established in the dermatological practice. While complications are rare, techniques for their management should be known by the dermatologist. Nodules may occur with the use of deeper application fillers, and the treatment is similar to that used for the more superficial and less viscous fillers. The use of a thinner cannula may reduce this risk, especially in areas where the dermis is thinner.

Aumento da dose eritematosa mínima a partir da ingestão de um suplemento vitamínico contendo antioxidantes / Increase in the minimum erythema dose level based on the intake of a vitamin supplement containing antioxidants

Introdução: O fotodano induzido pela luz ultravioleta leva agudamente a eritema solar, que é o fenômeno medido para avaliar a proteção solar de um determinado produto. Objetivo: Investigar a capacidade de um suplemento alimentar contendo antioxidantes (carotenoides, oligoelementos, óleo de linhaça e vitaminas E e C) para prevenir fotodano, usando como parâmetro a dose eritematosa mínima. Método: Foi determinada a dose eritematosa mínima de 28 voluntários de fototipos 2 e 3 de Fistspatrick, com um simulador solar, antes e após 30 e 60 dias do uso do suplemento. Resultados: O uso diário do suplemento foi bem tolerado. Houve aumento significativo da dose eritematosa mínima no grupo avaliado (p = 0,017) Conclusão: A associação de antioxidantes estudada exibiu aumento estatisticamente significativo da dose eritematosa mínima, sugerindo a atividade fotoprotetora.

Introduction: UV light-induced photodamage is an acute precipitator of solar erythema, which is the phenomenon measured to assess the protection against the sun provided by a particular product. Objective: To investigate the ability of a dietary supplement containing antioxidants (carotenoids, trace elements/oligoelements, flaxseed oil, and vitamins E and C) to prevent photodamage, using as a parameter the minimum erythema dose level. Method: The minimum erythema dose level of 28 volunteers (Fitzpatrick skin types 2 and 3) was measured with a solar simulator, before and after 30 and 60 days of supplement use. Results: The daily use of the supplement was well tolerated. There was a significant increase in the minimum erythema dose level in the group evaluated (p = 0.017). Conclusion: The studied combination of antioxidants was demonstrated to increase the minimum erythema dose level with statistical significance, suggesting the presence of photoprotective activity.

Barreira cutânea na dermatite atópica: o valor de um limpador adequado / Skin barrier in atopic dermatitis: the importance of an appropriate cleansing agent

Introdução: A xerose cutânea, comum na dermatite atópica, favorece o prurido e a inflamação. A higiene com tensoativos syndet é suave e preserva a barreira cutânea. Objetivo: Avaliar a tolerância e melhora da xerose da pele com gel de banho especialmente desenvolvido para a pele atópica. Métodos: Avaliaram-se 33 pacientes entre 18 e 50 anos, durante quatro semanas de uso exclusivo; medidas de hidratação, perda de água transepidérmica e pH da superficie cutânea foram feitas no antebraço ao início do estudo, e, após aplicação única, a área foi comparada com a que não foi tratada (antebraço contralateral). Resultados: Todos os pacientes terminaram o estudo; não houve reações adversas. Foram constatados maiores níveis de hidratação e redução da perda de água transepidérmica na área lavada com o gel de banho em comparação à área lavada com água pura, observandose melhora significativa no tempo de duração de prurido, bem como na maciez da pele, além de menor irritação e ressecamento após o uso continuado. Conclusões: A higienização com gel syndet demonstrou não somente preservar a integridade da barreira cutanea no paciente atópico, como também a melhora clínica de sintomas e sinais relacionados à xerose, tais como ressecamento e prurido.

Introduction: Skin xerosis commonly occurs in atopic dermatitis, promoting pruritus and inflammation. Hygiene with syndets (synthetic detergents) is gentle and preserves the skin barrier. Objective: To evaluate the skin's tolerance, and improvement of the xerosis, with the use of a shower gel specially developed for atopic skin. Methods: Thirty-three patients (18 to 50-years-old) were evaluated during four weeks, when using exclusively this product. Hydration, transepidermal water loss, and skin surface pH measurements were taken from the forearm at baseline and after a single application, and were compared to the untreated control area (contralateral forearm). Results: All patients completed the study and there were no adverse reactions. Higher levels of hydration and a reduction of transepidermal water loss were verified in the area washed with the shower gel when compared to the area washed with pure water. Significant improvement was observed in the pruritus and skin smoothness, and there was less irritation and dryness after continued use. Conclusions: A cleansing process using a syndet gel was demonstrated as capable of preserving not only the skin's integrity, but also the skin barrier in atopic patients, in addition to improving clinical signs and symptoms related to xerosis, such as dryness and pruritus