Efficacy of a multifunctional plant complex in the treatment of the so-called 'cellulite': clinical and instrumental evaluation.

'Cellulite' or more correctly oedemateous fibrosclerotic panniculopathy, or local lipodystrophy, is a common aesthetic problem for many women, visually characterized by the orange peel or dimpled look of the skin, mainly on the buttocks and thighs. The cause of cellulite is still a matter of debate. It is currently considered an endocrine-metabolic microcirculatory disorder that causes interstitial matrix alterations and structural changes in subcutaneous adipose tissue. The first step in cellulite treatment is stimulation of microcirculation and the removal of accumulated fluids and toxic elements. This can improve the interstitial matrix basal regulation, fibroblast activity and decrease interstitial oedema, with subsequent increase in lipolysis and a better oxygen and nutrition of the adipose tissue. In this paper are reported two trials aimed at evaluating clinically and instrumentally the effects of different orally administered multifunctional plant extracts-based formulations in the treatment of cellulite compared with a placebo.

Oral fish cartilage polysaccharides in the treatment of photoageing: biophysical findings.

The topically applied cosmetic products can be helpful in improving the aged skin condition. The present study shows how oral fish-cartilage food supplementation can be helpful in improving the treatment of ageing skin. A total of 30 healthy women with signs of skin ageing were studied. Fifteen of the women were treated with a food supplement based on polysaccharides derived from the fish cartilage and a natural mix of antioxidants for 2 months and the other 15 with a placebo. Clinical evaluation and biophysical parameters related to skin function and wrinkle severity, such as silicone replica, skin thickness, mechanical properties, skin colour and capacitance, were measured. The results showed statistically significant changes in the active-treated group in comparison to the placebo. In particular, dermal thickness (treatment: from 1.13 to 1.23 mm; P < 0.001), skin wrinkling (treatment: from 9.5 to 3.5 R(a); P< 0.002), skin colour (treatment: brighter and less pigmented; P < 0.02) and viscoelasticity (treatment: from 0.70 to 0.97%; P < 0.02) showed considerable improvement. Most of these parameters are related to changes occurring within the dermal matrix, which is improved after the treatment, whereas most of the topically applied cosmetic products have a short-term effect on superficial structures. A combination treatment (oral and topical) can be more effective in reducing the signs of skin-ageing.

Glycerol accelerates recovery of barrier function in vivo.

Two studies were performed to evaluate the influence of glycerol on the recovery of damaged stratum corneum barrier function. Measurements of transepidermal water loss and capacitance were conducted in a 3-day follow-up after tape stripping (study 1) and a 7-day follow-up after a barrier damage due to a repeated washing with sodium lauryl sulphate. In study 1 a faster barrier repair (transepidermal water loss) was monitored in glycerol-treated sites. Significant differences between glycerol open vs. untreated and glycerol occluded vs. untreated were observed at day 3. Stratum corneum hydration showed significantly higher values in the sites treated with glycerol+occlusion, compared with all other sites. In study 2 a faster barrier repair was seen in glycerol-treated sites, with significant differences against untreated and base-treated sites 7 days after the end of the treatment. Stratum corneum hydration showed highest values in the glycerol treated sites after 3 days of treatment. Glycerol creates a stimulus for barrier repair and improves the stratum corneum hydration; stratum corneum hydration is not strictly related to barrier homeostasis and can be optimized by different mechanisms and pathways. The observed effects were based on the modulation of barrier repair and were not biased by the humectant effect of glycerol. As the glycerol-induced recovery of barrier function and stratum corneum hydration were observed even 7 days after the end of treatment, glycerol can be regarded as a barrier stabilizing and moisturizing compound.

Effects of prolonged occlusion on stratum corneum barrier function and water holding capacity.

PURPOSE OF THE STUDY: We aimed to evaluate whether prolonged occlusion can induce stratum corneum barrier damage, alterations in stratum corneum hydration or water-holding capacity (WHC) lasting longer than the occlusion time. MATERIALS AND METHODS: 12 subjects were occluded on the forearm for 24, 48, 72 and 96 h. Two hours after occlusion removal, transepidermal water loss (TEWL) and skin hydration were measured and a sorption-desorption test performed. RESULTS: TEWL showed an increase reaching a plateau on day 2. Hydration and WHC did not show significant changes. Hygroscopicity showed the highest level on day 1, decreasing during the following days. A highly significant correlation between capacitance values and the WHC could be detected (p < 0.0001, r = 0.8206). No correlation could be detected between hygroscopicity and TEWL. CONCLUSIONS: Prolonged occlusion induces barrier damage without skin dryness. Occlusion also induces an increased hygroscopicity. A correlation between these two findings could not be proven.

Alpha hydroxyacids modulate stratum corneum barrier function.

Alpha hydroxyacids (AHAs) are used to enhance stratum corneum desquamation and improve skin appearance. The purpose of this study was to evaluate whether some AHAs improve skin barrier function and prevent skin irritation. Eleven healthy subjects (aged 28 +/- 6 years, mean +/- SD) entered the study. Six test sites of 8 x 5 cm (four different AHAs, vehicle only (VE) and untreated control (UNT) were selected and randomly rotated on the volar arm and forearm. The four different AHAs at 8% concentration in base cream were glycolic acid (GA), lactic acid, tartaric acid (TA) and gluconolactone (GLU). The products were applied twice a day for 4 weeks (2 mg/cm2). At week 4, a 5% sodium lauryl sulphate (SLS) challenge patch test was performed under occlusion for 6 h (HillTop chamber, 18 mm wide) on each site. Barrier function and skin irritation were evaluated by means of evaporimetry (Servomed EP-1) and chromametry (a* value, Minolta CR200) weekly, and at 0, 24 and 48 h after SLS patch removal. No significant differences in transepidermal water loss (TEWL) and erythema were observed between the four AHAs at week 4. After SLS challenge, GLU- and TA-treated sites resulted in significantly lower TEWL compared with VE, UNT (P < 0.01) and GA (P < 0.05) both at 24 and 48 h. Similarly, a* values were significantly reduced after irritation in GLU- and TA-treated sites. This study shows that AHAs can modulate stratum corneum barrier function and prevent skin irritation; the effect is not equal for all AHAs, being more marked for the molecules characterized by antioxidant properties.

Effects of systemic treatment with statins on skin barrier function and stratum corneum water-holding capacity.

BACKGROUND: Topical application of inhibitors of HMGCoA reductase, the rate-limiting enzyme of cholesterol synthesis, has been shown to induce impairment of barrier function. OBJECTIVE: Assessing whether oral administration of statins used for reducing blood levels of cholesterol induces functional changes in stratum corneum barrier. MATERIALS AND METHODS: 69 subjects of both sexes under-going treatment for hypercholesterolemia (mean age 48 +/- 11 years) entered the study; 43 had been treated with simvastatin and 11 with pravastatin for 6 months; 15 only on dietary regimen served as controls. Efficiency of stratum corneum water barrier was evaluated by transepidermal water loss (TEWL) measurement using an evaporimeter; water-holding capacity of the stratum corneum was assessed by the sorption-desorption test measured by capacitance. Statistical analysis was performed using ANOVA. RESULTS: No differences were found between the groups (simvastatin, pravastatin, diet) concerning both basal TEWL and the dynamic of water binding in the stratum corneum. CONCLUSIONS: Prolonged treatment with cholesterol-lowering drugs based on inhibition of HMGCoA reductase does not alter the permeability barrier of the skin.

Effects of site and menstrual cycle on barrier function and stratum corneum water-holding capacity.

BACKGROUND/AIMS: Areas of the skin with similar anatomical structure may have different functional behaviour. In vivo barrier function and stratum corneum water-holding capacity during the menstrual cycle on two sites of the volar forearm (upper and lower) and on the anterior aspect of the thigh were evaluated using the plastic occlusion stress test (POST). METHODS: 13 healthy women (age 31 ± 4) with regular menses entered the study. POST was performed by applying a plastic chamber (1.8 cm diameter) on the skin for 24 h. After removal the skin surface water loss (SSWL) was measured using an evaporimeter (EP1-Servomed, Sweden) every 5 min for 30 min. Measurements were taken on the 10th and 25th day of the menstrual cycle. Statistical analysis was performed using one-factor Anova for repeated measures. Free and bound water compartments of evaporation were also analysed. RESULTS: Higher hydration and SSWL were detectable on the 25th day of the cycle. However, no significant influence of menstrual cycle was found. Significant differences between the upper and lower volar foream were detected (P < 0.001). CONCLUSION: The differences observed were mainly related to the evaporation of bound water, confirming a different barrier function at the sites investigated; therefore, it must be taken into account that adjacent skin sites with equal structure may have different functional behaviour.

Effects of water temperature on surfactant-induced skin irritation.

Surfactant-induced irritant reactions may be elicited by several endogenous and exogenous factors. Among these, surfactant concentration, and duration and frequency of exposure play important rôles. The study focuses on the influence of water temperature in determining damage of the skin barrier. 10 subjects of both sexes entered the study. 4 areas (4 x 4 cm2) were randomly selected on the volar forearm and were treated with a daily open application of 5% sodium lauryl sulphate for 4 days. The solutions were at 3 temperatures: 4 degrees, 20 degrees and 40 degrees C. One site served as untreated control. On the 5th day, skin irritation was evaluated using transepidermal water loss (TEWL) measurements, erythema (a* value), skin reflectance (L* value), hydration (capacitance) and desquamation (stripping). The results show a significant effect of the solution's temperature in determining skin irritation (P < 0.001). Skin damage was higher in sites treated with warmer temperatures and a highly significant correlation (P < 0.001) between irritation and temperature was found. In conclusion, the study shows that water temperature during washing has an important effect on the onset of irritant contact dermatitis.

The modulation of skin irritation.

Irritant contact dermatitis (ICD) is a multifactorial disease, the onset and modulation of which depend on both endogenous and exogenous factors. Among the former, age, race, site, sex and history of dermatitis may all be important. Such variables can now readily be quantified by objective noninvasive techniques, such as measurement of transepidermal water loss (TEWL). Moreover, effects of irritants on the epidermis are related to the particular chemical properties of each molecule, contributing further to clinical heterogeneity. Release of cytokines and mediators may be initiated by a number of cells, including living keratinocytes and those of the stratum corneum, thus modulating inflammation and repair. Furthermore, differences in mechanisms of inflammation between acute and chronic ICD may exist, the former being characterized predominantly by inflammation, the latter by hyperproliferation and transient hyperkeratosis. These findings may explain the complexity and difficulty of investigating ICD. Better understanding and quantification of these mechanisms may lead to identification of high-risk individuals and more effective prevention and treatment.

Non-invasive evaluation of topical calcipotriol versus clobetasol in the treatment of psoriasis.

Topical treatment of psoriasis with calcipotriol has been proven effective. The efficacy of calcipotriol has been compared to that of topical corticoids in a number of studies using subjective visual scoring systems such as the PASI index. The purpose of this study was to compare, with objective data, the efficacy of calcipotriol and clobetasol propionate 0.05% in the treatment of plaque type psoriasis. Transepidermal water loss (TEWL) and laser Doppler velocimetry (LDV) were used to monitor restoration of water barrier and normalization of blood flow, respectively, in psoriatic plaques of the limbs of 24 male patients during 3 weeks of treatment. Data were compared to subjective evaluation using the PASI index of the same areas. Significant differences were recorded during treatment in both groups. The results correlated well with the PASI score. Clobetasol was faster in restoring barrier function than calcipotriol. However, no significant differences were detected between the two groups. The use of vitamin analogues may be effective in the topical treatment of psoriasis by normalizing skin biophysical parameters and minimizing the risks of side-effects induced by potent topical corticoids.