A new model for assessing the damaging effects of soaps and surfactants on human stratum corneum.

To elucidate the damage to the horny layers of human skin produced by surfactants and soaps, we evaluated the cytological alterations of corneocytes using an in vitro assay. Suction blisters, 8 mm in diameter, were raised on the forearms of young adult Caucasoids. The roofs were cut off and the viable epidermis was removed. The discs of stratum corneum were then agitated for up to 6 h at 60 degrees C in 1% solution of five soap bars of differing irritancy. Additionally, individual examples of anionic, cationic and nonionic surfactants were similarly evaluated. Measurements of corneocytes included: (1) the number released with time (disaggregation), (2) size (swelling) and (3) morphologic degradation. The effects of the cationic and non-ionic surfactants did not differ significantly from those of distilled water. The anionic surfactant caused more release and less swelling and morphological change. The test soaps had vastly different effects on the structural integrity of the stratum corneum. The harsher ones caused greater disaggregation, more swelling and greater morphologic deterioration of corneocytes, whereas the milder ones had less marked effects on these parameters. This model would be a useful screening technique for formulating milder soaps and might also provide insights into the complex modes of action of surfactants on the stratum corneum.

Pretreatment of photoaged forearm skin with topical tretinoin accelerates healing of full-thickness wounds.

Pretreatment of skin with all-trans retinoic acid (tretinoin) has been shown to enhance wound healing. Previous studies have mainly used animal models to demonstrate this effect. We wanted to determine whether pretreatment could promote wound healing in severely photoaged dorsal forearm skin. Four elderly men with severely actinically damaged forearms were treated daily for 16 weeks. One arm was treated with 0.05-0.1% tretinoin cream (Retin A, Ortho), and the other with Purpose cream (Ortho) as a vehicle control. Four-millimetre punch biopsies were taken from both dorsal forearms prior to treatment. After 16 weeks, full-thickness 2-mm punch biopsies were taken from both sides. Serial photographs were taken, and healing of the wounds quantitatively assessed by image analysis. On the 11th day, the wounds were excised using a 4-mm biopsy punch. Biopsies were processed for light microscopy. After 16 weeks, the tretinoin-treated forearms showed moderate erythema and scaling. Polarized light photographs revealed multiple, red, vascularized foci and/or a diffuse network of small vessels. The histological effects were typical for tretinoin, i.e. compaction of the stratum corneum, epidermal acanthosis with correction of atypia, an increase in small vessels, and increased cellularity in the upper dermis. Purpose cream had no effect, either clinically or histologically. On the tretinoin-treated side, the wound areas were 35-37% smaller on days 1 and 4, and 47-50% smaller on days 6, 8, 11, compared with the controls. Clinically and histologically, reepithelialization occurred more rapidly. Thus tretinoin dramatically accelerated wound healing in photodamaged skin.

Stratum corneum lipids in skin xerosis.

Lipids of the stratum corneum are implicated in cohesion and desquamation of the stratum corneum as well as in the maintenance of normal barrier function. Evidence linking the intercellular lipids to such processes has mainly been derived from studies on acquired or inherited diseases of lipid metabolism manifesting abnormalities in the structure and the function of the stratum corneum. We have studied the composition of stratum corneum lipids in clinically normal individuals with typical xerosis or 'winter dry skin' in order to establish if the lipid composition differs from that of normal individuals, showing no signs of xerosis. The amount of total stratum corneum lipids was not related to xerosis (22.0 +/- 1.8 micrograms/cm2 for normal skin, and 26.3 +/- 2.9 micrograms/cm2 for severe xerosis), and no correlation was evident between polar lipids, cholesterol sulfate (2.8 +/- 0.5% for normal skin, and 1.6 +/- 0.2% for severe xerosis), or ceramides types I-VI, and dry skin. It therefore appears that dramatic changes in stratum corneum lipids are not detectable in normal 'winter dry' skin. However, a decreased proportion of neutral lipids (sterol esters, triglycerides), coupled to increased amounts of free fatty acids, were found associated to the severity of dry skin. Apart from a decline in the sebaceous function and in esterases activity, winter dry skin does not appear to be associated to dramatic changes in polar stratum corneum lipids.

Age-associated changes in stratum corneum lipids and their relation to dryness.

Stratum corneum lipids (SCL) were collected on the right and left legs of 50 subjects of varying ages and skin dryness. The level of dryness and composition of the lipid was the same on both sides. While skin dryness continuously increased with age, the composition of SCL showed a constant profile from the 50s. Aging was mostly associated with a decrease in sterol esters and triglycerides. On the legs, the SCL do not seem to primarily govern the increased desquamative process which features xerosis.