Effects of a leave-on product on the strength of the dermoepidermal junction: An exploratory, intraindividual, randomized controlled trial in older adults with dry skin.

Background and Aims: Skin aging is associated with dry skin and a decrease of the strength of the dermoepidermal adhesion, which increases the risk for lacerations (skin tears). Application of leave-on products improves dry skin and seems to reduce skin tear incidence. The aim of this study was to measure the effects of a humectant containing leave-on product on the strength of the dermoepidermal junction in older adult participants with dry skin. Methods: A randomized controlled trial using a split body design was conducted. One forearm was randomly selected and treated with a lipophilic leave-on product containing 5% urea for 8 weeks. The other forearm was the control. The parameters stratum corneum hydration (SCH), transepidermal water loss, pH, roughness, epidermal thickness and skin stiffness were measured at the baseline, Weeks 4 and 8. At Week 8, suction blisters were created and time to blistering was measured. Blister roofs and interstitial fluid were analyzed for Interleukin-1α, 6 and 8. Results: Twelve participants were included. After 8 weeks treatment, SCH was higher (median difference 11.6 AU), and the overall dry skin score (median difference -1) and median roughness (Rz difference -12.2 µm) were lower compared to the control arms. The median group difference for Interleukin-1α was -452 fg/µg total protein (TP) in the blister roofs and -2.2 fg/µg TP in the blister fluids. The median time to blister formation was 7.7 min higher compared to the control arms. Conclusion: The regular application of humectant containing leave-on products improves dry skin and seems to lower inflammation and contribute to the strengthening of the dermoepidermal adhesion. This partly explains how the use of topical leave-on products helps to prevent skin tears.

Randomized assessor-blinded controlled trialon the efficacy and safety of virgin coconut oil versus mineral oil as a therapeutic moisturizer for Senile Xerosis

Background@#Xerosis is one of the most common dermatologic complaints in the elderly. People in the tropics, including the Philippines, have effectively used coconut oil as a traditional moisturizer for centuries. Its film-forming qualities allow it to act as a skin moisturizer and as a protectant against moisture loss. To date, only one randomized clinical trial has proven the efficacy and safety of coconut oil as a skin moisturizer for xerosis. With the increasing number of VCO products in the market, this study aimed to validate the use of an indigenous agricultural product, virgin coconut oil, for senile xerosis. With its moisturizing, antioxidant, and antiseptic effects, VCO may be superior and more cost-effective compared to the frequently used synthetic mineral oil.@*Objective@#This study aimed to determine the efficacy and safety of virgin coconut oil compared to mineral oil for the treatment of senile xerosis.@*Methods@#This was a community-based assessor-blinded, randomized controlled trial, which included elderly patients with mild to moderate senile xerosis of the legs. Participants were instructed to apply the test oil twice daily to the legs for 2 weeks. The following primary outcomes were measured at baseline and 2-weeks post treatment: skin dryness (over-all dry skin score, ODSS), skin hydration (corneometer readings), skin lipid content (sebumeter readings), and quality of life (Dermatology Life Quality Index). Secondary outcomes like patient-assessed clinical efficacy and adverse effects were also measured.@*Results@#A total of 148 participants (59 males, 89 females) with mean age of 68 years (SD 6.02) were included in the study. Eighty-one (81) were assigned under the VCO group and 67 under the mineral oil group. There was a total of 25 dropouts, 7 in the virgin coconut oil group, and 18 in the mineral oil group. The distribution of the patients’ ODSS after treatment with VCO and mineral oil showed a trend towards improvement: 43% in the VCO group had no visible signs of leg xerosis versus 22.4% in the mineral oil group. The proportion of participants with>1 point decrease in ODSS, was statistically greater in the VCO group at 74% (60/81) compared to the mineral oil group, 34% (23/67) (p<0.0001). VCO showed significantly greater skin hydration at 74% (60/81) as compared to 46% (31/67) in the mineral oil group (p<0.0010). Improvement in the skin lipid content using the sebumeter showed 82.7% (67/81) in the VCO group compared to 61.2% (41/67) in the mineral oil group (p=0.6591). Moreover, the patients’ perceived efficacy of the oil applied on their skin was 29.6% (24/81) in the VCO group compared to 5.9% (4/67) in the mineral oil group (p=0.0030). Baseline DLQI scores showed no significant difference in the assessed quality of life of the patients between the two treatments (p=0.0161).Over all, the VCO group showed 32.1% (26/81) treatment success compared to 8.9% (6/67) in the mineral oil group (p=0.004614). Adverse events in the 2 groups were all mild and transient with 8% (6/74) patients in the VCO group and 26.5% (13/49) in the mineral oil group (p=0.089).@*Conclusion@#Among elderly patients with mild to moderate xerosis, 2-week topical application of VCO was superior to mineral oil in the immediate improvement of leg xerosis based on primary outcome measures of the Over-all Dry Skin Score (ODSS), corneometer, sebumeter readings, and the Dermatology Life Quality Index.

Efficacy of an emollient containing diethylene glycol/dilinoleic acid copolymer for the treatment of dry skin and pruritus in patients with senile xerosis.

BACKGROUND AND AIMS: Pruritus frequently reduces quality of life (QOL) in patients with senile xerosis. This study investigated the moisturizing and antipruritic effects of a topical emollient containing a diethylene glycol/dilinoleic acid copolymer (D/DC) in patients with pruritic senile xerosis. METHODS: This single-blind study involved 50 subjects, aged 50-75 years. Patients were randomized to self-applied treatment of the lower legs with 10% (n = 20) or 20% (n = 20) D/DC-containing cream, white petrolatum (n = 5), or no treatment (n = 5) thrice daily for four weeks. Clinical scores of skin dryness and scratch marks, skin conductance, and Skindex-16 were evaluated before and after treatment. The degree of pruritus was evaluated by visual analog scale (VAS) score once a week. RESULTS: Patients treated with 10% and 20% D/DC showed significant improvements in skin dryness and scratch mark scores, as well as increased skin conductance, compared with the untreated group, whereas white petrolatum treatment improved only skin dryness scores. Moreover, patients treated with 20% D/DC showed significant improvements in skin dryness scores and skin conductance compared with white petrolatum treatment. The VAS scores in the D/DC-treated and white petrolatum-treated groups were significantly lower than in the untreated group, being particularly lower after one week of treatment with 20% D/DC. CONCLUSION: Topical application of an emollient containing D/DC is effective in improving skin dryness and pruritus in patients with senile xerosis.

Effect of topical glucocorticoid on skin barrier function of patients with senile xerosis / 第二军医大学学报

Objective To evaluate the effect of topical glucocorticoid on skin barrier function of patients with senile xerosis. Methods A total of 32 patients were treated with 0. 1% topical hydrocortisone cream on one side of the forearms (topical hydrocortisone group), once a xggiday for 8 weeks, and the other forearms were taken as control (control group). Skin barrier function was evaluated at 0, 2, 4 and 8 weeks after experiment using Corneometer and Tewameter. Results The water content of stratum corneum in the topical hydrocortisone group peaked at 2 weeks, while the transepidemal water loss (TEWL) value was the lowest. Compared with the control group, topical hydrocortisone significantly increased the water content of the stratum corneum (P<0. 01) and decreased the TEWL value of stratum corneum (P<0. 01) after an 8-week treatment. Conclusion The application of topical glucocorticoid in patients with senile xerosis results in no impairment of skin barrier function after an 8-week treatment, and it can temporarily improve the skin barrier function after 2-week treatment.

Effectiveness of a heparinoid-containing moisturiser to treat senile xerosis.

BACKGROUND AND OBJECTIVES: With the increasing elderly population in Japan, skin problems have become a greater concern. A heparinoid-containing moisturiser is frequently used in Japan, but there is a lack of evidence for its efficacy in treating senile xerosis. To determine whether there is a correlation between age and the hydration state of the stratum corneum (SC) assessed by skin capacitance, and to evaluate the efficiency of a heparinoid-containing moisturiser and a bed bath to treat senile xerosis. METHODS: We recruited 73 individuals to assess the hydration state of the SC on their flexor forearm by measuring their skin capacitance. To evaluate the efficacy of a heparinoid-containing moisturiser on senile xerosis, we recruited seven inpatients with an inactive daily life (IDL) who had senile xerosis. They were treated with the moisturiser in addition to a bed bath in two different protocols, and we measured the skin capacitance on their flexor forearms on days 0, 7 and 14. RESULTS: There was a weak negative correlation (-0.3854, P < 0.01) between skin capacitance and age. Following the moisturiser treatments, the seven inpatients had increased hydration of both arms on days 7 and 14. The skin capacitance of the right forearm slightly decreased on day 14, even though it was significantly different from day 0 (P < 0.05). CONCLUSIONS: These findings indicate that treatment with a heparinoid-containing moisturiser together with a bed bath is an effective method for treating patients who have senile xerosis and IDL.

Relationship between activity of daily living and asteatosis in the lower legs among elderly residents in long-term care institutions: a cross-sectional study.

This cross-sectional observational study investigated the relationship between the level of activities of daily living (ADL) and asteatosis in the lower legs among elderly residents. We enrolled 173 residents from a long-term care health facility and two special nursing homes for elderly persons in the Tokyo metropolitan area and Oshima Island, Japan. The level of ADL was measured by the Barthel Index. The relationship between the Barthel Index total score and the presence of asteatosis in the lower legs diagnosed by a dermatologist was analysed by multivariate logistic regression analysis. Among the residents, 79·2% had asteatosis in their lower legs. An increase of 1 point in the Barthel Index total score was significantly associated with a decreased probability of lower leg asteatosis after adjusting for age, sex and the type of institution (adjusted odds ratio = 0·982; 95% confidence interval: 0·966-0·998). A higher level of ADL is associated with a lower probability of having asteatosis in the lower legs among residents in long-term care institutions. Nurses should pay specific attention to residents with limited ADL for initiating preventive care for asteatosis.