Abstract
A daily moisturizing routine is a vital part of the management of patients with atopic
dermatitis and other dry skin conditions. The composition of the moisturizer determines
whether the treatment strengthens or deteriorates the skin barrier function, which
may have consequences for the outcome of the dermatitis. One might expect that a patient's
impaired skin barrier function should improve in association with a reduction in the
clinical signs of dryness. Despite visible relief of the dryness symptoms, however,
the abnormal transepidermal water loss has been reported to remain high, or even to
increase under certain regimens, whereas other moisturizers improve skin barrier function.
Differing outcomes have also been reported in healthy skin: some moisturizers produce
deterioration in skin barrier function and others improve the skin. Possible targets
for barrier-influencing moisturizing creams include the intercellular lipid bilayers,
where the fraction of lipids forming a fluid phase might be changed due to compositional
or organizational changes. Other targets are the projected size of the corneocytes
or the thickness of the stratum corneum. Moisturizers with barrier-improving properties
may delay relapse of dermatitis in patients with atopic dermatitis. In a worst-case
scenario, treatment with moisturizing creams could increase the risks of dermatitis
and asthma.
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Footnotes
The Knowledge Foundation, Sweden, financed part of this work.
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© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
