Cohort Using a Ceramides Containing Cleanser and Cream With Salicylic Acid for Dry, Flaking, and Scaling Skin Conditions
January 2019 | Volume 18 | Issue 1 | Original Article | 80 | Copyright © 2019
Ronald B. Vender MD FRCPC,a Anneke Andriessen PhD,b Benjamin Barankin MD FRCPC,c Anatoli Freiman MD FRCPC,c Dimitrios Kyritsis MD FRCPC,d Loukia-Maria Mistos MD FRCPC,d Jennifer Salsberg MD FRCPC,e Laetitia Amar MDf
aMcMaster University Hamilton, ON, Canada bRadboud UMC Nijmegen, Andriessen Consultants, Malden, The Netherlands cToronto Dermatology Centre, North York, ON, Canada dCentre Med Pierrefonds, Pierrefonds, QC, Canada eBay Dermatology Centre,Toronto, ON, Canada fMontreal, QUE, Canada
INTRODUCTION: The skin of subjects with dry, flaking, and/or scaling conditions is characterized by decreased water and skin lipids content among other findings. It is well understood that daily use of gentle cleansers and moisturizers may help to restore and maintain an optimal skin barrier function. A cohort study of patients with dry skin was developed to evaluate efficacy of daily use of a ceramide containing cleanser and cream that also has salicylic acid. METHODS: Thirty-five adults with mild-to-moderate dry skin conditions were recruited from four dermatology centers in Canada. With consent, the subjects received twice daily treatment with the ceramides containing cleanser and cream that also has salicylic acid. Physician and subject assessed skin condition comparing baseline versus (day 0) versus day 28 (end) was scored using the Dry skin classification scale and the Global Aesthetic Improvement Scale (GAIS). Subjects also rated satisfaction, product features, quality of life aspects, safety, and tolerability. RESULTS: Thirty-four subjects completed the treatment and study period; one was lost to follow up. Daily use of the evaluated cleanser and moisturizer significantly improved skin condition when comparing day 0 versus day 28 (+/- 5 days (end)) results. Both the physicians and subjects using the dry skin classification scale and GAIS scored a significant improvement of the dry skin condition. After treatment subjects reported a significant improvement in the quality of their professional life, self-image, and social life. The products were shown to be safe, comfortable, and well tolerated. CONCLUSION: The results indicated the cleanser and moisturizer to offer an effective, easy and comfortable option for dry skin conditions. J Drugs Dermatol. 2019;18(1):80-85.
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The skin barrier is formed by protein-rich cells of the stratum corneum with intervening intercellular lipids. In the viable epidermis, the nucleated cells possess a tight gap and adherent junctions with desmosomes and cytoskeletal elements that contribute to the skin barrier.1,2 Soap-free cleansers, suitable for dry skin conditions, are designed to leave the skin barrier intact while providing effective cleansing. Moisturizers attempt to mimic the intercellular lipids that are synthesized in the keratinocytes during epidermal differentiation and then are extruded into the extracellular domains. These lipids are composed of ceramides, free fatty acids, and cholesterol, which covalently bind to the cornified envelope proteins.1,2 Continued basic science and clinical research has led to more recent recognition and general acceptance that the stratum corneum completes many vital “barrier” tasks. The skin of subjects with dry, flaking, and/or scaling conditions is characterized by decreased water and skin lipids content, leading to skin irritation, scales, micro-fissures and cracks, which form portals for pathogens.2-5 A cohort study was designed to evaluate a ceramides contain- ing cleanser and cream with salicylic acid (SA) in adult subjects with dry, flaking, and/or scaling skin conditions seeking treatment or maintenance using a gentle cleanser and moisturizer.