Clinical Experience Using a Monofilament Fiber Cleansing and Debriding Technology for Various Skin Conditions

November 2022 | Volume 21 | Issue 11 | 1173 | Copyright © November 2022


Published online October 31, 2022

doi:10.36849/JDD.6261

Anneke Elizabeth Andriessen PhDa, Cornelia Wiegand PhDb, Thomas Eberlein MDc, Cornelia Erfurt-Berge MDd, Claas Roes PhDe

aNijmegen and Andriessen Consultants, Malden, The Netherlands
bDepartment of Dermatology, University Hospital Jena, Jena, Germany
cDepartment of Surgery, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
dDepartment of Dermatology, University Hospital Erlangen, Erlangen, Germany eLohmann & Rauscher GmbH & Co. KG, Rengsdorf, Germany

Abstract
Background: Gentle skin cleansing and exfoliation and the use of moisturizers as an adjunct to medical treatment should be part of the prevention, treatment, and maintenance of cutaneous conditions such as acne vulgaris (acne) psoriasis, and xerosis. A monofilament fiber debriding technology (MFDT) is used for effective, safe, and rapid skin cleansing and exfoliation and debris, slough, and biofilm removal. The current review addresses the clinical experience using MFDT for various cutaneous conditions that require cleansing or exfoliation or both and how to combine it with medical treatment.
Methods: A literature review explored clinical insights into the role of skin cleansing and exfoliation for patients with various dermatological conditions. The searches yielded 29 publications, 7 guidelines/algorithms, 13 reviews, 8 clinical studies, and one in vitro study.
Results: Mechanical cleansing using a device can be helpful; however, avoid injury of the skin as it may result in thickening of the epidermis leading to hyperkeratosis and disruption of the skin barrier. Clinical experience with MFDT for acne, psoriasis, atopic dermatitis, and xerosis is discussed. Additionally, MFDT was used to exfoliate hyperkeratosis, actinic keratosis, and traumatic skin tattoos.
Conclusions: Mechanical cleansing using MFDT was shown to be safe and beneficial for skin cleansing and exfoliation of various cutaneous conditions; however, only anecdotal evidence or small studies are available to support its use for these conditions.

J Drugs Dermatol. 2022;21(11):1173-1180. doi:10.36849/JDD.6261

INTRODUCTION

Skin cleansing, exfoliation, and moisturizers as adjunct to medical treatment are an integral part of the prevention, treatment, and maintenance of many skin conditions such as acne vulgaris (acne), psoriasis, and xerosis.1-8 The skin of subjects with dry, flaky, or scaling conditions is characterized by decreased water and skin lipids content, among other findings.6 It is well understood that the daily use of gentle cleansers and moisturizers may help to restore and maintain an optimal skin barrier function.7

Strategies for acne care include prescription or over-the-counter agents and non-comedogenic cleansers and moisturizers.2-4

Exfoliation may reduce hyperkeratosis, scabs, and scales in patients with chronic venous hypertension, lymphedema, xerosis, and diabetes-related skin changes.6-9 Removal of nonvital tissue is an accepted method to eradicate biofilms and to stimulate healing.9,10 There are various methods available for skin cleansing, including mild cleansers with a physiological pH (4-7), scrubbing, or skin massage using brushes or derma rollers.11-13 In choosing the right cleanser and cleansing device, it is important to consider aspects such as pathophysiology, skin condition, cleansing efficacy, patient tolerance, and interaction between skin condition, skin type, and the cleanser.14 Further factors to consider are adherence to the treatment, the optimal time and method of cleansing, and the patient's cosmetic perception.6,14,15

Monofilament fiber debriding technology (MFDT) demonstrated benefits for skin cleansing, exfoliation, mechanical debridement of wounds, and the removal of biofilm.1,4,8-10,16 The current review addresses the clinical experience using MFDT for various skin conditions that require cleansing or exfoliation or both, and how to combine it with standard treatment and maintenance.