Efficacy of a Moisturizing Foam in Skin Barrier Regeneration and Itch Relief in Subjects Prone to Atopic Dermatitis
November 2016 | Volume 15 | Issue 11 | Supplement Individual Articles | 77 | Copyright © November 2016
Peter A. Lio MD
Northwestern University Feinberg School of Medicine and Medical Associates of Chicago, Chicago, IL
INTRODUCTION: Atopic dermatitis (AD) is characterized by impaired epidermal barrier with increased transepidermal water loss (TEWL). Scratching further compromises skin integrity, contributing to a cycle of inflammation. The objective of the present study was to investigate a topical anti-itch foam in improving skin barrier and itch. MATERIAL AND METHODS: A single center open study was performed on 26 adults previously diagnosed with AD but without active lesions. One leg was treated with a single application of an anti-itch foam. Dryness, scaling, roughness, cracking, and signs of scratching were assessed before, 6, and 24 hours after application. Skin hydration was measured at 24 hours. The same product was applied twice daily for 7.5 days to the other leg, and skin hydration and TEWL were measured at baseline and on days 2, 8, and 10. Pruritus was assessed by volunteers and by a dermatologist. RESULTS: A significant increase in skin moisture (P less than 0.001) was measured 6 hours after a single application. Scores of dryness, scaling, roughness (P less than 0.001) and cracking (P=0.002) were significantly improved up to 24 hours after a single application. After a 7.5-day repeated application period, the anti-itch foam significantly reduced TEWL (P less than 0.001) compared to baseline. Skin hydration significantly improved (P less than 0.001) in the same time period. 48 hours after the last application, these improvements remained significant (P less than 0.001). CONCLUSIONS: The anti-itch foam improved the skin barrier. It provided immediate relief of clinical signs of AD including pruritus. Moreover, it delivered a long-lasting moisturizing effect, comforting the skin, and improving overall skin condition. J Drugs Dermatol. 2016;15(suppl 11):s77-80.
Skin prone to atopic dermatitis (AD) is commonly characterized by an impaired epidermal barrier that results in increased transepidermal water loss (TEWL) and leaves the skin rough, dry, and itchy.1 Subsequent scratching behavior further compromises the integrity of the skin, contributing to a cycle of inflammation.2 This “itch-scratch cycle” fuels the disease and likely leads to increased penetration of irritants, allergens, and infectious agents that cause persistent inflammation in the skin and may actually lead to the development of other immunologic alterations.2,3 Although the barrier defect has been considered a secondary phenomenon in some models,4 the most modern conception of the disease suggests that skin barrier function is a fundamental component of AD that must be addressed.5It is well established that appropriate moisturizers can help restore barrier function and alleviate symptoms of AD.6,7 Further, topical anti-itch preparations provide direct relief of pruritus but also likely work to abate the itch-scratch cycle.8 The anti-itch foam preparation used in the study was formulated with glycerol, a powerful humectant which also has anti-irritant, barrier-restoring, and even antimicrobial effects, all of which make it an excellent choice in patients with AD.9 Additionally, the foam contains a proprietary synthetic avenanthramide based on the active ingredient in colloidal oatmeal that possesses anti-irritant, anti-itch and antihistaminic properties.10,11 Remarkably, this component has been shown to actually reduce redness and itch in irritated skin as a monotherapy.12The objective of the present study was to investigate a topical anti-itch foam in skin barrier regeneration and itch alleviation.
MATERIALS AND METHODS
A single center open clinical study was performed. A total of 42 subjects were screened, and 26 subjects were enrolled (average age, 30.4; range, 21.6-44.7 years) with dry and pruritic skin who had previously been diagnosed with AD, but were without active lesions at enrollment (Table 1). One leg was treated with a single application of an anti-itch foam. Clinical scores for dryness, scaling, roughness, cracking, and clinical signs of scratching were assessed by a dermatologist before, 6, and 24 hours after the application. In addition, skin hydration was measured at 24 hours. The same product was applied twice daily for 7.5 days to the other leg. Skin hydration and TEWL were measured at baseline and on days 2, 8, and 10 by means of corneometry and tewametry. Volunteers assessed pruritus intensity during the study using