Clinical Improvements in Very Dry Skin from a Natural Ingredient-Based Moisturizing Cream Compared With a Leading Colloidal Oatmeal Control

July 2018 | Volume 17 | Issue 7 | Original Article | 758 | Copyright © July 2018


Hemali B. Gunt PhD,a Stanley B. Levy MD,b Celeste A. Lutrario BSa

aBurt’s Bees Inc., Durham, NC bDuke University School of Medicine, Durham, NC

Abstract
The objective of this 6-week clinical study was to demonstrate the effectiveness of a natural ingredient-based moisturizing cream versus a colloidal oatmeal moisturizing cream in improving the hydration, barrier function, appearance, and feel of dry leg skin. Thirty-two subjects completed the study. After a 5-day washout, subjects used the natural ingredient-based moisturizing cream and oatmeal-containing cream on randomly-assigned legs twice a day for a period of three weeks. For the following two weeks subjects did not use any moisturizer on their legs. Skin moisture measurements showed a statistically significant increase in hydration for both products at all time points during the treatment phase of the study. Both products reduced transepidermal water loss measurements during the treatment phase of the study, showing their abilities to improve stratum corneum barrier function. Clinical evaluations showed that both products significantly decreased visual dryness and tactile roughness during the treatment phase. Improvements in the assessed clinical parameters persisted even after treatment cessation. In conclusion, the natural ingredient-based moisturizing cream was highly effective in providing moisturization and improving the skin barrier of subjects with very dry leg skin. It also produced significant improvements in visual dryness and tactile roughness that persisted during regression. Overall, these results show that the natural ingredient-based moisturizing cream delivers comparable benefits to that of a colloidal oatmeal-containing benchmark product and is an option for health care providers and consumers who seek relief from dry skin and prefer a product with all-natural ingredients. J Drugs Dermatol. 2018;17(7):758-764.

INTRODUCTION

Dry skin is a pervasive and continuing dermatologic concern. It occurs as a sequela to various chronic disease conditions, such as atopic dermatitis and psoriasis.1–3 However, dry skin is also frequently observed in otherwise normal skin and can result from a variety of factors in the general population including weather, chemicals, age, and photodamage.4–6 Depending on its location and severity, dry skin can be unsightly, uncomfortable, and a source of embarrassment.1,3,7 Prall et al. reported that about 60% of female consumers have recurrent or continuous skin dryness, and that an even higher percentage are motivated to initiate some type of preventative therapy for dry skin.8Moisturizers play a key role in dry skin management. They are part of evidence-based care for certain disease conditions and are among the non-prescription products most frequently recommended by dermatologists.9,10 They are also popular among consumers.11 Yet despite their popularity, the term ‘moisturizer’ is vague. The Oxford Online Dictionary definition is simply, “A cosmetic preparation used to prevent dryness in the skin.”12 This is certainly true; however, moisturizer technology is much more complex. Moisturizers available in the marketplace generally fall into one of four broad classes: emollient-dominant, humectant-based, occlusive, and therapeutic.13 These classes differ in terms of their ingredients, mechanism(s) of action, and the level of dry skin relief they provide.Health care provider and consumer interest is growing in cosmetic products that are based on ‘natural’ rather than chemically-derived ingredients, although some are skeptical of natural products’ abilities to deliver benefits comparable to their non-natural counterparts.14–17 A number of moisturizers that contain natural ingredients are now in the market, although not all are based solely on natural ingredients.Colloidal oatmeal enjoys a long history of use as a skin benefit agent and is recognized as a skin protectant active ingredient,18 so it is not surprising that it is found in commercial moisturizer formulations. Such formulations are reported to improve moderate to severe dry skin, relieve dry skin-related itch, and benefit conditions such as atopic dermatitis.2,19–22