A Consensus About the Importance of Ceramide Containing Skincare for Normal and Sensitive Skin Conditions in Neonates and Infants

August 2020 | Volume 19 | Issue 8 | Original Article | 769 | Copyright © August 2020

Published online July 31, 2020

Lawrence A. Schachner MD FAAD FAAPa, Anneke Andriessen PhDb, Latanya Benjamin MD FAAP FAADc, Alanna F. Bree MDd, Peter A. Lechman MD MBA FAAPe, Ayleen A. Pinera-Llano MDf, Leon Kircik MD FAADg

aDivision of Pediatric Dermatology, Department of Dermatology & Cutaneous Surgery, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, FL bRadboud UMC, Nijmegen and Andriessen Consultants, Malden, The Netherlands cFlorida Atlantic University, Boca Raton, FL dBaylor College of Medicine and Texas Children’s Hospital, Houston, TX; A Children’s House for Pediatric Dermatology, Houston, TX eNorthwestern Medical Group, Chicago, IL; Northwestern University Feinberg School of Medicine, Chicago, IL fKing Bay Pediatrics, Maimi, FL, General Pediatrics, Nicklaus Children’s Hospital, Miami, FL gIchan School of Medicine at Mount Sinai, New York, NY; Indiana University Medical Center, Indianapolis, IN; Physicians Skin Care, PLLC, Louisville, KY; DermResearch, PLLC, Louisville, KY

diseases associated with the depletion of stratum corneum lipids and stratum corneum lipid substitution therapy. Skin Pharmacol. Physiol. 2015;28:42- 55.
23. Strugar TL, Kuo A, Seite S, Lin M, Lio P. Connecting the Dots: From Skin Barrier Dysfunction to Allergic Sensitization, and the Role of Moisturizers in Repairing the Skin Barrier. J Drugs Dermatol. 2019;18(6):581.
24. Simpson E, Chalmers JR, Hanfin JM, et al. Emollient enhancement of the skin barrier from birth offers effective atopic dermatitis prevention. J Allergy Clin Immunol. 2014;134:818-23. doi: 10.1016/j.jaci.2014.08.005.
25. Horimukai K et al. Application of moisturizer to neonates prevents development of atopic dermatitis. J Allergy Clin Immunol. 2014;134:824-30. doi: 10.1016/j.jaci.2014.07.060.
26. Browning, J. Dermatology Edited by Jean L. Bolognia Julie V. Schaffer Lorenzo Cerroni Fourth edition China: Elsevier, 2018, ISBN 978–0–7020–6275–9. Pediatric Dermatology. 35(2):289-289.
27. Eichenfield LF, Ellis CN, Mancini AJ, et al. Atopic dermatitis: epidemiology and pathogenesis update. Sem Cut Med Surg. 2012;31(3):S3–S5. doi:10.1016/j.sder.2012.07.002.
28. Garg N, Silverberg JI. Epidemiology of childhood atopic dermatitis. Clin Dermatol. 2015;33(3):281-288. doi:10.1016/j.clindermatol.2014.12.004
29. Lyons JJ, Milner JD, Stone KD. Atopic dermatitis in children: clinical features, pathophysiology, and treatment. Immunol Allergy Clin North Am. 2015;35(1):161-183. doi:10.1016/j.iac.2014.09.008.
30. Flohr C, Mann J. New insights into the epidemiology of childhood atopic dermatitis. Allergy. 2014;69(1):3-16. doi: 10.1111/all.12270.
31. Ito S, Ishikawa J, Naoe A, Yoshida H, et al. Ceramide synthase 4 is highly expressed in involved skin of patients with atopic dermatitis. J Eur Acad Dermatol Venereol. 2017;31: 135-141.
32. Ishikawa J, Narita H, Kondo N, et al. Changes in the ceramide profile of atopic dermatitis patients. J Invest Dermatol. 2010;130: 2511-2514.
33. Kim D, Lee NR, Park S-Y, et al. As in atopic dermatitis, nonlesional skin in allergic contact dermatitis displays abnormalities in barrier function and ceramide content. J Invest Dermatol. 2017;137(3):748-750. doi:10.1016/j. jid.2016.10.034
34. Rerknimitr P, Otsuka A, Nakashima C, Kabashima K. Skin barrier function and atopic dermatitis. Curr Dermatol Rep. 2018;7(4):209-220. doi:10.1007/ s13671-018-0232-y
35. Kapur S, Watson W, Carr S. Atopic dermatitis. J Allergy Clin Immunol. 2018;14:52-52. doi:10.1186/s13223-018-0281-6
36. Lowe AJ, Su JC, Allen KJ et al. A randomized trial of a barrier lipid replacement strategy for the prevention of atopic dermatitis and allergic sensitization: the PEBBLES pilot study. Br J Dermatol. 2017;178(1)e19-e21. https:// doi.org/10.1111/bjd.15747.
37. Del Rosso JQ, Harper J, Kircik L, et al. Consensus recommendations on adjunctive topical management of atopic dermatitis. J Drugs Dermatol. 2018;17: 1070-1076.
38. Kircik LH, Del Rosso JQ. Nonsteroidal treatment of atopic dermatitis in pediatric patients with a ceramide-dominant topical emulsion formulated with an optimized ratio of physiological lipids. J Clin Aesthet Dermatol. 2011;4(12):25-31.
39. van Zuuren EJ, Fedorowicz Z, Christensen R, Lavrijsen A, Arents BWM. 2017. Emollients and moisturisers for eczema. Cochrane Database Syst. Rev. 2: CD012119.
40. Visscher MO, Barai N, LaRuffa AA, et al. Epidermal barrier treatments based on vernix caseosa. Skin Pharmacol. 2011;Physiol. 24: 322–329.
41. Lynde CW, Andriessen A. A cohort study on a ceramide-containing cleanser and moisturizer used for atopic dermatitis. Cutis. 2014;93(4)207-2013.
42. Elias PM, Sugarman J. Does moisturizing the skin equate with barrier repair therapy? Ann Allergy, Asthma Immunol. 2018;121(6):653-656.e2. 10.1016/j. anai.2018.07.008.
43. Reda AM, Elgendi A, Ebraheem AI, et al. A practical algorithm for topical treatment of atopic dermatitis in the Middle East emphasizing the importance of sensitive skin areas. J Dermatol Treat. 2019;30(4):366-373. doi: 10.1080/09546634.2018.1524823. Epub 2018 Nov 21
44. Tay YK, Chan YC, Chandran NS, et al. Guidelines for the Management of Atopic Dermatitis in Singapore. Ann Acad Med Singapore. 2016;45(10):439- 450.
45. Galli E, Neri I, Ricci G, et al. Consensus Conference on Clinical Management of pediatric Atopic Dermatitis. Ital J Pediatr. 2016;42:26.
46. Eichenfield LF, Tom WL, Berger TG, et al. Guidelines of care for the management of atopic dermatitis: Section 2: Management and treatment of atopic dermatitis with topical therapies. J Am Ac Dermatol. 2014;71(1):116-132.
47. Lynde CW, Bergman J, Fiorillo L, Guenther L, Keddy-Grant J, Landells I et al. Clinical insights about topical treatment of mild-to-moderate pediatric and adult atopic dermatitis. J Cutan Med Surg. 2019;23(3_suppl):3S-13S. doi: 10.1177/1203475419843108. Epub 2019 Apr 9.
48. Saeki H, Nakahara T, Tanaka A, et al. Clinical practice guidelines for the management of atopic dermatitis. J Dermatology. 2016;43(10):1117-1145.
49. Ring J, Alomar A, Bieber T, et al. Guidelines for treatment of atopic eczema (atopic dermatitis) Part I. J Eur Acad Dermatol Venereol. 2012;26(8):1045- 1060.
50. Guenther LC, Andriessen A, Lynde CW, et al. Development of a clinical pathway for atopic dermatitis patients: a case-based approach. J Drugs Dermatol. 2AD 016;15(12):1485-1494.
51. Wollenberg A, Oranje A, Deleuran M, et al. ETFAD/EADV Eczema task force 2015 position paper on diagnosis and treatment of atopic dermatitis in adult and paediatric patients. J Eur Acad Dermatol Venereol. 2016;30(5):729-747.
52. Wollenberg A, Barbarot S, Bieber T, et al. part I. Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: J Eur Acad Dermatol Venereol. 2018;32(5):657-682.
53. Wollenberg A, Barbarot S, Bieber T, et al. Part II. Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children. J Eur Acad Dermatol Venereol. 2018;32(6):850-878.
54. Ring J, Alomar A, Bieber T, et al. Guidelines for treatment of atopic eczema (atopic dermatitis) Part II. J Eur Acad Dermatol Venereol. 2012;26(9):1176- 1193.
55. Sidbury R, Tom WL, Bergman JN, et al. Guidelines of care for the management of atopic dermatitis part 4: Prevention of disease flares and use of adjunctive therapies and approaches. J Am Acad Dermatol. 2014;71(6):1218- 1233.
56. Irvine AD, Mina-Osorio P. Disease trajectories in childhood atopic dermatitis: an update and practitioner's guide. Br J Dermatol. 2019 Nov;181(5):895-906. doi: 10.1111/bjd.17766. Epub 2019 May 15.
57. Lynde CW, Tan J, Skotnicki S, Andriessen A. Clinical insights about the role of skin pH in inflammatory dermatological conditions. J Drugs Dermatol. 2019;18(12)S-1:1-16.
58. Danby SG, et al. Skin Pharmacol Physiol. 2016; 29:135-147
59. Dominguez-Bello MG, Costello EK, Contreras M, et al. Delivery mode shapes the acquisition and structure of the initial microbiota across multiple body habitats in newborns. Proc Natl Acad Sci USA. 2010;107:11971-11975.
60. Baldwin H, Bhatia N, Friedman A, et al. The role of cutaneous microbiota harmony in maintaining a functional skin barrier. J Drugs Dermatol. 2017;16:12- 18. 10.25251/skin.1.supp.138.
61. Paller AS, Spergel JM, Mina Osorio P, Irvine AD. The atopic march and atopic multimorbidity: Many trajectories, many pathways. J Allergy Clin Immunol. 2019;143(1):46-55. doi: 10.1016/j.jaci.2018.11.006. Epub 2018 Nov 17.
62. Filanovsky MG, Pootongkam S, Tamburro JE, Smith MC, Ganocy SJ, Nedorost ST. The financial and emotional impact of atopic dermatitis on children and their families. J Pediatr. 2016;169:284-290.
63. Ronnstad ATM, Halling-Overgaard AS, Hamann CR, Skov L, Egeberg A, Thyssen JP. Association of atopic dermatitis with depression, anxiety, and suicidal ideation in children and adults: A systematic review and meta-analysis. J Am Acad Dermatol. 2018;79(3):448-56.e430.
64. Xu S et al. Cost-effectiveness of prophylactic moisturization for atopic dermatitis. JAMA Pediatr.


Anneke Andriessen PhD anneke.a@tiscali.nl