Moisturizer use decreases trans-epidermal water loss (TEWL) through occlusive agents, which can be combined with humec- tants to attract water to the skin.26 Gentle cleansers and moisturizers are recommended for daily use to restore and preserve skin barrier integrity in dry skin conditions.27 This type of skin care was shown to improve the clinical signs and symptoms of AD, including pruritus, erythe- ma, fissuring, and lichenification.27
Products composed of ceramides, cholesterol and fatty acids aim to mimic natural lipids,7 and may reduce the need for other medications.27-29 These moisturizers help to close fissures by filling spaces, sealing moisture into the skin through the pro- duction of an occlusive barrier, thereby softening the skin (Table 3).3,20
A cream with skin-identical ceramides has been shown to ameliorate dry skin conditions, which in turn improves skin barrier function, thus reducing skin irritation.28,29 A cohort study by Vender et al28 demonstrated that daily use of a ceramides- containing cleanser and moisturizer regimen over a four-week period significantly improved dry skin conditions and subject- reported quality of life.
Specifically designed diabetic skin care might contain anti-aging ingredients, urea, and essential ceramides, and MVE (layered delivery of ingredients) technology may be of benefit to treat some of the common skin conditions seen in DM or as adjunct skin maintenance regimen. A moisturizer acts as a humectant, hydrating the SC through a hygroscopic effect, thereby increas- ing its elasticity.27,28 Moreover, aphysiological pH moisturizer has keratolytic and anti-pruritic action, providing soothing and nourishing relief for dry/itchy skin.27,28 An unpublished clinical study using products with these components demonstrated that improvement in skin hydration following product application lasted up to 48 hours.
Diabetic skin changes may benefit from the use of the products included in the diabetic skin care line, enabling easy and effective skin care.
DISCUSSION
Metabolic changes associated with DM exert a major impact on the skin, leading to skin lesions, infections, angiopathy and neu- ropathy.2,5,18 The prevalence of DM-associated skin infections is greater when compared to the normal population.2
Although there is evidence from in-vitro and in-vivo studies sup- porting that hyperglycemia and impaired insulin signaling might be directly involved in the development of chronic complications of diabetes, the mechanisms behind DM-related skin changes are not yet elucidated and clinical data are lacking.1,2 There are limited clinical data regarding early-stage skin disorders in DM patients, which consequently impede efforts to include skin care as part of prevention and treatment of diabetic skin changes.2,3
As patients encounter a broad spectrum of disorders in DM, skin conditions are usually neglected and frequently underdiag- nosed.1,2,11 Moreover, adherence to treatment is a considerable challenge in patients with diabetes1-5,18-20 For this reason, it is important to educate patients on DM skin care, as well as physicians, ancillary health care professionals such as diabetes educators and nurses, who may have more extensive contact with and influence on patients with DM.18-20 For educational purposes, the authors of the current review propose the term “diabetic skin syndrome†a broad term denoting anatomic and physiologic changes in the skin of those with DM. The use of this term may support education on the various issues related to this condition, with a structured approach to its prevention, treatment and maintenance as part of the multidisciplinary total care package of these patients.
Updating knowledge on skin care is required, since classical physician training used to include the message that “one can’t add moisture to the skin.†As such, many physicians practicing today may still hold this view. Evidence supporting the use of gentle cleansers and moisturizers3,27-30 should be included in
Although there is evidence from in-vitro and in-vivo studies sup- porting that hyperglycemia and impaired insulin signaling might be directly involved in the development of chronic complications of diabetes, the mechanisms behind DM-related skin changes are not yet elucidated and clinical data are lacking.1,2 There are limited clinical data regarding early-stage skin disorders in DM patients, which consequently impede efforts to include skin care as part of prevention and treatment of diabetic skin changes.2,3
As patients encounter a broad spectrum of disorders in DM, skin conditions are usually neglected and frequently underdiag- nosed.1,2,11 Moreover, adherence to treatment is a considerable challenge in patients with diabetes1-5,18-20 For this reason, it is important to educate patients on DM skin care, as well as physicians, ancillary health care professionals such as diabetes educators and nurses, who may have more extensive contact with and influence on patients with DM.18-20 For educational purposes, the authors of the current review propose the term “diabetic skin syndrome†a broad term denoting anatomic and physiologic changes in the skin of those with DM. The use of this term may support education on the various issues related to this condition, with a structured approach to its prevention, treatment and maintenance as part of the multidisciplinary total care package of these patients.
Updating knowledge on skin care is required, since classical physician training used to include the message that “one can’t add moisture to the skin.†As such, many physicians practicing today may still hold this view. Evidence supporting the use of gentle cleansers and moisturizers3,27-30 should be included in
