DISCUSSION
Both ESM and IRML significantly improved skin hydration and barrier function by corneometer and assessment of TEWL after 4 weeks of twice-daily application. ESM had a statistically signifi-cantly better effect in hydrating the skin when compared to IRML at week 4. Both products increased skin ceramide content, with no significant differences between them. Participants reported favor-able perceptions of both products, but there was a numerical trend in favor of ESM. As shown via clinical photography, ESM was effective and suitable for a range of skin types, which is important in the representation, diagnosis, and treatment of those with eczema and eczema-prone skin across diverse populations.
Supplementation of ceramides through topical products is an important way to support a healthy skin barrier with OTC treatments, and both products tested in this study increased skin ceramide levels. However, moisturizers should not rely on ceramide supplementation alone.9 ESM has additional beneficial ingredients compared to IRML, such as colloidal oatmeal, a well-established soothing ingredient, and the filaggrin technology including the breakdown products, arginine, and sodium PCA. In eczema, filaggrin abnormalities encourage invasion of foreign substances including anti-gens and microbes, which in turn trigger allergic reactions.4,10 Thus, the inclusion of filaggrin technology helps to support skin barrier
