between clinical and dermoscopy evaluation both at baseline, day 7, and day 14 (r = 0.73, r = 0.76, r = 0.71, respectively).39
A randomized, investigator-blinded, split-leg study treated xerosis in 53 women using a ceramides-containing cleanser and moisturizer for 4 weeks. Skin hydration, visible signs of xerosis, subject sensory discomfort, ceramides, cholesterol, and free fatty acid levels in the SC were evaluated. The skincare regime improved skin water content through corneometry, a reduction in the subject's perceived sensory discomfort, and the dermatologist investigator-assessed resolution of the signs of dry skin. Improvement continued for 48 hours after moisturizer withdrawal.40
Another study in matured skin subjects showed that topical applications of a moisturizer containing SC lipids improved SC hydration and reduced skin surface pH and circulating levels of proinflammatory cytokines.41 A further investigator-blinded randomized clinical trial of 52 patients with moderate-to-severe xerosis treated group 1 (n = 39) with a mild cleanser and moisturizer twice daily for 2 weeks and group 2 (n = 13) with a gentle cleanser without moisturizer. Total Clinical Score (TCS; erythema, scale, and fissures), Visual Dryness Score (VDS), and subjective itch-related quality of life (ItchyQoL) were assessed at week 2. Group 1 showed more improvement in TCS and VDS compared with group 2. ItchyQoL (symptoms, functioning, and emotions) showed significantly greater improvements for group 1 compared with group 2.42
In an unpublished study by Filippi and colleagues, 30 men and women over 70 years of age with xerosis, applied a ceramides-containing cleanser and a ceramides-
