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Gentle Cleansing and Moisturizing for Patients with Atopic Dermatitis and Sensitive Skin

Abstract

Atopic dermatitis is a common condition characterized by pruritus, inflammation, and dryness of the skin. Inflammation disrupts the barrier function of the stratum corneum, predisposing the skin to be dry, and increases susceptibility to irritants and secondary bacterial infection. Sensitive skin is common, reported by 40–50% of women and 30% of men in the US, Europe, and Japan. Basic requirements in managing eczema and sensitive skin include effective cleansers that do not compromise skin barrier integrity, alleviation of skin dryness, and restoration of skin barrier function through the use of therapeutic moisturizers. The selection of a skin cleanser is therefore an important part of managing these conditions. Studies have reported clinical improvement with the use of soap-free cleansers in combination with topical treatments. While topical corticosteroids and immunosuppressive agents are mainstays of treatment for atopic dermatitis, therapeutic moisturizers are important adjuncts. Moisturizers improve skin hydration, reduce susceptibility to irritation, restore the integrity of the stratum corneum, and enhance the efficacy of topical corticosteroids.

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References

  1. Guidelines for the management of atopic eczema. Primary Care Dermatology Society 2000 [online]. Available from URL: http://www.pcds.org.uk/Information%20Resource/Guide_manatopic.asp [Accessed 2008 Jun 22]

  2. Williams HC, Burney PGJ, Pembroke AC. UK Atopic Dermatitis Diagnostic Criteria Working Party: independent hospital validation. Br J Dermatol 1994; 131: 406–16

    PubMed  Article  CAS  Google Scholar 

  3. Loden M. Role of topical emollients and moisturizers in the treatment of dry skin barrier disorders. Am J Clin Dermatol 2003; 4 (11): 771–88

    PubMed  Article  Google Scholar 

  4. Lin YT, Wang CT, Chiang BL. Role of bacterial pathogens in atopic dermatitis. Clin Rev Allergy Immunol 2007; 33 (3): 167–77

    PubMed  Article  CAS  Google Scholar 

  5. Lipozencic J, Wolf R. Atopic dermatitis: an update and review of the literature. Dermatol Clin 2007; 25 (4): 605–12

    PubMed  Article  CAS  Google Scholar 

  6. Steinhoff M, Steinhoff A, Homey B, et al. Role of vasculature in atopic dermatitis. J Allergy Clin Immunol 2006; 118 (1): 190–7

    PubMed  Article  CAS  Google Scholar 

  7. Tagami H, Kobayashi H, O’Goshi K, et al. Atopic xerosis: employment of noninvasive biophysical instrumentation for the functional analyses of the mildly abnormal stratum corneum and for the efficacy assessment of skin care products. J Cosmet Dermatol 2006; 5 (2): 140–9

    PubMed  Article  Google Scholar 

  8. Kligman AM, Sadiq I, Zhen Y, et al. Experimental studies on the nature of sensitive skin. Skin Res Technol 2006; 12 (4): 217–22

    PubMed  Article  CAS  Google Scholar 

  9. Willis CM, Shaw S, De Lacharriere O, et al. Sensitive skin: an epidemiological study. Br J Dermatol 2001; 145 (2): 258–63

    PubMed  Article  CAS  Google Scholar 

  10. White MI, Jenkinson DM, Lloyd DH. The effect of washing on the thickness of the stratum corneum in normal and atopic individuals. Br J Dermatol 1987; 116 (4): 525–30

    PubMed  Article  CAS  Google Scholar 

  11. Peterson JD, Chan LS. A comprehensive management guide for atopic dermatitis. Dermatol Nurs 2006; 18 (6): 531–42; quiz 43

    PubMed  Google Scholar 

  12. Mills OH, Berger RS, Baker MD. A controlled comparison of skin cleansers in photoaged skin. J Geriatr Dermatol 1993; 1: 173–9

    Google Scholar 

  13. Solodkin G, Chaudhari U, Subramanyan K, et al. Benefits of mild cleansing: synthetic surfactant based (syndet) bars for patients with atopic dermatitis. Cutis 2006; 77 (5): 317–24

    PubMed  Google Scholar 

  14. Data on file. Fort Worth (TX): Galderma Laboratories, 1984

  15. Uehara M, Takada K. Use of soap in the management of atopic dermatitis. Clin Exp Dermatol 1985; 10 (5): 419–25

    PubMed  Article  CAS  Google Scholar 

  16. Chamlin SL, Kao J, Frieden IJ, et al. Ceramide-dominant barrier repair lipids alleviate childhood atopic dermatitis: changes in barrier function provide a sensitive indicator of disease activity. J Am Acad Dermatol 2002 Aug; 47 (2): 198–208

    PubMed  Article  Google Scholar 

  17. Lucky AW, Leach AD, Laskarzewski P, et al. Use of an emollient as a steroidsparing agent in the treatment of mild to moderate atopic dermatitis in children. Pediatr Dermatol 1997; 14 (4): 321–4

    PubMed  Article  CAS  Google Scholar 

  18. Hanifin JM, Hebert AA, Mays SR, et al. Effects of a low-potency corticosteroid lotion plus a moisturizing regimen in the treatment of atopic dermatitis. Curr Ther Res 1998; 59: 227–33

    Article  CAS  Google Scholar 

  19. Buraczewska I, Berne B, Lindberg M, et al. Changes in skin barrier function following long-term treatment with moisturizers, a randomized controlled trial. Br J Dermatol 2007; 156 (3): 492–8

    PubMed  Article  CAS  Google Scholar 

  20. Loden M, Andersson AC, Lindberg M. Improvement in skin barrier function in patients with atopic dermatitis after treatment with a moisturizing cream (Canoderm). Br J Dermatol 1999; 140 (2): 264–7

    PubMed  Article  CAS  Google Scholar 

  21. Berson D. Recommendation of moisturizers and cleansers: a study of unmet needs among dermatology patients. Cutis 2005; 76 (6 Suppl.): 3–6

    PubMed  Google Scholar 

  22. Ghali FE. Improved clinical outcomes with moisturization in dermatologic disease. Cutis 2005; 76 (6 Suppl.): 13–8

    PubMed  Google Scholar 

  23. Chan YC, Tay YK, Sugito TL, et al. A study on the knowledge, attitudes and practices of Southeast Asian dermatologists in the management of atopic dermatitis. Ann Acad Med Singapore 2006; 35 (11): 794–803

    PubMed  Google Scholar 

  24. Hon KL, Leung TF, Wong Y, et al. A survey of bathing and showering practices in children with atopic eczema. Clin Exp Dermatol 2005; 30 (4): 351–4

    PubMed  Article  CAS  Google Scholar 

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Acknowledgments

The author has received lecture grants from Galderma and honoraria for participation in the SENSE Advisory Board that led to this publication.

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Correspondence to Wai Kwong Cheong.

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Cheong, W.K. Gentle Cleansing and Moisturizing for Patients with Atopic Dermatitis and Sensitive Skin. AM J Clin Dermatol 10, 13–17 (2009). https://doi.org/10.2165/0128071-200910001-00003

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Keywords

  • Atopic Dermatitis
  • Stratum Corneum
  • Topical Corticosteroid
  • Skin Barrier
  • Sensitive Skin