Organ of the
GD Society for Dermopharmacy
Dry skin low in Lipids
Vitally important – appropriate Skin Cleansing and Skin Care
Since dry skin is a mass phenomenon, the question poses for a large part of the population as to the optimal method for cleansing and care of dry skin. Appropriate skin cleansing and care measures are to prevent the formation of a straining problem with disease extent from a trivial appearing lack of humidity and lipids. Background information regarding dry skin were presented by the dermatologist professor Dr. med. Wolfgang Gehring, Karlsruhe and the pharmacist Dr. Nicole Chauvet, Altkirch, France in the course of a lunchtime seminar organized by the company Sebapharma GmbH & Co. KG in the course of the GD’s 8th Annual Meeting in Halle, Salle, on 31 March 2004.
Dry skin in general is defined by a dry and low-in-lipid skin condition which may be caused by a reduced activity of the sebaceous glands, a reduced water-binding-capacity and/or a disorder in the structure of the horny layer. Either the entire skin organ or only individual skin regions may be affected.
The appearance of dry skin is characterized by roughness, scaling, dullness and/or a lack of elasticity. Due to the fact that a feeling of tension, itching and an increased readiness to react on exogenous noxae may persist, dry skin is in most cases perceived and described by persons concerned as sensitive skin
Causes of dry skin
Dry skin may be constitutional or contracted. Persons suffering from atopical diathesis often have a defect in the horny layer barrier which is primarily caused by a lack of ceramides and may result in an increased transepidermal water loss.
Dry skin is predominantly contracted by too frequent bathing or having showers. Further, climatic factors as cold and low humidity as well as occupational strain by humid work or contact by irritating substances may evoke dry skin. Owing to the fact that the quality of the epidermis lipids, the sebum production as well as the synthesis of the natural humidifying factors decrease with progressing age, dry skin frequently appears with aged persons.
groups of persons
The following groups of persons are particularly affected by dry and sensitive skin:
Persons taking baths or showers frequently
Women after the menopause
Babies and infants
Persons particularly exposed to dry ambient air (for example flight attendants)
Patients suffering from atopical diathesis
Patients suffering from psoriasis
Patients taking regularly pharmaceuticals (for example cholesterol lowering drugs, diuretics or retinoids) which may induce dry skin.
Consequently, dry skin is encountered in large parts of the population. In particular, the effect of bathes and showers may be responsible for the increased incidence of dry skin low in lipids. To prevent this incidence or at least a progressing of already existing skin dehydration is, however, by no means merely a question of the individual mental condition.
In case of no or inappropriate counter measures dry skin condition may transform into an eczema, at atopical disposition into an atopical or otherwise in a cumulative-toxically eczema. The latter represents a transition for contact allergies, so that at corresponding exposition also allergenic contact eczema may finally develop. In order to avoid these consecutive problems as far as possible, appropriate cleansing and care for dry skin is essential.
Not every skin cleansing
product is suitable
As dry skin may so-to-speak be effected by the washing process, skin cleansing should be reduced to the actual necessity. The skin cleansing products applied should prevent from a dehydration of the skin or in the ideal case improve an already existing skin condition. Alkaline soaps, hard water, alcohol-containing face lotions as well as washing lotions and bath preparations on basis of skin-aggressive washing raw materials should by all means be avoided. In particular, sodium lauryl sulphate and other surfactants with similarly strong irritative effect should not be contained in cleansing products for dry skin.
Recommendable, however, are shower oils rich in lipids and syndets adjusted to the pH 5.5 on basis of skin tolerable surfactants. Refattening admixtures are considered controversially due to the fact that an increased amount of surfactants are required to achieve the same cleansing effect. Contrariwise, products containing refatters are often subjectively perceived by the consumers as pleasant on the skin and therefore favoured.
of care products
The selection of an appropriate preparation is likewise essential for the care of dry skin. Predominantly hydrophilic emulsions and micro-emulsions may, in particular when applying directly after washing, impair the barrier function and increase the trans-epidermal water loss due to their releasing of emulsifiers on the skin.
In contrast, the use of urea-containing o/w emulsions and lipophilic w/o emulsions is in general better suited for dry skin. They hydrate the skin effectively, enhance the barrier thus protecting from external noxae. For the optimal lipid substitution lipophilic, however only sparsely occluding substances are recommended. Typically ceramids, phospholipids and fatty acid esters are applied.
Only recently phytosterols, a group of lipophilic substances, are in use with dry skin. On the one hand they have a minor hydrating effect, are however able to significantly reduce irritative skin reddening after prior experimental damage. They strengthen the skin’s barrier function which can presumably be explained by their cholesterol-like structure.
A benefit for dry skin is also expected from various additives from the sector of cosmetic active agents. Thus high doses of vitamin E do not only exert an anti-oxidative effect but are also hydrating and smoothening on the skin surface. Also Dexpanthenol used for an enhancement of wound healing has a hydrating effect and lowers the trans-epidermal water loss. The latter could also be shown for Ectoine. (tmb/jk)
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