▶ Previous Artlcle : #4-1. Understanding Moisturizers
The most ideal moisturizer would effectively hydrate the stratum corneum and minimize transepidermal water loss. It would also smooth and moisturize the skin surface and give a sophisticated and graceful appearance. Moreover, it should be hypoallergenic, non comedogenic and stable at room temperature. Affordability is also an important factor of a good moisturizer.
The composition of a moisturizer often mimics the physiologic lipid composition of the skin to help restore the lipid barrier. Products using this concept contain ceramide:cholesterol:saturated free fatty acid:unsaturated free fatty acid in the ratio of 3:1:1:1. They act as a occlusive moisturizer and at the same time as raw materials for intercellular lipids that accelerate restoration of intercellular lipids.
Various roles of a moisturizer
Moisturizers contain substances with anti-inflammatory actions and alleviates the skin inflammation arising from weakened skin barrier. They also contain preservatives, perfume and water, etc. However, preservatives or perfumes are not favored ingredients in cosmetic products due to problems of skin allergies. Side effects are therefore minimal from a moisturizer. However, side effects include tingling or burning sensation in patients with atopic dermatitis or after application over a wound.
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Preservatives such as benzoic acid or sorbic acid are more likely to cause side effects and humectant, such as lactic acid, urea, pyrrolidone carboxylic acid, and sodiuim chloride, etc., can also cause the above side effects. Less common side effects include acne, folliculitis or photosensitivity. Comparison of moisturizers released by various companies show unique characteristics, advantages and disadvantages of each product.
Galderma’s Cetaphil AD is released in the cream and lotion types. It is a physiologic lipid mixture containing N-(2-hydroxyhexadecanoyl)-sphingonin, ceramide precursor that increases ceramide 1 and 3. The product insert does not mention lipid emulsion structure. This product includes NMF but there is no mention of acidity. It does not contain ingredients such as colorings, perfumes or antiseptics that may cause contact dermatitis.
Stiefel’s Physiogel AI Repair is released in the cream and lotion types. It is a physiologic lipid mixture containing ceramide 3. The lipid emulsion structure is dermal membrane structure (DMS) which is similar to the skin structure. It contains NMF and is mildly acidic. It also contains palmitoylethanolamide(PEA) with anti-inflammatory action. It does not contain colorings, perfumes or antiseptics that may cause contact dermatitis.
Neopharm’s Zeroid is a physiologic lipid mixture containing PC-9S pseudoceramide, a synthetic ceramide similar to ceramide 1. The lipid emulsion structure is multi-lamella emulsion (MLE). It contains NMF with pH level of 5.5. It also contains defensamide with antibacterial action. and does not contain coloring, perfumes or antiseptics that may cause contact dermatitis.
Pacific pharma’s Atobarrier is a physiologic lipid mixture containing pseudoceramide. The lipid emulsion structure is Derma ON. It contains NMF and pH level is 5-6. It also contains cactus extracts with anti-inflammatory action and panduratin with antibacterial effect. It does not contain colorings, perfumes or antiseptics that may cause contact dermatitis.
Dong Wha Pharm’s Intrinsic is a physiologic lipid mixture. The lipid emulsion consists of skin lipid matrix that has identical structure as the human skin lipid components. The skin lipids components consist of caprylic/capric triglyceride, triglycrides extracted from palm oil, squalene extracted from olives, ceramide NP, a ceramide extracted from yeast, cholesterol extracted from shea-butter, and phopholipid extracted from soybeans, etc. Ceramide intrinsic factor promotes ceramide synthesis and tight junction intrinsic factor accelerates tight junction recovery. It does not contain colorings, perfumes or antiseptics that may cause contact dermatitis.
Barummedi’s Cellbrick is available in lotion and cream types of nano multilamellar formulations. It is mildly acidic and contains TES, a patented component. It contains lipids of caprylic/capric triglyceride, cholesterol, and ceramide 3. It does not contain colorings, perfumes, alcohol, antiseptic that may cause contact dermatitis.
The following conditions require cautious use of moisturizers; xeroderma with abnormal keratinization, ichthyosis, diabetes or hypothyroidism, atopic dermatitis, contact dermatitis of occupational origin, acne, rosacea, retinoid dermatitis and psoriasis. Moisturizers are also helpful for weakened skin of the elderly and children as well as foot management in diabetic patients.
Proper use of moisturizers can free patients with severely dry skin from worries about steroids. Regular use of a moisturizer can supplement a therapy and also prevent further progression of the disease.
-To be continued-
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