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Skin Barrier & Barrier Function:
The Role of DMS in Restoring Skin Barrier Function
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NORMAL SKIN
STRATUMCORNEUMSTRATUMLUCIDUM
STRATUMGRANULOSUM
STRATUMSPINOSUM
STRATUM BASALE
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Normal skin barrier is contributed by the stratum
Corneum which is composed of:
INTERCELLULAR LIPIDS
CERAMIDES
SEBACEOUS LIPIDS
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There are severalFACTORS which affectthe MOISTURECONTENT of the SKIN:
FACTORS
Secreted from the SEBACEOUSGLANDS Complex oily substance which formsan emulsion with sweat, providing afilm on the skin surface whichprevents TRANSEPIDERMAL WATERLOSS (TEWL) the evaporation ofmoisture from the skin
SEBUM
SEBUM
NMF
CEMENT SUBSTANCE
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There are severalFACTORS which affectthe MOISTURECONTENT of the SKIN:
FACTORS
Contained in the Stratum corneum This is a mixture of hydroscopic substances which arecapable of absorbing large quantities of water & retainingmoisture Main constituents are free amino acids (10%), sodiumpyrrolidone carboxylic acid (12%), urea (7%), lactate (12%)
Natural Moisturizing Factor (NMF)
SEBUM
NMF
CEMENT SUBSTANCE
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There are severalFACTORSwhich affect theMOISTURE CONTENT ofthe SKIN:
FACTORS
Consists of various lipids (e.g. ceramide) & proteins This may be found in between the corneocytes &
are important for preserving the moisture withinthe Stratum corneum
INTERCELLULAR CEMENT SUBSTANCE
SEBUM
NMF
CEMENT SUBSTANCE
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FEATURES
DRY SKIN or XEROSIS
presents in various degrees ofseverity & in different forms.
DRY SKIN
means dehydrated skin, or skinwhich has lost a certainamount of moisture within itscells.
The Stratum corneum of normal skin contains 15 -25% of moisture
in DRY SKIN, the levelfalls.
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The rate at which moisture is lost from the skin determines itsDRYNESS
Hydration of theskin is achieved bydiffusion from theBLOOD & LYMPH
VESSELS of theunderlying tissues &in a very minor way,from the sweatglands.
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DRY SKIN should be differentiated from the loss
of elasticity of the dermis which occurs withageing & excessive sun exposure
The WRINKLES which appear are due to thedeterioration of the collagen & elastic fibers of the
dermis & is to be differentiated from dryness
DRY SKIN VSWRINKLE
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The condition can present in varying degrees of severity from a mildcosmetic dryness to severe scaling & cracking as in ICHTHYOSIS
Almost everybody will suffer from dry skin atsome time.
The condition is generally evident on theextremities & on the face.
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conditions leading toDRY SKIN
Relative HUMIDITY is important in determining the
moisture content of the stratum corneum.
People will tend to have more dry skin during
COLD months when HUMIDITY is LOW.
Dryness usually occurs when the relative humidity
falls below 30%.
The use of SOAPS & DETERGENTS has a degreasing
action on the skin allowing increased water loss &
leading to dryness.
HUMIDITY
HUMIDITY
CLEANSING AGENTS
AGE
CONDITIONS
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conditions leading toDRY SKIN
This condition is generallyknown as SENILEASTEATOSIS & can be veryitchy.
epidermal cells become smaller
rate of cell division in the epidermis is reduced
individual cells in the stratum corneumbecome larger
rate of sebum production decreases
rate of perspiration decreases
In the elderly, there is anincreased tendency to flaky
dry skin, particularly on the
lower legs.
SENILE ASTEATOSIS may be
due to certain changes of
the skin due to the ageing
process.
HUMIDITY
CLEANSING AGENTS
AGE
CONDITIONS
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GeneticAcquired A- PhysiologicalB- Dermatological
C- SystemicD- Drugs
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Atopic Dermatisis Ichthyoses
Disorders of Eccrine glands (EctodermatalDysplasias)
Keratosis Pilaris
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EATURES
The disorders of CORNIFICATION is adiverse group characterized bylocalizedor generalized scaling orhyperkeratosis.
These have beencalled ICHTHYOSIS, aterm from the Greekword ichthys forfish.
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Physiological Causes Seasonal Winters
Hot Bath & Excessive Shower
Prolonged exposure to warmth Excessive use of Soaps and Detergents
Senile
Dehydration
Post Menopausal
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Dermatological Vit. A Deficiency
Asteatotic Eczema
Pityriasis Alba Leprosy
Psoriasis
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Systemic Diabetes Mellitus (Autonomic Loss)
Chronic Renal Failure (Dehydration,Decreased Function of Eccrine Sweat Glandand Decreased Sebum)
Systemic Malignancies (Unknown Mechanism )
Hypothyroidism (Reduced Sweat and Oil)
Malnutrition
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Drugs Lipid Lowering Agents
Systemic Retinoids
Antihistamines Anticholinergics (Hyoscine, Pseudoephedrine)
Nictotine
Diuretics
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MANAGEMENT
Since DRY SKIN is the result of low
moisture content in the Stratum
corneum, the principle of therapy
is directed towards the INCREASE
HYDRATION of the skin.
MANAGEMENT
TREATMENT is achieved through replacement
of those factors responsible for maintainingthe moisture in normal skin, commonly
known as
MOISTURIZERS & EMOLLIENTS.
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MANAGEMENT
MOISTURIZERS are products which aim to replace or add waterto the skin
HUMECTANTS are substances which penetrate the horny layer &attract water into the Stratum corneume.g. glycerin, urea, pyrrolidone carboxylic acid
For maximum efficacy, it is best to apply these products on slightlymoist skin, like immediately after bathing.
EMOLLIENTS are lipids which form barrier on the skinsurface to reduce moisture loss.The lipid may be animal or vegetable derived or it maybe obtained from mineral oils.Lipid may also be synthetic in origin.
MANAGEMENT
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Emollients remain the mainstay of treatment
for all dry scaling disorders
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Emollients have three basic properties: Occlusion
providing a layer of oil on the surface of the skin to slow
water loss and thus increase the moisture content of the
stratum corneum
Humectant
increasing the water-holding capacity of the stratum
corneum
Lubrication
adding a slip or glide across the skin.
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Emollients soothe, smooth and hydrate the skinTheir effects are short-lived and they should be applied
frequently even after improvements occurs
Emollients should be applied especially after bathing
to hydrate the stratum corneum while the skin is still
wet
They are useful in dry eczematous disorders
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Classical preparations;
Ointments (water-free)
Fatty creams (W/O)
Creams/Lotions (O/W)
Disadvantage:
Occlusive-Effect
Wash-Out-Effect
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DMS = Derma Membrane Structure
Skin oriented composition
Skin oriented lamellar structure
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Skin Lipids
Triglycerids
SqualeneCeramides
Cholesterol
Phospholipids
DMS Cream
Caprylic/Capric
Triglycerids (plant)
Squalane (plant )
Ceramide 3 (yeast)
Phytosterols (plant)
Phospholipids (plant)
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Cream/Lotion concentrate Physiologically oriented (ICL) epidermal lipids
surrogate Lamellar structures similar to SC bilayers
(High pressure) Barrier strengthening effect
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Emulsifiers Preservatives Mineral oil Fragrance
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Prolonged Moisturization Barrier enhancement
Protection against Hydro-& Lipophilic irritants Comparative barrier integrity study DMS vsConventional Emulsifier
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Technology platform for creams & lotions Lamellar organized, proposing a physiologicalfusion with SC lipids Does not contain emulsifiers having an impacton the barrier function Does not contain physiologically precarious
ingredients Shows superior claim substantiation in field ofbarrier recover and barrier support
DMS - ideal treatment for dehydrated & itchy skin
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