New treatments for restoring impaired epidermal barrier permeability: Skin barrier repair creams
Introduction
The skin barrier is an essential element of health, separating the body from the external world. Without this barrier, human life could not exist. Protection is necessary from infectious organisms that might enter the body causing serious disease and possibly death. A means of regulating electrolyte balance, body temperature, and sensation is also part of this barrier. Although the barrier is self-maintaining, with replacement on a 14-day cycle, disease states may perturb the barrier and delay repair or alter repair kinetics. To meet this need, a variety of barrier repair products have been introduced to speed the healing of barrier-impaired skin and to maintain a healthy barrier. This article examines the construction and effect of these new barrier repair devices on skin health.
Section snippets
The barrier
The skin barrier is formed by the protein rich cells of the stratum corneum with intervening intercellular lipids. In the viable epidermis, the nucleated cells possess tight, gap, and adherens junctions with desmosomes and cytoskeletal elements that contribute to the barrier. Barrier repair devices attempt to mimic the intercellular lipids that are synthesized in the keratinocytes during epidermal differentiation and then extruded into the extracellular domains. These lipids are composed of
Barrier products
A variety of barrier repair products have been launched into the prescription marketplace. These creams are different than traditional over-the-counter (OTC) nonprescription moisturizers because the U.S. Food and Drug Administration (FDA) has approved them as a 510(k) device. The 510(k) device approval process was originally developed to ensure the safety of equipment with an on/off switch. Lasers, light devices, cardiac pacemakers, and insulin pumps represent equipment requiring this type of
Conclusions
An intact skin barrier is essential for skin health. All dermatologic diseases are due to barrier defects, ranging from mild to severe. Barrier repair creams do not actually repair the barrier, but rather, create an environment optimal for healing. They contain occlusive ingredients to retard TEWL, humectants to attract water to the epidermis, and other assorted ingredients to decrease inflammation, reduce itching, and provide materials to simulate the intercellular lipids. These barrier repair
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