Abstract
The skin is the largest organ in the human body. Among other components, it contains epidermal cells, which are modified epithelial cells that rest on a basal membrane that separates them from the dermis. When the epidermis presents variations in its structural composition and the distribution of its elements, the result is the loss of large amounts of water, which perpetuates these variations and leads to permanent dehydration. Emollients are the first line of treatment for pathologies that affect the hydration of the skin, such as atopic dermatitis, which is one of the most important ones. This document entails the description of the epidermal barrier with its main components and functions, the characteristics of an altered skin barrier, and the mechanisms for its repair. Subsequently, this paper includes the definition of emollient, hydration mechanisms for the recovery of the barrier, types of emollients, the situations that must be taken into account when the use of emollients is prescribed, evidence with or without connection with their advantages, and the key points at the time of its formulation.
References
Murata T, Honda T, Egawa G, Yamamoto Y, Ichijo R, Dainichi T, et al. Transient elevation of cytoplasmic calcium ion concentration at a single cell level precedes morphological changes of epidermal keratinocytes during cornification. Sci Rep. 2018;8(1):6610. DOI: 10.1038/s41598-018-24899-7
Jonca N, Leclerc EA, Caubet C, Simon M, Guerrin M, Serre G. Córneodesmosomes and córneodesmosin: From the stratum córneum cohesion to the pathophysiology of genodermatoses. Eur J Dermatology. 2011;21(2 Suppl):35-42. DOI: 10.1684/ejd.2011.1264
Ishida-Yamamoto A, Igawa S, Kishibe M. Molecular basis of the skin barrier structures revealed by electron microscopy. Exp Dermatol. 2018;27(8):841-846. DOI: 10.1111/exd.13674
Ishida-Yamamoto A, Simon M, Kishibe M, Miyauchi Y, Takahashi H, Yoshida S, et al. Epidermal lamellar granules transport different cargoes as distinct aggregates. J Invest Dermatol. 2004;122(5):1137-1144. DOI: 10.1111/j.0022-202X.2004.22515.x
De Jager M, Groenink W, van der Spek J, Janmaat C, GoorisG, Ponec M, et al. Preparation and characterization of a stratum córneum substitute for in vitro percutaneous penetration studies. Biochim Biophys Acta. 2006;1758(5):636-644. DOI: 10.1016/j.bbamem.2006.04.001
Feingold KR, Elias PM. Role of lipids in the formation and maintenance of the cutaneous permeability barrier. Biochim Biophys Acta. 2014;1841(3):280-294. DOI: 10.1016/j.bbalip.2013.11.007
Elias PM, Gruber R, Crumrine D, Menon G, Williams ML, Wakefield J, et al. Formation and functions of the córneocyte lipid envelope (CLE). Biochim Biophys Acta. 2014;1841(3):314-318. DOI: 10.1016/j.bbalip.2013.09.011
Meguro S, Arai Y, Masukawa Y, Uie K, Tokimitsu I. Relationship between covalently bound ceramides and transepidermal water loss (TEWL). Arch Dermatol Res. 2000;292(9):463-468. DOI: 10.1007/s004030000160
Behne M, Uchida Y, Seki T, Ortiz-de Montellano P, Elias PM, Holleran WM. Omega-hydroxyceramides are required for córneocyte lipid envelope (CLE) formation and normal epidermal permeability barrier function. J Invest Dermatol. 2000;114(1):185-192. DOI: 10.1046/j.1523-1747.2000.00846.x
Hon KL, Kung JSC, Ng WGG, Leung TF. Emollient treatment of atopic dermatitis: latest evidence and clinical considerations. Drugs Context. 2018;7:212530. DOI: 10.7573/dic.212530
Berkers T, van Dijk L, Absalah S, van Smeden J, Bouwstra JA. Topically applied fatty acids are elongated before incorporation in the stratum córneum lipid matrix in compromised skin. Exp Dermatol. 2017;26(1):36-43. DOI: 10.1111/exd.13116
De Jager M, Groenink W, Bielsa I, Guivernau R, Andersson E, Angelova N, et al. A novel in vitro percutaneous penetration model: Evaluation of barrier properties with P-aminobenzoic acid and two of its derivatives. Pharm Res. 2006;23(5):951-960. DOI: 10.1007/s11095-006-9909-1
Van Smeden J, Bouwstra JA. Stratum córneum lipids: their role for the skin barrier function in healthy subjects and atopic dermatitis patients. Eur PMC. 2016;49:8-26. DOI: 10.1159/000441540
Ananthapadmanabhan KP, Mukherjee S, Chandar P. Stratum córneum fatty acids: their critical role in preserving barrier integrity during cleansing. Int J Cosmet Sci. 2013;35(4):337-345. DOI: 10.1111/ics.12042
Wertz PW, van den Bergh B. The physical, chemical and functional properties of lipids in the skin and other biological barriers. Chem Phys Lipids. 1998;91(2):85-96. DOI: 10.1016/S0009-3084(97)00108-4
Rawlings A V, Harding CR. Moisturization and skin barrier function. Dermatol Ther. 2004;17(Suppl 1):43-48. DOI: 10.1111/j.1396-0296.2004.04s1005.x
Verdier-Sévrain S, Bonté F. Skin hydration: a review on its molecular mechanisms. J Cosmet Dermatol. 2007;6(2):75-82. DOI: 10.1111/j.1473-2165.2007.00300.x
Feuillie C, Vitry P, McAleer MA, Kezic S, Irvine AD, Geoghegan JA, et al. Adhesion of Staphylococcus aureus to Córneocytes from atopic dermatitis patients is controlled by natural moisturizing factor levels. mBio. 2018;9(4). DOI: 10.1128/mBio.01184-18
Celleno L. Topical urea in skincare: a review. Dermatol Ther. 2018;31(6):e12690. D
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright (c) 2020 Revista Alergia México