Facial skin physiology recovery kinetics during 180 min post-washing with a cleanser

Five dimensions of cleansing: A holistic view on the facets and importance of skin cleansing

Cleansing is an important human ritual practised for hygiene, well-being and relaxation over centuries. As part of body care it is often taken for granted, yet its relevance cannot be underestimated. Although cleansing the skin may seem trivial to some, it is accepted, that this fundamental function of skin cleansing products is highly complex, diverse and crucial for a variety of reasons in the personal, public, healthcare and dermatological settings. Employing a comprehensive and strategic approach in viewing cleansing and its rituals, supports innovation, understanding and development. Apart from being a fundamental function, as far as we know, there is no comprehensive presentation of skin cleansing with all its effects besides 'removing dirt'. To our knowledge, comprehensive analyses on the multi-dimensional facets of skin cleansing are either rare or not published. Against this background, we examine the importance of cleansing in terms of function, relevance and concepts. First, the key functions and efficacies of skin cleansing were investigated by literature research. Based on this survey, the functions were analysed, sorted and merged and a novel approach to skin cleansing 'dimensions' was developed. Herewith, we took into consideration the evolution of skin cleansing in terms of concept evolution, complexity and testing methods for cleansing products and their claims. Several multi-dimensional functions of skin cleansing were identified and then established into five skin cleansing dimensions, namely: hygienic and medical importance; socio-cultural and interpersonal relevance; mood, emotion and well-being; cosmetic and aesthetic function; corneobiological interactions. It became obvious, that these five dimensions with their corresponding 11 sub-dimensions, are influenced by each other throughout history by culture and society, technical progress, scientific knowledge and consumer trends. This article presents the enormous complexity of skin cleansing. Skin cleansing has evolved from basic care up to a highly complex and diverse cosmetic product category in terms of technology, efficacy and usage routine(s). In view of future challenges, such as the effects of climate and associated lifestyle changes, the development of skin cleansing will remain an exciting and important topic and thus will finally, again, further increase the complexity of skin cleansing itself.

An optimal method for quantifying the facial sebum level and characterizing facial sebum features

BACKGROUND

Evidence suggests that sebum content is important in skin disorders such as acne. However, sebum levels change depending on the external environment, and quantifying skin sebum levels is challenging. Here, we propose an optimal method for quantifying the facial sebum level.

MATERIALS AND METHODS

Four hundred and sixty participants (160 males and 300 females) aged 20-40 were enrolled in this study. A Sebumeter SM 810 was used to measure the sebum level at five facial locations: the forehead, the chin, the left cheek, the right cheek, and the nose. The participants were divided into two groups; one group underwent a one-time measurement (n = 390, male: female = 120: 270), and the other underwent three consecutive measurements (n = 70, male: female = 40: 30). The casual sebum level (CSL) was measured in all patients after a 30-min acclimatization; subsequently, the sebum removal process was conducted, followed by a resting period of 1 h to determine the sebum excretion rate (SER). Spearman's correlation analysis and the Wilcoxon signed-rank test were used to compare the sebum level consistency and differences between the groups.

RESULTS

Although three consecutive measurements better reflected the sebum content, the one-time measurement also represented the relative sebum level. One hour after sebum removal, the sebum level recovered to 70%-90%; thus, this method was applicable for use in SER quantification. Of the five testing points, the sebum content was highest in the nose and lowest in the cheeks (both left and right). In addition, the cheeks were the most stable sites in terms of testing points, testing times, and CSL/SER values. A one-time measurement of the CSL could represent the SER 1 h after the sebum removal. In our cohort, the sebum level of males with oily skin was decreased at age 32-35, and that of males with non-oily skin increased at 28-35. The opposite trend was observed in female participants.

CONCLUSION

Sebum measurement methods were assessed, including testing times, indices (interval of time) and sites in a conditioned external environment. A one-time measurement of the CSL 1 h after sebum removal was sufficient to determine the sebum level and SER, and the cheeks are recommended as the testing site. Sex and skin type differences were observed in sebum level changes with age.

Demodex infestation as a cause of sensitive skin in a dermatology outpatient clinic

BACKGROUND

Sensitive skin is subjective cutaneous hyperreactivity to environmental factors. Demodicosis is a skin disorder caused by Demodex mites. There may be a link between demodicosis and sensitive skin.

AIM

This study aimed to examine facial Demodex mites density and other factors associated with sensitive skin in patients.

METHODS AND METHODS

A total of 349 randomly selected patients presented to the dermatology department. The research data were collected using a questionnaire form that included the participants' sociodemographic and lifestyle characteristics, a sensitive skin questionnaire, the Dermatology Life Quality Index (DLQI), and European Health Interview Survey (EHIS). Patients underwent standardized superficial skin surface biopsy of 4 areas of the face. D. folliculorum count greater than 5 mites/cm² was considered positive.

RESULTS

In relation to Demodex, there was an increase in skin sensitivity with higher Demodex density (p = 0.04). There was a statistically significant, weak positive correlation between skin sensitivity and DLQI score (r = 0.33, p = 0.00), and there was also a significant but very weak negative correlation between skin sensitivity and EUROHIS (r = -0.164, p = 0.002). Skin sensitivity was more common in patients with a concomitant dermatological disease (p = 0.01) and increased with more frequent cosmetic use (p = 0.00).

CONCLUSION

Alongside other risk factors, for the patients presenting with complaints of sensitive skin, investigating Demodex population density may help alleviate sensitive skin symptoms with appropriate therapies and preventive measures.

Relationship between the skin barrier function of 2-week-old infants after bathing and facial skin problems during the first 6 weeks of life: A prospective observational cohort study

AIM

This study aimed to identify the relationship between the skin barrier function after bathing at 2 weeks of age and subsequent facial skin problems during the first 6 weeks of life.

METHODS

A prospective observational study was conducted from July 2017 to February 2018 on healthy newborns aged 2 weeks. Skin barrier function was evaluated before bathing and at 30 and 90 min after bathing by measuring transepidermal water loss (TEWL), stratum corneum hydration (SCH), sebum secretion, and skin pH. Infantile facial skin problems were assessed using skin condition diaries maintained by a parent for 4 weeks.

RESULTS

Analysis of the data from 56 infants showed that 29 infants (51.8%) experienced facial skin problems from 2 to 6 weeks of age. A lesser change in the sebum secretion on the forehead before bathing to 90 min after bathing and a higher SCH of the forehead before bathing were less likely to result in facial skin problems (adjusted odds ratio [AOR] = 0.98, 95% confidence interval [CI]: 0.97-0.99; AOR = 0.96, 95% CI: 0.92-0.99).

CONCLUSIONS

A greater change in the sebum secretion on the forehead before bathing to 90 min after bathing and a lower SCH of the forehead before bathing were associated with subsequent infantile facial skin problems, indicating that a better ability to recover after bathing is important to prevent facial skin problems. Future studies should identify factors that enhance the recuperative functions of infantile skin.

Skin effect of facial cleansing combined with an electric sonic device

BACKGROUND

New technologies, such as sonic devices, have been developed to optimize the skin cleansing process and improve its efficiency. To evaluate the effectiveness of these cosmetic procedures, skin bioengineering is an objective method to assess the biophysical parameters of the skin.

AIMS

This study aimed to assess the effect of facial cleansing on the physiological properties of the skin by comparing a cleansing process with cosmetic product applied manually to cleansing with cosmetic product associated with the use of an electric sonic device.

PATIENTS/METHODS

A gentle skin cleanser was applied to the entire face of 12 subjects; the sonic device was used on one half of the face and the manual process was performed on the other half. Instrumental skin analyses included sebummetry, corneometry, transepidermal water loss (TEWL), infrared thermography, and high-frequency ultrasound and were measured before and up to 90 min after cleansing. Results were compared using two-way ANOVA and Friedman tests.

RESULTS

Data obtained from the statistical analysis of sebummetry, TEWL, thermography, and ultrasound parameters did not show any significant difference. When assessing the corneometry parameters, a significant reduction in hydration values (17.19%) was observed in the manual cleansing area, while the values remained similar to baseline values in the area where the sonic device was used.

CONCLUSION

The cleansing process with a sonic device did not cause a significant hydration reduction, suggesting better preservation of skin homeostasis when compared to manual cleansing.

Washing with water alone versus soap in maintaining remission of eczema

BACKGROUND

There is no consensus on the use of soap in skin care for atopic dermatitis in Japan. Thus, this study aimed to evaluate the efficacy of soap to maintain eczema remission in atopic dermatitis patients during the fall-winter period in Japan.

METHODS

This assessor-blinded, pragmatic randomized, non-inferiority study enrolled atopic dermatitis patients whose eczema was controlled by regular steroid ointment application less than or equal to 2 days / week (tacrolimus ointment was permitted). For 8 ± 3 weeks, participants washed their upper and lower limbs on one side with soap (soap side) and on the other side with water alone (water side). The primary outcome was an Eczema Area and Severity Index score at week 8 ± 3.

RESULTS

Twenty-nine participants were analyzed. The Eczema Area and Severity Index scores at week 8 ± 3 of the water and soap sides were 0.0 (0.0-0.4) and 0.0 (0.0-0.4), respectively (P = 0.18). The difference between both sides was -0.02 (-0.11-0.08), and the limits of the 95% confidence interval did not reach the prespecified non-inferiority margin. The average Patient-Oriented Eczema Measure score was 1.27 ± 1.7 and 1.32 ± 1.8 for the water and soap sides, respectively (P = 0.92). The total number of additional steroid ointment applications was four (0-20) times and six (0-23) times, respectively (P = 0.98). Participants were categorized according to self-assessments of the usefulness of soap, with 2, 24, and 3 participants in the water-effective, invariant, and soap-effective groups, respectively.

CONCLUSIONS

For children with controlled atopic dermatitis, washing with water alone was not inferior to washing with soap for maintaining remission of eczema during the fall-winter period in Japan.

Effect of a botanical cleansing lotion on skin sebum and erythema of the face: A randomized controlled blinded half-side comparison

BACKGROUND

Elevated levels of skin sebum are associated with the growth of Propionibacterium acnes. Intensive degreasing of the skin reduces Propionibacterium acnes but also may cause skin irritation.

AIMS

We assessed the degreasing effect and skin tolerability of a botanical face cleanser with hops and willow bark extract and disodium cocoyl glutamate as mild cleansing agent compared to a standard face cleanser with sodium laureth sulfate (SLES).

MATERIALS AND METHODS

A total of 21 healthy volunteers with normal to oily skin were enrolled in this study. Both cleansers were applied twice a day on the left or right side of the forehead for 15 days in a standardized manner. Bioengineering measurements were performed on day 8 and 15 and on day 17 after an application break of 48 hours. The sebum level was determined using a Sebumeter^® , and skin redness was measured using a Mexameter^® .

RESULTS

The botanical face cleanser significantly reduced the sebum level (P < .01) in the test area on day 17. The SLES containing cleanser showed a statistically relevant degreasing effect already on day 15, but after the application break the sebum level increased again on day 17. None of the cleansers caused skin irritation as determined by skin redness measurements.

CONCLUSIONS

In contrast to the SLES containing cleanser, the botanical skin cleanser with hops and willow bark extract had a continuous degreasing effect without reactive seborrhoe after the treatment break. Skin cleansing without SLES might be advantageous for sensitive skin.

Evaluation of the relation between lipid coat, transepidermal water loss, and skin pH

OBJECTIVE

The epidermis is an epidermal barrier which accumulates lipid substances and participates in skin moisturizing. An evaluation of the epidermal barrier efficiency can be made, among others, by the measurement of the following values: the lipid coat, the transepidermal water loss (TEWL) index, and pH.

MATERIALS

The study involved 50 Caucasian, healthy women aged 19-35 years (mean 20.56).

METHODS

Measurements were made using Courage & Khazaka Multi Probe Adapter MPA 580: Tewameter TM 300, pH-Meter PH 905, Sebumeter SM 815. The areas of measurements included forehead, nose, left cheek, right cheek, chin, and thigh.

RESULTS

In the T-zone, the lipid coat was in the range between 0 and 270 μg/cm² (mean 128 μg/cm² ), TEWL between 1 and 55 g/m² /h (mean 11.1 g/m² /h), and pH 4.0-5.6 (mean 5.39). Lower values of the lipid coat up to 100 μg/cm² were accompanied by TEWL greater than 30 g/m² /h and less acidic pH of 5.6-9.0. In the U-zone the range of lipid coat was up to 200 μg/cm² (mean 65.2 μg/cm² ), the skin pH remained 4.0-5.6 (mean 5.47), and TEWL was in the range between 1 and 20 g/m² /h (mean 8.7 g/m² /h). Lower values of the lipid coat up to 100 μg/cm² were accompanied by TEWL between 1 and 20 g/m² /h and less acidic pH of 5.6-9.0. High values of the lipid coat between 180 and 200 μg/cm² were connected with TEWL of 1-15 g/m² /h. On the skin of the thigh, we observed a very thin lipid coat - 35 μg/cm² (mean 5.6 μg/cm² ), pH (mean 5.37), and TEWL (mean 8.5 g/m² /h) were considered by us to be within regular limits.

CONCLUSIONS

In the T-zone, a thinner lipid coat resulted in relatively high TEWL and pH levels changing toward alkaline. In the U-zone, thinner lipid coat was accompanied by lower TEWL and pH changing toward alkaline. We also observed that lower values of lipid coat up to 100 μg/cm² were associated with higher pH values ranging toward the basic character pH 5.6-9.0).

Pilot study on benefits of applying a hot towel for 10 s to the skin of elderly nursing home residents during bed baths: Towards safe and comfortable bed baths

This study examined the effects of applying a hot towel to the skin of elderly people for 10 s (AHT10s) during a bed bath. We hypothesized from our previous studies that AHT10s would increase the stratum corneum water content and improve the skin barrier function of the elderly and invited residents (n = 21) of long-term care facilities to participate in this crossover study. Each participant received a bed bath with AHT10s and also a bed bath without hot towel application. The stratum corneum water content and transepidermal water loss (TEWL) were measured during bed bathing sessions and the experience was subjectively evaluated by participants. The TEWL increased significantly when bed bath did not involve AHT10s, but there was no such significant increase when AHT10s was performed. AHT10s also raised the skin surface temperature and provided warmth and comfort to all participants. These results suggest that, in the target population, AHT10s will lead to TEWL advantages and provide warmth and comfort.