Dermatitis

Ceramide-based regimen corrects skin barrier dysfunction in eczema


Use of a ceramide moisturising cream and cleanser appears to improve skin barrier function in patients with moderate eczema.

An Australian study of 100 adult patients found transepidermal water loss (TEWL) decreased and skin hydration increased after 28 days of treatment compared to placebo.

However the primary efficacy outcome – symptom severity as assessed by EASI at day 28 – was similar in both treated and control groups. Both the ceramide-based regimen and placebo resulted in a significant decrease in EASI scores between baseline and 28 days.

The study also found no significant difference in the amount of mometasone furoate used as a rescue medication by either group at any time point.

As well, DLQI scores improved significantly over time in both groups (p < 0.0001) but with no significant difference observed between groups (p = 0.7804).

The study found treated patients were more likely to report positively than controls on questions about relief of itch and dry skin, skin softness and smoothness.

The most common treatment-related adverse events reported were stinging on application in 5% in the active group only, itch in 3% in the active group and 1% in the placebo group, and dry skin in the placebo group only by 2% of patients.

“The positive effect of the ceramide cream and cleanser on restoring skin barrier function is most likely due to the presence of unique ingredients which have different mechanisms of action,” the study said.

The study said that ceramides act as water modulators and an integral part of the skin’s permeability barrier by forming multi-layered lamellar structures with cholesterol and free fatty acids between cells of the stratum corneum.

“Ceramide EOP and ceramide NP were utilised as these ceramides have been demonstrated to be deficient in eczematous skin.”

The researchers, including senior investigator and Sydney dermatologist Associate Professor Stephen Shumack, said the study highlights the need for moisturisers and cleansers to be formulated specifically for eczema.

“This is the first study to show clinical evidence that a commercially available moisturising cream and cleanser containing ceramides and other lipids in the appropriate physiological ratio, successfully and safely improves the signs and symptoms of moderate eczema in adults.”

The study, published in Dermatologic Therapy, was sponsored by Ego Pharmaceuticals which manufactures the ceramide cream and cleanser.

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