title: Functional assessment of a washing emulsion for sensitive skin: mild impairment of stratum corneum hydration, pH, barrier function, lipid content, integrity and cohesion in a controlled washing test.
abstract: OBJECTIVE
  Sensitive skin has been described as a skin type with higher reactivity than normal skin and exaggerated reactions to external irritants. Washing with soaps is harmful for barrier-related parameters. Cutaneous irritation induced by cleansing products under exaggerated test conditions, e.g. patch testing, is not necessarily predictive of the irritation occurring under standardized daily use conditions. The purpose of the study was to assess the effect of an improved washing solution for sensitive skin in a half-site comparison on barrier-related parameters.
  
  
  METHODS
  Thirty healthy volunteers with self-reported sensitive and so-called problematic skin performed standardized washings with a soap-free washing emulsion with mild acidity (pH 5.5) for 3 weeks. Test areas were both forearms and the cheek. Non-invasive biophysical measurements of the following skin parameters, epidermal permeability barrier function measured as transepidermal water loss (TEWL), stratum corneum (SC) hydration, pH value, skin surface lipids, skin temperature and SC integrity/cohesion, were assessed prior to the first washing, on days 7, 14 and 21 after beginning the washing procedure. SC cohesion was quantified using two independent methods on D-Squame tapes: optical spectroscopy measuring the absorbance and a protein assay assessing the total protein (Bradford). Both methods showed a good correlation. SC integrity was quantified by measuring TEWL after sequential stripping with D-Squame tapes.
  
  
  RESULTS
  The use of the washing emulsion led to a mild damage of the epidermal permeability barrier function with no marked difference to water application. Furthermore, a mild but significant dehydration was assessed after 21 days vs. baseline without any differences between the water-treated and the washing emulsion-treated forearm. On the cheek no dehydration was detectable but the lipid content was reduced under the washing emulsion. The pH value increased in all three test areas after 21 days, again without significant differences between water and the washing solution. SC cohesion was quantified using two independent methods on D-Squame tapes: optical spectroscopy measuring the absorbance and a protein assay assessing the total protein (Bradford). Both methods showed a good correlation. The SC cohesion decreased after 21 days on the water-treated as well as on the washing emulsion-treated arm. The decrease over time was significant when used the optical spectroscopy measuring. A standardized questionnaire revealed positive characteristics of the washing emulsion and good acceptance.
  
  
  CONCLUSIONS
  The investigated standardized washing model with the endpoints epidermal barrier function, SC hydration, surface pH, skin surface lipids, skin temperature and SC integrity/cohesion showed only mild damage comparable to washing with water.
authors.affiliation: Skin Physiology Laboratory, Department of Dermatology, Friedrich-Schiller-University, Jena, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Bornkessel
authors.forename: M
authors.initials: M
authors.lastname: Flach
authors.forename: M
authors.initials: M
authors.lastname: Arens-Corell
authors.forename: P
authors.initials: P
authors.lastname: Elsner
authors.forename: J W
authors.initials: JW
authors.lastname: Fluhr
mesh_terms: D000287:Administration, Topical; D000328:Adult; D001834:Body Water / Q000187:drug effects / Q000378:metabolism*; D017453:Dermatitis, Irritant / Q000209:etiology / Q000517:prevention & control; D003902:Detergents / Q000008:administration & dosage* / Q000009:adverse effects; D004643:Emollients / Q000008:administration & dosage* / Q000009:adverse effects; D004655:Emulsions; D004817:Epidermis / Q000187:drug effects* / Q000378:metabolism*; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D050356:Lipid Metabolism; D008297:Male; D008875:Middle Aged; D010539:Permeability / Q000187:drug effects; D012867:Skin / Q000187:drug effects / Q000378:metabolism; D012881:Skin Temperature / Q000187:drug effects; D012915:Soaps / Q000008:administration & dosage; D014867:Water / Q000378:metabolism*
chemical_list: D003902:Detergents; D004643:Emollients; D004655:Emulsions; D012915:Soaps; D014867:Water