title: A novel method to control the balance of skin microflora Part 2. A study to assess the effect of a cream containing farnesol and xylitol on atopic dry skin.
abstract: BACKGROUND
  It is recognized that colonization by Staphylococcus aureus (SA) on the skin is one of the factors that can worsen atopic dermatitis (AD). Antibiotics and germicides are not the best choice to remove bacteria from the skin of AD patients, because of problems of irritation to the skin and bacterial resistance. We therefore turned our attention to the biofilm of SA with the aim of removing only SA from the skin surface of AD patients. We found that xylitol (X) and farnesol (F) synergistically inhibited biofilm formation by SA and dissolved biofilm formed in vivo (Part 1).
  
  
  OBJECTIVE
  To test whether application of AD for 1 week with FX cream can reduce SA without affecting Staphylococcus epidermidis.
  
  
  METHODS
  A randomized, double-blind, placebo-controlled right-and-left comparison study was performed. The arms of 17 patients with dry-type AD were applied with skin-care cream including/or not including a 0.02% F and 5% X combination for 1 week. The clinical response, biophysical assessment of the skin surface and counts of skin microflora were recorded before and after 1 week of therapy.
  
  
  RESULTS
  The ratio of SA in total bacteria at sites to which FX cream had been applied was significantly decreased after 1 week (P = 0.007), compared with before application and with placebo sites (P = 0.045). The mean skin conductance (a parameter indicating the state of hydration of the skin surface) of FX cream sites was increased significantly compared with the conductance before application (P = 0.0001) and at placebo sites (P = 0.002).
  
  
  CONCLUSIONS
  This study provides evidence supporting the idea that cream containing F and X is a useful skin-care agent for atopic dry skin colonized by SA.
authors.affiliation: Life Science Research Center, Shiseido Co. Ltd., Tsuzuki-ku, Yokohama, Japan. masako.katsuyama@to.shiseido.co.jp
authors.forename: Masako
authors.initials: M
authors.lastname: Katsuyama
authors.forename: Katsuyama
authors.initials: K
authors.lastname: Masako
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Kobayashi
authors.initials: K
authors.lastname: Yusuke
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Ichikawa
authors.forename: Ichikawa
authors.initials: I
authors.lastname: Hideyuki
authors.forename: Atsuko
authors.initials: A
authors.lastname: Mizuno
authors.forename: Mizuno
authors.initials: M
authors.lastname: Atsuko
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Miyachi
authors.forename: Miyachi
authors.initials: M
authors.lastname: Yoshiki
authors.forename: Kayoko
authors.initials: K
authors.lastname: Matsunaga
authors.forename: Matsunaga
authors.initials: M
authors.lastname: Kayoko
authors.forename: Makoto
authors.initials: M
authors.lastname: Kawashima
authors.forename: Kawashima
authors.initials: K
authors.lastname: Makoto
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D001834:Body Water / Q000378:metabolism; D015169:Colony Count, Microbial; D003876:Dermatitis, Atopic / Q000188:drug therapy* / Q000378:metabolism / Q000382:microbiology* / Q000473:pathology; D003879:Dermatologic Agents / Q000008:administration & dosage; D004311:Double-Blind Method; D005204:Farnesol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008855:Microscopy, Electron, Scanning; D012867:Skin / Q000187:drug effects* / Q000382:microbiology* / Q000473:pathology; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000472:pathogenicity* / Q000648:ultrastructure; D013212:Staphylococcus epidermidis / Q000187:drug effects / Q000502:physiology; D014993:Xylitol / Q000008:administration & dosage*
chemical_list: D003879:Dermatologic Agents; D005204:Farnesol; D014993:Xylitol