Atopic dermatitis, the most common form of eczema, significantly compromises the patient′s quality of life due to the intractable itching and other associated factors such as disfigurement, sleeping disturbances and social stigmatization from the visible lesions. Its mainstay treatment involves applying topical glucocorticosteroids and calcineurin inhibitors combined with regular use of moisturizers. However, conventional treatments may be associated with a certain degree of adverse effects, which raises concerns among the patients leading to nonadherence to treatment. Thus, using moisturizers to improve barrier repair and function possess great value. One of the strategies could be incorporating bioactive ingredients with clinically proven therapeutic benefits into dermocosmetics emollient. These dermocosmetics emollients improve the skin barrier and alleviate inflammation, pruritus and xerosis. 

Vanessa et al conducted a study performing a critical and comprehensive narrative review of the literature. It identified studies and trials focusing on moisturizers that include phytochemicals, natural moisturizing factors, essential fatty acids, endocannabinoids and antioxidants by searching electronic databases (PubMed and MEDLINE). 

The review found active ingredients such as plant-derived ingredients (e.g., licorice, chamomile, comfrey, oatmeal and cannabinoids), essential lipids (e.g., ceramide, linoleic acid), natural moisturizing factors (e.g., urea, arginine, pyrrolidone carboxylic acid, lactic acid) and antioxidants (e.g., furfuryl palmitate, vitamin E) to be potentially safe and effective treatments in alleviating symptoms of atopic eczema. Notably, it found the efficacy of some of the active ingredients comparable to low- to medium-potency corticosteroids. Furthermore, the study found that these actives-containing moisturizers deliver high treatment compliance and tolerability and reduce corticosteroid use. 

Yet, there is low-level clinical evidence for recommending these ingredients for clinical use. Hence, more head-to-head clinical trials, homogenization of clinical outcomes and improvement of the study designs are needed to better understand the clinical roles of active ingredients in moisturizers. 

Source: Vanessa VV, Wan Ahmad Kammal WSL, Lai ZW, et al. A review of moisturizing additives for atopic dermatitis. Cosmetics. 2022;9:75.