Emollients that restore the skin barrier function would expand their role beyond basic maintenance therapy in atopic dermatitis (AD). 

The present study investigated the effect of a novel emollient plus cream (EC) on the skin barrier in vitro and in patients with mild to moderate AD. It evaluated the effect of EC on skin barrier recovery using a tape-stripping (TS) model. After TS, the study treated organ cultures with EC (undiluted or diluted 1:1 with water) and analyzed at 18 to 120 hours using hematoxylin and eosin, Oil Red O, immunohistochemical and immunofluorescent techniques. 

The study witnessed the application of EC or placebo once daily for 2 months to antecubital folds of the upper and lower limbs of patients with mild to moderate AD in clinical remission. It assessed epidermal thickness, vascularization and epidermal hydration by optical coherence tomography and corneometry, respectively, at baseline and 1 and 2 months following treatment initiation.

The study observed:

• EC treatment significantly increased epidermal thickness and lipid content versus diluent in the skin organ culture, as well as claudin-1, involucrin and caspase-14 expression, after TS proposed skin barrier repair.
• EC treatment also decreased keratin-16 expression and increased levels of Toll-like receptors 1 and 2 versus diluent, indicating involvement in regulating the epidermal immune response.
• In 20 patients randomized 1:1 to EC or placebo, EC treatment at the elbow fold/popliteal fossa remarkably reduced epidermal thickness after 2 months and the number of blood vessels at the elbow fold after 1 and 2 months, versus placebo.
• EC greatly improved skin hydration after 2 months versus baseline. 

This study suggests that a novel multi-action EC may help to revitalize epidermal homeostasis and improve the skin of patients with AD. Thus, this novel multi-action EC could be a valid adjuvant therapy in patients with AD. Novel multi-action EC helps to restore epidermal homeostasis and improves the skin affected by AD.

Source: Quadri M, Lotti R, Bonzano L, et al. A novel multi-action emollient plus cream improves skin barrier function in patients with atopic dermatitis: in vitro and clinical evidence. Skin Pharmacol Physiol. 2021;34(1):8-18.