Healthy Skin Barrier for Xerosis in Mature Skin

Xerosis associated with pruritis is a common concern in mature skin, according to a poster presentation from South Beach Symposium (SBS) 2023¹. The skin barrier study found that lipid-containing products such as gentle ceramide cleansers and moisturizers promote a healthy skin barrier, reducing xerosis and pruritis in patients with mature skin.

The study authors noted that the majority of the global population lives into their 60s or older, and fundamental dermal and epidermal changes in chronically aged skin have significant dermatological associations. Approximately 55.6% of patients with mature skin have xerosis, with a mean age of 75.1 years. The skin barrier study discusses aging-associated changes in epidermal function leading to xerosis and pruritus, as well as the benefits of maintaining or improving a healthy skin barrier using ceramide-containing skin care products.

To assess the benefits of ceramide-containing products for mature skin, a panel of 7 dermatologists met to review xerosis in mature skin, skin barrier changes, and nuances in the treatment and maintenance of mature skin using gentle cleansers and moisturizers. After considering related literature, 13 statements were drafted. The 13 statements were evaluated at a workshop followed by a plenary discussion to narrow down the statements to 5 based on feedback and experience.

The 5 selected statements include:

1. The exact etiology of xerosis is not entirely understood and likely depends on several genetic and environmental mechanisms
2. Xerosis in older adults is multifactorial and may include intrinsic age-related changes, use of diuretics and similar medications, systemic conditions, hypothyroidism, and overuse of heaters or air conditioners
3. Aging-associated changes in epidermal function include a 30% reduction in total lipids in the stratum corneum relative to young skin due to reduced epidermal lipid synthesis
4. In aging skin, xerosis is significantly associated with pruritus
5. Moisturizers containing urea, ceramides, and lactate have shown benefits in promoting a healthy skin barrier structure and function in xerotic skin

A previous clinical study² determined that using a ceramide-containing gentle cleanser and ammoisturizing cream can offer relief to patients with xerosis in mature skin. The clinical trial included 30 men (63%) and women (37%) over 70 years of age with xerosis. Participants used a ceramide-containing cleanser once a day and applied a ceramide-containing cream at least twice a day for 4 weeks.

“Physician and patient evaluation (5-point scale) were at baseline and after 28 days scoring dryness, roughness and/or desquamation, discomfort, fissures, and cracks. Patients scored quality of life (4-point scale) aspects at baseline and four weeks,” according to the study.

Overall, the mean physician scores at 4 weeks of roughness and desquamation decreased from 3.1 to 0.6, discomfort from xerosis decreased from 2.9 to 0.2, and fissures decreased from 2.3 to 0.1. Participants reported that their xerosis improved as well as their quality of life. Up to 77% of participants noted they no longer felt embarrassed due to their xerosis and 90% do not feel that their xerosis affects their social/leisure activities or daily activities. The study authors concluded that gentle ceramide-containing cleansers and moisturizers promote a healthy skin barrier, reducing xerosis and pruritus.

References

1. Gold M, Andriessen A, Burgess C, et al. Promoting a healthy skin barrier using skin care in people with mature skin xerosis. Presented at the 2023 South Beach Symposium Meeting; February 9-12, 2023; Miami Beach, FL. Accessed February 10, 2023. https://www.livderm.org/wp-content/uploads/2023/01/CeraVe-1.pdf

2. Filippi et al. Poster 33125 Am Acad Dermatol Annual Meeting, March, 2023