The Impact of Anti-Inflammatory Moisturizers in Mild to Moderate Atopic Dermatitis Treatment

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In patients with mild to moderate atopic dermatitis (AD), moisturizers with anti-inflammatory ingredients improved skin hydration even further than those without, according to a recent study.¹ Although clinical improvement was seen in both variations, anti-inflammatory moisturizers further improved skin hydration and barrier function while reducing inflammatory lesions in patients.

The double-blind, randomized clinical trial took place over 14 days at the Dermatology and Venereology Outpatient Clinic of Dr. Soetomo General Academic Hospital in Indonesia. Patients were adults between the ages of 18 and 64; 17 were male and 15 were female.

Most participants were classified with mild AD (n = 29) while 3 were considered to have moderate disease, according to the Hanifin-Rajka criteria. Almost half of the patients had a family history of AD.

Participants were evenly divided between the control group receiving non-anti-inflammatory moisturizer and the experimental group receiving anti-inflammatory moisturizer. Each applied the product twice a day on their arms and legs.

Both moisturizers included the occlusive of dimethicone, emollients of shea butter and squalane, and humectants of glycerin, saccharide, butylene glycol, and hyaluronic acid, to create a more potent and moisturizing effect in all patients. However, the anti-inflammatory moisturizer contained additional soothing ingredients such as bacterial lysate, allantoin, bisabolol, Phragmites kharka extract, Poria cocos, Mirabilis jalapa, and more shea butter.

Investigators used the Courage Khazaka Cutometer MP-580 on the inner arm to assess levels of stratum corneum hydration. Disease severity was also evaluated using the Scoring Atopic Dermatitis (SCORAD) tool. These measurements were taken at baseline, week 1, and week 2.

In the experiment group, the mean skin hydration was 35.97 ± 6.04, while the control group had an average of 40.74 ± 10.94. By day 14, there was a significant difference in skin hydration values and outcomes between the two cohorts (p < 0.05). The experimental group had an average of 66.06 ± 15.84 while the control group had an average of 56.12 ± 8.34. Similarly, differences in the corneometric value of each group were also observed (p < 0.05).

Clinical severity was also reduced in both groups by the second week but with a significant difference (p < 0.05). In the experimental group, the SCORAD decreased by 24.50% compared with baseline. There was a 12.9% reduction between the first and second week. Conversely, the control group saw a 16.70% change from baseline to day 14 with only a 5.20% decrease between weeks 1 and 2.

Patients with AD have a disrupted skin barrier from the constant itch-scratch cycle, thus making proper skin hydration an important aspect of treatment. Moisturizers can repair the epidermis and prevent flare-ups while possibly reducing itching and lowering the need for corticosteroid treatment.²

“According to the five pillars of AD management outlined by the Asia Pacific consensus, medical therapy should focus on preserving the skin barrier, reducing inflammation, and managing pruritus,” the authors wrote. “Because moisturizing hydrates skin and restores epidermal barrier function, it is regarded as the first stage in treating AD.”

Due to the chronic nature of AD, researchers recommend a future study longer than 2 weeks to assess any long-term positive or negative impacts of these anti-inflammatory ingredients on the skin.

References

1. Prakoeswa CR, Damayanti, Anggraeni S, et al. The role of moisturizer containing anti‐inflammatory on skin hydration in mild‐moderate atopic dermatitis patients. Dermatology Research and Practice. 2024;2024(1). doi:10.1155/drp/3586393

2. Wollenberg A, Kinberger M, Arents B, et al. European guideline (EuroGuiDerm) on atopic eczema - part II: non-systemic treatments and treatment recommendations for special AE patient populations. J Eur Acid Dermatol Venereol. 2022;36(11):1904-1926. doi:10.1111/jdv.18429