Moisturizers versus Current and Next-Generation Barrier Repair Therapy for the Management of Atopic Dermatitis

Abstract

We compare here the principal characteristics of over-the-counter moisturizers with physiologic lipid-based barrier repair therapy. Moisturizers are standard ancillary therapy for anti-inflammatory skin disorders, like atopic dermatitis (AD), and can attenuate the emergence of AD, the initial step in the "atopic march." But not all moisturizers are beneficial; some can make skin function worse, and can even induce inflammation, possibly accounting for the frequent occurrence of "sensitive skin" in women. In contrast, physiologic lipid-based barrier repair therapy, if comprised of the 3 key stratum corneum lipids, in sufficient quantities and at an appropriate molar ratio, can correct the barrier abnormality and reduce inflammation in AD, and perhaps in other inflammatory dermatoses.

Keywords: Antihistamines; Atopic dermatitis; Barrier function; Barrier response; Ceramides; Cytokines; Epidermal lipids; Kallikreins; Moisturizers; PPAR; pH.