Turpentine Ointment in Bacterial Skin Infections: A Randomized, Placebo-Controlled, Double-Blind Clinical Trial.

BACKGROUND: Turpentine-containing substances are considered effective in treating cutaneous bacterial infections, but reliable clinical data are scant. OBJECTIVE: We investigated the efficacy and safety of an ointment containing larch turpentine (from Larix decidua), eucalyptus oil (from Eucalyptus globulus), and turpentine oil (from Pinus pinaster) in outpatients with painful skin abscesses in a randomized, placebo-controlled, double-blind study. INTERVENTION: 116 outpatients with skin abscesses used verum or placebo for 10 days. Sum score of the patient's discomforts, changes in abscess size, rate of therapeutic success, and complete healing served as outcome parameters. RESULTS: Fifty-four patients were treated with verum and 56 with placebo. According to the patient's discomfort sum score, patients in the verum group showed a better improvement compared to the placebo group (7.3 vs. 4.7; p = 0.024), and subjective assessment by the investigators revealed a higher treatment success rate after verum (70% vs. 48%; p = 0.021). Complete healing was documented in 67% of the patients receiving verum versus 46% in the placebo group (p = 0.037). There was a positive trend toward a larger decrease in the abscess sizes in the verum group compared to the placebo group (p = 0.07). CONCLUSION: The ointment studied is an effective and safe option for the treatment of bacterial skin diseases.

Surface Evaluation of Living Skin (SELS) parameter correlation analysis using data taken from astronauts working under extreme conditions of microgravity.

BACKGROUND: In space, due to fluid shift a 45% decrease in the skin topography parameter volume (mm3 ) was seen using the VisioScan® camera. Simultaneously, the parameters roughness, scaling and wrinkles changed dramatically as well. Thus, the present study has the objective to understand the relationship between the SELS parameters under extreme conditions and their application by addressing scientific-dermatological questions. MATERIAL AND METHODS: SELS measurements were performed on the volar forearms of six astronauts. The Pearson correlation coefficient was used to determine the association between the variables. RESULTS: A significant correlation was found between the skin topography parameter volume and the skin parameters roughness, scaling and wrinkles. A closer look at each astronaut revealed a significant correlation for all astronauts for the parameters volume and roughness and for more than 65% of the astronauts for the parameters volume and scaling and volume and wrinkles. However, no correlation could be found between the parameters skin hydration and roughness and scaling, respectively. CONCLUSION: Only the parameter skin volume leads to meaningful data under microgravity. Physiological changes observed by fluid shift are comparable to the skin condition edema on earth. Based on the obtained data, we can conclude that the formulas for the SELS parameters roughness, scaling and wrinkles for this special skin condition need to be reviewed.

Application of an Easy-to-Perform High-Energy and Low-End Visible Light Transmittance Method and the Influence of Tinted Sunscreens on High-Energy/Low-End Visible Light Transmittance and Infrared Protection.

BACKGROUND: About 50% of the sun's radiation arriving on earth is visible light (VIS). For a long time, its effects on human health have not been fully investigated. But recently, the influence of VIS has gained more attention, especially regarding skin physiology. Studies showed various effects, many of them harmful, comparable to UV radiation. As a result, there are now a few sunscreens commercially available which claim protection against VIS. The question of whether protection is necessary is still much discussed. AIMS: The objective of this study was to develop an easy-to-perform high-energy visible (HEV) and low-end visible (LEV) light transmittance method to determine the direct VIS protection of sunscreens and other cosmetic samples. Furthermore, the influence of the brightness of the tested products on the HEV, LEV, and infrared A protection was investigated. METHODS: An experimental setup consisting of a light source, a VIS-transmissible filter system, and a sensor unit was built to measure the direct VIS protection of sunscreens and other daily skin care products in two ranges of the VIS area. For a closer look, the brightness of the samples was evaluated by photometric assessment. RESULTS/CONCLUSION: The experimental setup could be validated. It could be demonstrated for the first time that there is a strong positive linear correlation between transmittance and brightness of tinted sunscreen and daily skin care products with sunscreen properties in the HEV, LEV, and infrared A range. However, tinted samples worked best in the blue light region, and the higher the wavelength range, the lower the protection.

Self-Reported Skin Changes by a Selected Number of Astronauts after Long-Duration Mission on ISS as Part of the Skin B Project.

BACKGROUND: One of the most challenging and important factors of manned space missions is to keep astronauts healthy on orbit. In a study on 46 ISS crew members who were on 6-month (average) missions, skin rashes were the most self-reported event. Furthermore, among notable events, 40% were classified as skin rashes/hypersensitivities. Thus, especially skin conditions during space travel are of major clinical interest and require further research. AIMS: The aim of the study was to determine skin conditions in space flight among US and European astronauts, especially taking into account the terrestrial skin conditions as well as on-orbit skin care habits. METHODS: A preflight questionnaire was given to the astronauts asking about their terrestrial skin care habits and skin conditions/atopy before launch. In addition, they were asked to fill out a postflight questionnaire asking about their on-orbit skin care routine and whether any special observations regarding the skin were made during flight. RESULTS: A total of 23 skin symptoms were recorded by 8 nonatopic astronauts (mean age: 41 years) during the mission. The symptoms were peeling (21.74%), rash (17.39%), dryness (13.04%), severe dryness (8.70%), reddening (8.70%), itchiness (8.70%), bruising (4.35%), skin sensitivity (4.34%), bumps (4.35%), acne (4.35%) and slow healing of contusions and lacerations (4.35%). Especially the hands and feet were affected by skin problems. As a result of this examination, it was shown that the skin symptoms correlate with poor hygiene on orbit, whereas the factor "environment" on the ISS plays a minor role. Surprisingly, 2 astronauts even experienced positive effects on their skin. CONCLUSION: Based on these preliminary data, it is important to pay more attention to skin hygiene and maintenance in space.

Current Data on Effects of Long-Term Missions on the International Space Station on Skin Physiological Parameters.

BACKGROUND: Skin reaction to spaceflight has not really been studied yet, although the skin has a very important barrier function to protect the body and can contribute to a more general understanding of physiology. It is proposed here to make a more thorough investigation of the skin during long-term spaceflight, using noninvasive techniques. AIMS: The aim of the present Skin-B study is to investigate the kinetics and range of possible skin modifications during long-duration spaceflights and their recovery. METHODS: In order to investigate the effect on skin physiological parameters during spaceflight, measurements were carried out on 6 astronauts with respect to skin hydration, transepidermal water loss/barrier function, and surface evaluation of the living skin in orbit. Additional measured parameters on the ground were skin elasticity, skin density and thickness, as well as microcirculation. RESULTS: Data from the Skin-B subjects (n = 6) contradict the results obtained in the previous pilot study SkinCare (n = 1 subject). In the present study, no deterioration of the skin was found but rather an improvement in skin hydration and skin barrier function, and no changes or improvement in the appearance of the skin surface. Furthermore, the skin density and skin thickness as well as skin elasticity values were unchanged from pre-flight values. CONCLUSION: In conclusion, we found that spaceflight under present conditions has no negative impact on skin physiological parameters.

Determination of the Influence of the Antiphlogistic Ingredients Panthenol and Bisabolol on the SPF Value in vivo.

BACKGROUND: Today, the sun protection factor (SPF) value of sunscreen products is determined in vivo with a standardized protocol (EN ISO 24444:2010), and the measured SPF biological end point is the visible skin erythema. However, many of the sunscreen products currently available on the market have antiphlogistic ingredients, which may potentially result in an overestimated SPF of the sunscreen. AIMS: To investigate the potential influence of the antiphlogistic ingredients panthenol and bisabolol in sunscreens on the determined SPF value in vivo. METHODS: Formulations with different concentrations of the antiphlogistic ingredients bisabolol or panthenol were tested. As a reference, a base formulation (vehicle) without antiphlogistic ingredients was used. First, the SPF of the sunscreen formulas with and without antiphlogistic ingredients was analyzed in vitro. To investigate whether the antiphlogistic ingredient may suppress the inflammatory response to ultraviolet (UV) irradiation, the SPF was determined in vivo. Finally, selected formulations were also analyzed in an erythema model for testing formulations on UV-induced inflammation. RESULTS: It could be confirmed that no differences between the formula with and that without the active antiphlogistic ingredients bisabolol or panthenol exist when measured in vitro. However, there was also no statistically significant difference in the erythemal response between the vehicle (without an antiphlogistic active ingredient) and the test formulations with different concentrations of the antiphlogistic active ingredients in the in vivo determination of the SPF. Evidence of anti-inflammatory activity of the sunscreen antiphlogistics bisabolol and panthenol was also not apparent in the UV model over a time course of 48 h. Conlusion: The antiphlogistic ingredients panthenol and bisabolol incorporated in the tested sunscreen formula do not interfere with erythema reddening and thus do not affect the SPF value in vivo.

Development of an in vitro Test Procedure to Determine the Direct Infrared A Protection of Sunscreens and Non-Cosmetic Samples.

BACKGROUND: Every day human skin is exposed to infrared A (IRA) radiation as part of the natural sun rays. As IRA radiation accounts for around one third of the solar radiation, it has gained great attention concerning its effects on the human body and skin. In the past few years it has been discussed controversially whether IRA radiation (of solar origin) is harmful or not. Nonetheless, there are several sunscreens on the German market that claim IRA protection for themselves. AIMS: The present study seeks to find an experimental set-up and a test procedure for the determination and quantification of direct IRA protection (realized via reflection or absorption of the IRA radiation), since to our knowledge these do not yet exist. METHODS: In this study we proved the usability of a set-up consisting of a light source, an IRA-transmissible filter system and a sensor unit, for the determination and quantification of the IRA protection of cosmetic and non-cosmetic samples. RESULTS/CONCLUSION: The applicability of the IRA emission of the light source, the spectral detector, transmissivity of the filter systems and the sample carriers could be validated. This experimental set-up can be used as an in vitro test procedure for the determination of direct IRA protection.

Effect of the multifunctional cosmetic ingredient sphinganine on hair loss in males and females with diffuse hair reduction.

Sphingolipids are well known to promote keratinocyte differentiation and to induce ceramide production. In addition, they show anti-inflammatory and antimicrobial activities. Thus, the aim of this study is to investigate the potential effect of sphinganine on prolonging the hair anagen rate and improving the overall hair quality and scalp health. The inhibitory potential of sphinganine toward 5-α-reductase was studied using an in vitro assay. The stimulation of the antimicrobial peptide HBD2 by sphinganine was measured by real-time polymerase chain reaction and immunostaining. Sphinganine bioavailability was studied ex vivo using a pig skin model. A placebo-controlled, double-blind study was designed to evaluate the efficacy of sphinganine on hair loss and hair/scalp quality in vivo. In vitro results showed that sphinganine is a potent inhibitor of 5-α-reductase type I that prevents the conversion of testosterone to dihydrotestosterone, a key factor of androgenetic male baldness. In vivo results demonstrated efficacy in reducing non-illness-related hair loss among males. In terms of expert rating, all hair quality and scalp parameters improved after application of sphinganine. Improved scalp health might be linked to the observed increase of the antimicrobial peptide HBD2. Thus, sphinganine is well suited as a topical alternative for the improvement of scalp health and hair quality and anti-hair loss application.

Sebusuppressive efficacy of the antioxidant bis-ethylhexyl hydroxydimethoxy benzylmalonate in the treatment of oily and blemished skin.

The aim of this study was to assess the effect of 2% bis-ethylhexyl hydroxydimethoxy benzylmalonate (HDBM; RonaCare(®) AP) as an active ingredient in the treatment of oily and blemished skin. This study was carried out as a randomized, placebo-controlled, single-blind study on 44 test subjects with blemished skin over a period of 8 weeks. Sebum measurement, skin inflammation/redness scoring by an expert, photographic documentation and a self-assessment with regard to skin improvement, and tests of skin compatibility and galenic characteristics were performed. Treatment with 2% HDBM resulted in a significant reduction of sebum excretion and showed efficacy against inflamed/red lesions also shown by photographic documentation. Efficacy and galenic performance of 2% HDBM were judged to be superior to the placebo emulsion. Additionally, 2% HDBM was well tolerated; approximately 80% of the test subjects rated the compatibility as good to very good.

Green tea polyphenols provide photoprotection, increase microcirculation, and modulate skin properties of women.

Dietary constituents including polyphenols and carotenoids contribute to endogenous photoprotection and modulate skin characteristics related to structure and function of the tissue. Animal and in-vitro studies indicate that green tea polyphenols affect skin properties. In a 12-wk, double-blind, placebo-controlled study, 60 female volunteers were randomized to an intervention or control group. Participants consumed either a beverage with green tea polyphenols providing 1402 mg total catechins/d or a control beverage. Skin photoprotection, structure, and function were measured at baseline (wk 0), wk 6, and wk 12. Following exposure of the skin areas to 1.25 minimal erythemal dose of radiation from a solar simulator, UV-induced erythema decreased significantly in the intervention group by 16 and 25% after 6 and 12 wk, respectively. Skin structural characteristics that were positively affected included elasticity, roughness, scaling, density, and water homeostasis. Intake of the green tea polyphenol beverage for 12 wk increased blood flow and oxygen delivery to the skin. Likewise, in a separate, randomized, double-blind, single-dose (0.5, 1.0, and 2.0 g) study of green tea polyphenols, blood flow was maximized at 30 min after ingestion. In summary, green tea polyphenols delivered in a beverage were shown to protect skin against harmful UV radiation and helped to improve overall skin quality of women.

Interlaboratory studies with a proposed patch test design to evaluate the irritation potential of surfactants.

BACKGROUND: Development of cosmetic products and household detergents necessitates comparative study designs to assess the skin tolerance of products. In initial tests, the epicutaneous patch test for irritation is widely used. OBJECTIVES: This study was conducted to develop a protocol that would facilitate a comparison of results obtained when tests are conducted by different laboratories. METHODS: 'In-house' and standardized patch test protocols were used to assess irritation potentials of surfactant-based products in intra- and interlaboratory studies using defined surfactant samples. RESULTS: The various in-house protocols tested did not consistently produce equivalent results. In order to develop a study design that yields comparable results, various factors were identified and adjusted. The standardized study protocol includes occlusive application of 70 microl of the test substance to the back of 30 subjects, defined reading times and schemes, assessments based mainly on erythema, and inclusion of sodium laureth sulfate and sodium dodecyl sulfate as positive controls as well as water as a negative control. CONCLUSIONS: Use of the standardized protocol and training of assessors improved the reliability and consistency of results whereby the irritation potentials of the references and test samples were ranked similarly by the laboratories.

Intervention with flaxseed and borage oil supplements modulates skin condition in women.

Ingestion of selected nutrients modulates dermal properties. In the present study, two groups of women ingested flaxseed or borage oil for 12 weeks. The control group received a placebo containing medium-chain fatty acids. Dose was 2.2 g total fatty acids/d with alpha-linolenic acid and linoleic acid as major constituents in the flaxseed oil group; in the borage oil group linoleic and gamma-linolenic acid were predominant. In the flaxseed oil group, the contribution of alpha-linolenic acid to total fatty acids in plasma was significantly increased on weeks 6 and 12, whereas there was an increase in gamma-linolenic acid in the borage oil group (P < 0.05). Skin irritation was performed by nicotinate treatment, and changes in skin reddening and blood flow were monitored. Compared to week 0, skin reddening was diminished in both groups; blood flow was also lowered. Skin hydration was significantly increased after 12 weeks of treatment compared to week 0, with flaxseed or borage oil (P < 0.05). Transepidermal water loss was decreased in both oil groups by about 10 % after 6 weeks of supplementation. A further decrease was determined after 12 weeks in the flaxseed oil group. Surface evaluation of living skin revealed that roughness and scaling of the skin were significantly decreased with flaxseed and borage oil comparing week 0 and week 12 (P < 0.05). Except for hydration, none of the parameters was affected in the placebo group. The present data provide evidence that skin properties can be modulated by an intervention with dietary lipids.

Absorption spectra of human skin in vivo in the ultraviolet wavelength range measured by optoacoustics.

Knowledge of the optical properties of human skin in the ultraviolet range is fundamental for photobiologic research. However, optical properties of human skin in the ultraviolet spectral range have so far mainly been measured ex vivo. We have determined the absorption spectra of human skin in vivo in the wavelength range from 290 to 341 nm in 3 nm steps using laser optoacoustics. In this technique, optical properties are derived from the pressure profile generated by absorbed light energy in the sample. In a study on 20 subjects belonging to phototypes I-IV, we studied the optical properties at the volar and dorsal aspect of the forearm as well as on the thenar. Analysis of the measured absorption spectra shows that comparable skin areas-like different sides of the forearm-have qualitatively similar optical characteristics. Still, the optical properties may vary substantially within the same area, probably due to the skin structure and inhomogeneities. Comparison of the spectra from different skin sites indicates that the spectral characteristics of the stratum corneum and its chromophores play an important role for the optical properties of human skin in vivo in the ultraviolet B range.

Wavelength-dependent penetration depths of ultraviolet radiation in human skin.

The wavelength-dependent penetration depth of ultraviolet radiation in human skin is a fundamental parameter for the estimation of the possible photobiological impact of ultraviolet (UV) radiation. We have determined the absorption spectra of human skin in vivo in the wavelength range from 290 to 341 nm in 3-nm steps using laser optoacoustics and calculated the respective penetration depths. Data were analyzed with respect to different skin regions and skin phototype of the 20 subjects in the study (phototype I: n=3; II: n=7; III: n=5; IV: n=5), revealing large variability between individuals. The penetration depth of UV radiation in human skin is highly dependent on wavelength and skin area, but no significant dependence on skin phototype could be found.

Effect of ultraviolet adaptation on the ultraviolet absorption spectra of human skin in vivo.

BACKGROUND: The absorption spectrum of human skin provides a basis for the estimation of the possible photobiological impact of ultraviolet (UV) radiation. The optical properties of human skin in the UV spectral range have so far mainly been measured ex vivo due to a lack of an appropriate in vivo technique and the change of optical properties during the course of adaptation to higher UV doses has hardly been addressed. METHODS: We have determined the absorption spectra of human skin in vivo in the wavelength range from 290 to 341 nm in 3 nm steps using laser optoacoustics. In this technique, optical properties are derived from the pressure profile generated by absorbed light energy in the sample. Spectra from the volar and dorsal aspects of the forearm of 20 subjects were compared, i.e. sites with native and various facultative pigmentation. RESULTS: UV adaptation shows as an increase in absorption coefficients over the entire measured UV range and especially in short-range UVB. Subject groups with high vs. low UV exposure can be discriminated by analyzing the difference absorption spectra between dorsal and volar aspects of the forearm. No dependence on the subject's phototype was seen in the degree of adaptation. CONCLUSION: The difference between native and facultative pigmentation may be explained by the absorption properties of the two prime chromophores responsible for adaptation to higher UV exposure: melanin and keratin. Stronger pigmentation, i.e. a higher melanin concentration, is found as an increase of absorption coefficients over the entire UVA-II/UVB range. The thickening of the horny layer and accordingly, a higher influence of keratin on the absorption spectra is prominent especially in the UVB region.

Consumption of flavanol-rich cocoa acutely increases microcirculation in human skin.

BACKGROUND: Long term cocoa ingestion leads to an increased resistance against UV-induced erythema and a lowered transepidermal water loss. AIM OF THE STUDY: To investigate the acute effects of a single dose of cocoa rich in flavanols on dermal microcirculation. METHODS: In a crossover design study, 10 healthy women ingested a cocoa drink (100 ml) with high (329 mg) or low (27 mg) content of flavanols. The major flavanol monomer in both drinks was epicatechin, 61 mg in the high flavanol, and 6.6 mg in the low flavanol product per 100 ml. Dermal blood flow and oxygen saturation of hemoglobin were examined by laser Doppler flowmetry and spectroscopically at 1 mm skin depth at t = 0, 1, 2, 4, and 6 h. At the same time points, plasma levels of total epicatechin (free compound plus conjugates) were measured by means of HPLC. RESULTS: Subsequent to the intake of high flavanol cocoa, dermal blood flow was significantly increased by 1.7-fold at t = 2 h and oxygen saturation was elevated 1.8-fold. No statistically significant changes were found upon intake of low flavanol cocoa. Maximum plasma levels of total epicatechin were observed 1 h after ingestion of the high flavanol cocoa drink, 11.6 +/- 7.4 nmol/l at baseline, and 62.9 +/- 35.8 nmol/l at 1 h. No change of total epicatechin was found in the low flavanol group. CONCLUSION: Flavanol-rich cocoa consumption acutely increases dermal blood flow and oxygen saturation.

Long-term ingestion of high flavanol cocoa provides photoprotection against UV-induced erythema and improves skin condition in women.

Dietary antioxidants contribute to endogenous photoprotection and are important for the maintenance of skin health. In the present study, 2 groups of women consumed either a high flavanol (326 mg/d) or low flavanol (27 mg/d) cocoa powder dissolved in 100 mL water for 12 wk. Epicatechin (61 mg/d) and catechin (20 mg/d) were the major flavanol monomers in the high flavanol drink, whereas the low flavanol drink contained 6.6 mg epicatechin and 1.6 mg catechin as the daily dose. Photoprotection and indicators of skin condition were assayed before and during the intervention. Following exposure of selected skin areas to 1.25 x minimal erythemal dose (MED) of radiation from a solar simulator, UV-induced erythema was significantly decreased in the high flavanol group, by 15 and 25%, after 6 and 12 wk of treatment, respectively, whereas no change occurred in the low flavanol group. The ingestion of high flavanol cocoa led to increases in blood flow of cutaneous and subcutaneous tissues, and to increases in skin density and skin hydration. Skin thickness was elevated from 1.11 +/- 0.11 mm at wk 0 to 1.24 +/- 0.13 mm at wk 12; transepidermal water loss was diminished from 8.7 +/- 3.7 to 6.3 +/- 2.2 g/(h x m2) within the same time frame. Neither of these variables was affected in the low flavanol cocoa group. Evaluation of the skin surface showed a significant decrease of skin roughness and scaling in the high flavanol cocoa group compared with those at wk 12. Dietary flavanols from cocoa contribute to endogenous photoprotection, improve dermal blood circulation, and affect cosmetically relevant skin surface and hydration variables.

Lycopene-rich products and dietary photoprotection.

Plant constituents such as carotenoids and flavonoids are involved in the light-protecting system in plants and contribute to the prevention of UV damage in humans. As micronutrients they are ingested with the diet and are distributed into light-exposed tissues where they provide systemic photoprotection. beta-Carotene is an endogenous photoprotector, and its efficacy to prevent UV-induced erythema formation has been demonstrated in intervention studies. Lycopene is the major carotenoid of the tomato and is a very efficient singlet oxygen quencher in the group of carotenoids. Following ingestion of lycopene or tomato-derived products rich in lycopene, photoprotective effects have been demonstrated. After 10-12 weeks of intervention a decrease in the sensitivity towards UV-induced erythema was observed in volunteers. Dietary carotenoids may contribute to life-long protection against harmful UV radiation.

Supplementation with tomato-based products increases lycopene, phytofluene, and phytoene levels in human serum and protects against UV-light-induced erythema.

Carotenoids are suitable photoprotectants, and beta-carotene supplements are used for protection against ultraviolet (UV) light-induced erythema. Protective effects are also observed when carotenoids are provided with the diet. Here, we investigated the photoprotective effects of synthetic lycopene in comparison with a tomato extract (Lyc-o-Mato) and a drink containing solubilized Lyc-o-Mato (Lyc-o-Guard-Drink). With these different sources, the volunteers ingested similar amounts of lycopene (about 10 mg/day). After 12 weeks of supplementation, significant increases in lycopene serum levels and total skin carotenoids were observed in all groups. Significant increases in the serum levels of phytofluene and phytoene occurred in the Lyc-o-Mato and the Lyc-o-Guard-Drink group. At weeks 0, 4, and 12 an erythema was induced with a solar light simulator. Dorsal skin of each subject was irradiated with 1.25 minimal erythemal dose (MED). Reddening of the skin was evaluated before and 24 hours after irradiation by chromametry and expressed as positive a-values (red/green-axis). delta a-values (difference of a-value before irradiation and after 24 hours) were used as an index of erythema intensity. A decrease in the delta a-value from week 0 to week 12, indicating prevention of erythema formation, was observed in all groups. Compared to week 0, the delta a-value at week 12 was 25% lower in the synthetic lycopene group. The protective effect was more pronounced in the Lyc-o-Mato (38%) and Lyc-o-Guard-Drink (48%) groups. In the two latter groups, phytofluene and phytoene may have contributed to protection. Both of these carotenoids exhibit absorption maxima at wavelengths of UV light. Absorption of UV light protects skin from photodamage and might explain the differences observed between groups.