Artificial intelligence model substantially improves stratum corneum moisture content prediction from visible-light skin images and skin feature factors.

BACKGROUND: Appropriate skin treatment and care warrants an accurate prediction of skin moisture. However, current diagnostic tools are costly and time-consuming. Stratum corneum moisture content has been measured with moisture content meters or from a near-infrared image. OBJECTIVE: Here, we establish an artificial intelligence (AI) alternative for conventional skin moisture content measurements. METHODS: Skin feature factors positively or negatively correlated with the skin moisture content were created and selected by using the PolynomialFeatures(3) of scikit-learn. Then, an integrated AI model using, as inputs, a visible-light skin image and the skin feature factors were trained with 914 skin images, the corresponding skin feature factors, and the corresponding skin moisture contents. RESULTS: A regression-type AI model using only a visible-light skin-containing image was insufficiently implemented. To improve the accuracy of the prediction of skin moisture content, we searched for new features through feature engineering ("creation of new factors") correlated with the moisture content from various combinations of the existing skin features, and have found that factors created by combining the brown spot count, the pore count, and/or the visually assessed skin roughness give significant correlation coefficients. Then, an integrated AI deep-learning model using a visible-light skin image and these factors resulted in significantly improved skin moisture content prediction. CONCLUSION: Skin moisture content interacts with the brown spot count, the pore count, and/or the visually assessed skin roughness so that better inference of stratum corneum moisture content can be provided using a common visible-light skin photo image and skin feature factors.

Transepidermal water loss and stratum corneum hydration in forearm versus hand palm.

BACKGROUND: Skin measurements of transepidermal water loss (TEWL) and stratum corneum hydration (SCH) reflect different aspects of skin physiology. Since epidermal water loss depends on epidermal-to-air water vapor gradients, a possible quantitative relationship between TEWL and SCH may exist. This investigation's purpose was to test the possible TEWL-SCH relationship. MATERIALS AND METHODS: SCH and TEWL were measured noninvasively on forearm and palmer thenar eminence (hand) in 40 young adults (20 males) along with total body fat percentage (FAT) via bioimpedance. RESULTS: A significant positive nonlinear correlation (p < 0.001) was detected between SCH and TEWL in hands of the male cohort that occurred when SCH exceeded a threshold level. This threshold level was not exceeded in male or female forearms and forearms did not display a SCH-TEWL correlation. There was a weak inverse dependence of TEWL on FAT on both forearm and hand (p < 0.05), but no SCH-FAT relationship was observed. TEWL values on the forearm and hand were moderately correlated with each other (p = 0.002) but SCH values were not. CONCLUSION: The findings clarify the relationship between forearm and palmer hydration and TEWL values, and their relationship to total body fat percentages in young healthy adults. The significant correlation between palmer stratum corneum hydration and palmer TEWL that was discovered in the male but not the female cohort suggests a threshold hydration level for which TEWL depends both on skin barrier function and stratum corneum hydration. This implies that conditions with increased SCH may in part account for elevated TEWL values.

The Protective Effects of Moisturizer Containing Potentilla anserina Extract in the Topical Treatment of Skin Damage Caused by Masks.

The use of face masks during the COVID-19 pandemic resulted in significant societal changes, particularly for individuals with sensitive skin. To address this issue, the researchers explored traditional medicine and identified Potentilla anserina extract as a potential solution due to its anti-inflammatory and moisturizing effects. This research investigated how this extract influences skin hydration, barrier function, and itching. The findings revealed that the extract had a hydrating effect by elevating Aquaporin-3 (AQP3) expression. Additionally, the study demonstrated that the extract improved skin barrier function, with Filaggrin (FLG) expression being approximately three times higher (p < 0.001) in the Potentilla-anserina-extract-treated group compared to the control group and the genes associated with itching being reduced. In this process, we researched and developed HPßCD (hydroxypropyl-ß-cyclodextrin)-Liposome containing Potentilla anserina extract, gradually and sustainably releasing the active components of the Potentilla anserina extract. During four weeks of clinical trials involving individuals wearing masks for over 6 h a day, a moisturizer containing Potentilla anserina extract demonstrated a notable reduction in skin redness. Hemoglobin values (A.U.), which serve as indicators of skin redness, showed decreases of 5.06% and 6.74% in the test area inside the mask after 2 and 4 weeks, respectively, compared to the baseline measurements. Additionally, the moisturizer containing Potentilla anserina extract notably decreased Trans Epidermal Water Loss (TEWL), with reductions of 5.23% and 9.13% observed in the test area inside the mask after 2 and 4 weeks, respectively. The moisturizer, especially in the test area treated with the extract-containing moisturizer, significantly enhanced skin hydration compared to the control group. The Corneometer values (A.U) exhibited notable increases of 11.51% and 15.14% in the test area inside the mask after 2 and 4 weeks, respectively. These discoveries emphasize the potential of Potentilla anserina extract and its utility in tackling skin issues caused by mask wearing, including enhancing moisture, fortifying the skin's barrier, and alleviating itching. These results indicate that moisturizers incorporating specific ingredients provide greater benefits compared to conventional moisturizers.

Investigating the effect of the pH of foot care product formulations on pedal skin in diabetic and non-diabetic subjects.

OBJECTIVE: The use of skin care formulations with acidic pHs is seen as an effective method to maintain the acidic mantel of the skin; however, because the skin pH varies depending on the area of the body and as data are lacking for the skin pH of the feet, there was a need to examine whether this assumption holds true for skin care formulations designed for the foot. Thus, three foot creams formulated with a neutral, acidic or alkaline pH were compared with each other as well as to an untreated control group in order to analyse their impact on skin pH, hydration and general skin condition. METHODS: An exploratory clinical investigation with 60 enrolled subjects, half of whom had a diagnosis of diabetes (type 1 or type 2), was undertaken. The investigation followed a randomized, double-blind, balanced incomplete block design (BIBD) including intra-individual comparison (before and after treatment). Evaluations of skin pH and hydration were carried out using a pH meter and a Corneometer respectively. Objective evaluation of skin condition for efficacy assessment was performed by a trained grader. For tolerability evaluation, objective and subjective dermatological assessments were performed. RESULTS: At the end of the treatment period, the skin pH was largely unchanged at five out of six of the test areas, with the mean value for each treatment group using test products showing similar fluctuations as the untreated control group. Furthermore, the skin condition parameters studied all improved by a comparable magnitude for each of the treatment groups using the test products, whereas the untreated control group experienced a worsening of the skin condition parameters. CONCLUSIONS: The results of this investigation suggest that where the skin of the foot is concerned, the pH of skin care formulations has no (physiologically) relevant influence on the skin's pH in either diabetic or non-diabetic subjects. Furthermore, the expectation that acidic formulations would be more beneficial for the skin's condition was not found to hold true for the skin of the foot, as no significant difference was observed between the performance of the three test products investigated in this study.

OBJECTIF: L'utilisation de formulations de soins cutanés à pH acide est considérée comme une méthode efficace pour préserver le manteau acide de la peau. Cependant, comme le pH de la peau varie en fonction de la zone corporelle et comme les données manquent concernant le pH de la peau des pieds, il était nécessaire d'examiner si cette hypothèse est vraie pour les formulations de soins cutanés conçues pour le pied. Ainsi, 3 crèmes pour les pieds à pH neutre, acide ou alcalin ont été comparées entre elles, ainsi qu'à un groupe témoin non traité, afin d'analyser leur impact sur le pH de la peau, l'hydratation et l'état général de la peau. MÉTHODES: Une étude clinique exploratoire a été menée sur 60 sujets inclus, dont la moitié avait reçu un diagnostic de diabète (de type 1 ou de type 2). L'étude a suivi une conception randomisée, en double aveugle, en blocs incomplets équilibrés (balanced incomplete block design, BIBD), comprenant une comparaison intra-individuelle (avant et après le traitement). Les évaluations du pH de la peau et de l'hydratation ont été réalisées à l'aide d'un pH-mètre et d'un cornéomètre, respectivement. Une évaluation objective de l'état de la peau a été réalisée par un évaluateur formé en ce qui concerne l'évaluation de l'efficacité. Pour l'évaluation de la tolérance, des évaluations dermatologiques objectives et subjectives ont été réalisées. RÉSULTATS: À la fin de la période de traitement, le pH de la peau était en grande partie inchangé dans 5 des 6 zones de test, la valeur moyenne pour chaque groupe de traitement utilisant des produits testés montrant des fluctuations similaires à celles du groupe témoin non traité. En outre, les paramètres de l'état de la peau étudiés se sont tous améliorés dans une mesure comparable pour chacun des groupes de traitement utilisant les produits à l'étude, tandis que le groupe témoin non traité a présenté une aggravation des paramètres de l'état de la peau. CONCLUSIONS: Les résultats de cette étude indiquent qu'en ce qui concerne la peau du pied, le pH des formulations de soins de la peau n'a pas d'influence (physiologiquement) pertinente sur le pH de la peau chez les sujets diabétiques ou non diabétiques. En outre, l'attente selon laquelle des formulations acides seraient plus bénéfiques pour l'état de la peau n'a pas été confirmée pour la peau du pied, car aucune différence significative n'a été observée entre les performances des 3 produits testés étudiés dans cette étude.

The effects of wearing a face mask and of subsequent moisturizer use on the characteristics of sensitive skin.

BACKGROUND: COVID-19 is a serious respiratory disease, and wearing masks has become essential in daily life. Nevertheless, the number of people complaining of skin problems caused by wearing masks is increasing. Therefore, we investigated the characteristics of changes in sensitive skin caused by wearing a mask. MATERIALS AND METHODS: Twenty healthy Korean women with sensitive skin participated in this study. To determine any skin-related changes caused by mask-wearing, we evaluated redness, hydration, transepidermal water loss (TEWL), and moisture at 2.5 mm below the surface before and 4 h after wearing a Korea Filter 94 mask. In addition, we tested whether applying a moisturizer for 30 min after mask removal could reverse any mask-induced changes. RESULTS: Skin redness and TEWL were significantly increased at 4 h after wearing a mask (p < 0.05), otherwise skin hydration and the 2.5 mm moisture were significantly decreased (p < 0.05). After applying the moisturizer, skin redness and TEWL were significantly decreased compared to their values 4 h after wearing masks (p < 0.05), whereas skin hydration and the 2.5 mm moisture were significantly increased (p < 0.05). Moreover, after applying the moisturizer, skin redness and TEWL were significantly reduced compared to the pre-masking baseline (p < 0.05), whereas skin hydration was significantly increased (p < 0.05); the 2.5 mm moisture showed no significant change. CONCLUSION: We observed that wearing masks causes physiological changes in sensitive skin, whereas applying a moisturizer after removing the mask improved skin conditions.

Capacitance and transepidermal water loss after soaking in water for different durations: A pilot study.

BACKGROUND: There is a scarcity of data on the effects of duration of bathing and cutaneous properties. AIMS: This study aimed to investigate the changes of capacitance and transepidermal water loss (TEWL) after soaking in water for the different durations. METHOD: This experimental biophysical study included healthy volunteers whose forearms were randomized to receive 3, 5, 10, 15, or 20 min of soaking of the volar aspect of the forearm. Skin hydration and integrity were assessed capacitance and TEWL measurement before and after soaking. RESULTS: Sixty-five subjects (130 forearms) were enrolled with an average age of 33 ± 10.8 years. The change in capacitance after soaking for durations of 3, 5, 10, 15, and 20 min was 41.54 ± 14.57, 47.13 ± 11.80, 40.25 ± 14.95, 40.48 ± 14.19, and 39.97 ± 9.47 AU, respectively. The highest capacitance was observed after soaking for 5 min; however, there was no significant correlation between bathing duration and capacitance (p = 0.256). The capacitance measured immediately after soaking was at the uppermost level, but it rapidly decreased within 5 min. The change in TEWL after soaking for durations of 3, 5, 10, 15, and 20 min was 30.27 ± 9.74, 30.57 ± 7.45, 33.78 ± 9.25, 33.44 ± 7.24, and 35.13 ± 9.37 g/m2 /h, respectively. There was also no significant correlation between duration of soaking and TEWL (p = 0.191); however, TEWL tended to increase with longer soaking duration. LIMITATIONS: This study had a small sample size and measured only capacitance and TEWL. Future studies with more subjects, and that measure other physiologic parameters may further improve our understanding of the effect of bathing on skin. CONCLUSIONS: There was no significant correlation between bathing duration and cutaneous properties including capacitance and TEWL. However, a 5-min soaking provided the highest skin hydration for healthy skin.

Omega-3 Fatty Acids Improve Chronic Kidney Disease-Associated Pruritus and Inflammation.

Background and Objectives: Chronic kidney disease-associated pruritus (CKD-aP) is a common symptom in hemodialysis patients. A frequent and intense itching sensation largely torments patients, impacts quality of life outcomes, and it has an independent association with mortality. The objective of this study is to investigate the effects of oral supplementation with omega-3 polyunsaturated fatty acid (omega-3 PUFA) on circulating interleukin-6 (IL-6), cardiometabolic parameters, skin moisturization, and the consequent symptoms of pruritus in hemodialysis patients. Materials and Methods: Volunteers on maintenance hemodialysis with very severe pruritus symptoms were enrolled in this prospective cohort study. Subjects were instructed to consume 1000 mg fish oil once daily for 3 months. Pruritus scoring, skin moisture, plasma IL-6, and cardiometabolic parameters were measured at baseline, and at the first, second, and third month post-supplementation with fish oil for assessment of the clinical significance. Results: A total of 27 patients who had a mean age of 67.33 ± 11.06 years and 3.98 ± 3.23 years on hemodialysis completed the study. Supplementation with omega-3 PUFA significantly decreased IL-6 levels (p < 0.001), but increased the levels of c-reactive protein (CRP) (p < 0.05). Evaluation of the cardiovascular risk showed significant (all p < 0.001) decreases in the total cholesterol (CHO), low-density lipoprotein (LDL), and triglycerides (TG) levels, and an increase in the high-density lipoprotein (HDL) level. A significant decrease in plasma creatinine (CR) was observed (p < 0.001), but the decrease was limited. Supplementation with omega-3 PUFA significantly improved (all p < 0.001) skin hydration on both the face and arms, as well as disease-related symptoms of pruritus. Conclusion: Omega-3 PUFA supplementation improved inflammation, renal function, cardiovascular parameters, dry skin conditions, and the consequent symptoms of pruritus in hemodialysis patients.

Oral Supplementation of Collagen Peptides Improves Skin Hydration by Increasing the Natural Moisturizing Factor Content in the Stratum Corneum: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.

INTRODUCTION: We aimed to investigate the effect of orally ingested collagen peptides (CPs) on skin condition and elucidate their mechanism of action. METHODS: A randomized, placebo-controlled, double-blind trial was conducted in 99 healthy Japanese women, aged 35-50 years. The subjects were randomized into 3 groups (33 subjects/group) to receive 1 or 5 g of CP or placebo once daily for 12 weeks. Skin water content, transepidermal water loss (TEWL), skin elasticity, and skin thickness were evaluated before treatment and after 4, 8, and 12 weeks of treatment. The level of natural moisturizing factor (NMF) constituents in the stratum corneum (SC) was quantified before treatment and after 12 weeks of treatment. RESULTS: Oral ingestion of CP increased the water content in the SC and epidermis and decreased TEWL. Furthermore, the NMF level in the SC was increased. However, skin elasticity and skin thickness remained unchanged. CONCLUSIONS: The improvement in skin water content following the oral ingestion of CP can be attributed to an increase in the level of NMF in the SC. TRIAL REGISTRATION: UMIN000030375 (retrospectively registered).

The assessment of skin sebum and moisture content of infants with atopic dermatitis

Background/aim: Atopic dermatitis (AD) is a chronic, inflammatory skin disorder characterized by dry skin, pruritus and eczematous lesions. The aim of this study is to evaluate the skin moisture and sebum content of the infants with AD and its relationship between the disease severity. Materials and methods: For this cross-sectional and case-control study we included 49 infants with AD aged between 2 and 24 months and 34 healthy infants with the same age and sex as a control group. Skin moisture and sebum content were measured by the bio- impedance method and recorded. Skin prick tests, total IgE levels and food-specific (milk, egg) IgE levels were performed. Results: There was a significant difference between the groups in terms of mean skin moisture and sebum content percentage (P < 0.001, both). The mean skin moisture and sebum content were correlated with CRP in patients with AD (P < 0.01, r = ­1.00, both), but we did not find any correlation between these parameters with the disease severity. Conclusion: We found that skin moisture and sebum content were low even in unaffected areas in AD. The skin structure of these patients may contribute to the pathogenesis of the disease.

Analysis of the Effect of Serum Estradiol Concentration on Facial Skin Moisture, Pore Width, Discoloration and Smoothness in 16- to 50-Year-Old Women at the 5th and 25th Days of the Menstrual Cycle.

BACKGROUND/AIMS: Analysis of the relationship between the estradiol blood concentration and the skin moisture, pore width, discoloration and smoothness in differently aged women on the 5th and 25th days of the menstrual cycle. METHODS: The study involved 57 women divided into 4 age groups. Measurements of skin moisture, pore width, discoloration and smoothness were performed using the Aramo SG Aram Huvis device. The estradiol serum concentration was determined by radioimmunoassay. RESULTS: In the luteal phase of the cycle, facial skin moisture increases from 93.5% of the correct standard moisture index in the youngest to 115.5% in the oldest group. A positive correlation (r2 = 0.45) between estradiol concentration and skin moisture was observed on the 5th day of the cycle in 40- to 50-year-olds. For women on the 25th day of the menstruation cycle, estrogen concentration below the normal range was more beneficial for skin smoothness and pore width for the oldest group. The difference was not statistically significant (p > 0.05); how-ever, in the 40- to 50-year age group, skin smoothness was much better (43.5 ± 6.7%) for low estradiol while it was 37.5 ± 4.7% in the 20- to 29-year age group. Similarly, in the 40- to 50-year age group, skin pore width was much smaller (35.2 ± 15.7%) for low estradiol while it was 54.3 ± 28.8% in the 20- to 29-year age group. CONCLUSIONS: Skin moisture was related to the concentration of estradiol only in the oldest examined group of women regardless of the phase of menstrual cycle. In the 40- to 50-year-old group of women, the low level of estradiol on the 25th day of the cycle is better used to maintain a good facial skin appearance and has a positive influence not only on skin moisture, but also on pore width and skin smoothness.

Medical compression stockings on the skin moisture in patients with chronic venous disease.

Background: Because of side effects like skin dryness and consecutive symptoms like itching the therapy of chronic venous insufficiency (CVI) with medical compression stockings (MCS) can lead to a diminished wear comfort and restricted compliance. Compression stockings with integrated skin care may have a positive influence on the skin hydration and moreover a positive effect on patients compliance. Patients and methods: In this monocentric, randomized prospective, controlled trial a below knee conventional MCS was compared to a medical compression stocking with integrated skin care (MCS-SC), interface pressure range 23-32 mmHg. Participants: 50 patients with CVI. Primary outcome: skin hydration. Secondary outcomes: transepidermal water loss, skin roughness, leg volume, interface pressure and questionnaires about quality of life and wear comfort. Results: In patients wearing MCS the skin moisture decreased (p = 0.021) and the skin roughness increased significantly (p = 0.001), whereas in patients wearing the MCS-SC skin moisture and skin roughness changed only slightly (n.s.). These protective effects of MCS-SC compared to MCS were most common in patients with CVI at stage 3 (p = 0.046), in male patients (p = 0.013) and patients with initial dry skin (p = 0.034). Both MCS reduced lower leg volume, MCS by 80 ml (p < 0.001) and MCS-SC by 60 ml (p < 0.001), both MCS improved quality of life: leg complaints (p = 0.0003); functional status (p = 0.010), well-being and life satisfaction (p = 0.030). Wear comfort: In terms of tightness, constriction in bond area and strenuous donning the MCS-SC was assessed significantly more comfortable than MCS (p < 0.001). Conclusions: MCS-SC revealed to be superior to MCS with regard to skin moisture, particularly in patients with low skin humidity, in male patients and in patients with C3, varicose veins accompanied by edema.

Assessment of changes of skin moisture in patients subject to general anesthesia with neurological diseases in an interview.

OBJECTIVE: Introduction: General anaesthesia is carried out using anaesthetic agents that among others depress the circulatory system and CNS. Central and peripheral thermoregulation occurs, which is due to mild hypothermia as well as changes in skin moisture. An important element of therapy in the perioperative period is adequate intravenous fluid therapy, which affects the final effects of treatment. The aim: Evaluation of skin moisture as a result of changes in central and peripheral thermoregulation during general anaesthesia and evaluation of the hydration status of patients. PATIENTS AND METHODS: Material and methods: The study included 180 patients undergoing general anaesthesia for elective surgery, aged 20-85 years of age. Before general anaesthesia, patients were evaluated for ASA-related risk of anaesthesia (ASA 1 - healthy patients, ASA 2 and 3 - patients with neurological and circulatory disorders). Patients were divided into 2 groups, the study group (90 people) were patients who were given no intravenous fluids before the surgery and the control group (90 patients) were those receiving doses of 500 ml crystalline intravenously one hour before anaesthesia. The research was carried out at the Operational Block of the Provincial Hospital in Tarnobrzeg, from November 2013 to November 2014. Skin moisture was measured using a CM 825 Corneometer: before general anaesthesia, after induction for anaesthesia, 15 min after surgical incision of the skin and after awakening the patient. RESULTS: Results: Both in the test and control groups, statistically significant differences were found in subsequent skin moisture measurements. Pairwise comparisons indicate statistically significant differences between each pair of measurements. In both groups of patients, there is a clear decrease in skin moisture after induction of anaesthesia compared to the measurement performed before general anaesthesia. The skin moisture values are reduced in subsequent measurements, however the difference is much lower. CONCLUSION: Conclusions: 1 Measurement of skin moisture can be used as one of the parameters to assess perioperative stress and changes in body temperature during general anaesthesia, which indirectly determines the functioning of the hypothalamus. 2 By measuring the skin moisture it is possible to indirectly assess the hydration status of patients as well as the decrease of the metabolism during general anaesthesia. 3 The decrease in skin moisture during general anaesthesia is the effect of changes in central and peripheral thermoregulation.

Innovative Natural Ingredients-Based Multiple Emulsions: The Effect on Human Skin Moisture, Sebum Content, Pore Size and Pigmentation.

The increased interest in natural cosmetics has resulted in a higher market demand for preservative-free products based on herbal ingredients. An innovative W/O/W type emulsions containing herbal extracts were prepared directly; its cation form was induced by an ethanolic rosemary extract and stabilized using weak herbal gels. Due to the wide phytochemical composition of herbal extracts and the presence of alcohol in the emulsion system, which can cause skin irritation, sensitization or dryness when applied topically, the safety of the investigated drug delivery system is necessary. The aim of our study was to estimate the potential of W/O/W emulsions based on natural ingredients for skin irritation and phototoxicity using reconstructed 3D epidermis models in vitro and to evaluate in vivo its effect on human skin moisture, sebum content and pigmentation by biomedical examination using a dermatoscopic camera and corneometer. According to the results obtained after in vitro cell viability test the investigated emulsion was neither irritant nor phototoxic to human skin keratinocytes. W/O/W emulsion did not cause skin dryness in vivo, despite the fact that it contained ethanol. We can conclude that the emulsion is safe for use as a leave-on product due to the positive effect on human skin characteristics or as a semisolid pharmaceutical base where active compounds could be encapsulated.

Identifying, managing and preventing skin maceration: a rapid review of the clinical evidence.

OBJECTIVE: To identify the clinical empirical evidence for identifying, managing and preventing skin maceration in human subjects. METHOD: A rapid review of the current literature was undertaken between 5 September and 19 September 2016 using the electronic databases CINAHL, MEDLINE, PUBMED and Cochrane, with the key words: skin macerat*, wound macerat*, moisture associated skin damage, wound exudate and hyper-hydration of skin, Results: Of 526 papers found using an electronic database search, four were identified as fitting the search parameters, and a further two were retrieved from a manual search of reference lists. There were three themes that emerged: how to identify and measure maceration, how to manage and reduce maceration once it has already occurred, and how to prevent skin maceration. Hyper-hydration can reach greater skin depths than previously thought, thus engendering more extensive damage potential, which in turn can impact on treatments and healing time. Realistically, the deeper the hyper-hydration issue, the more extensive the damage and it will take longer to recover-a problem compounded if the hyper-hydration is due to incontinence and skin is also exposed to urine and/or faeces. In relation to wound management, the authors advocate the removal of moisture away from the wound or skin, either through superabsorbent dressings, or by allowing the excess moisture to evaporate through semi-permeable dressings to reduce maceration, enhance patient comfort and encourage healing. However, we found no evidence regarding the limits of hydration of the dermis and epidermis and thereby the optimal conditions for managing exuding wounds and promoting skin health. Each of the six papers in this review calls for further research to help identify, treat and prevent maceration. CONCLUSION: Maceration causes patients' discomfort and pain as well as prolonging healing time and deserves more focused research. This rapid review highlights how limited the clinical empirical research is on identifying and managing skin maceration from an early stage so that health professionals may be better equipped to prevent it. Further clinical research is also needed to determine when levels of hydration in the skin become damaging. The small number of studies within this review show that skin maceration can be avoided, but clearer guidance is needed.

Effect of micro mist sauna bathing on thermoregulatory and circulatory functions and thermal sensation in humans.

To examine the effects of micro mist sauna bathing, produced by water crushing method, we exposed ten male subjects to five cases of micro mist sauna, namely (1) room temperature (RT) 38 °C with 100 % (actually 91 %) relative humidity (RH), (2) RT 41.5 °C with 80 % (actually 81 %) RH, (3) RT 41.5 °C with 100 % (actually 96 %) RH, (4) RT 45.0 °C with 64 % (actually 61 %) RH, and (5) RT 45.0 °C with 100 % (actually 86 %) RH, and measured tympanic temperature, mean skin temperature, heart rate (HR), and cheek moisture content, as well as ratings of thermal and sweating sensation tympanic temperatures at RT 45 °C were significantly higher at 86 % RH than those at 61 % RH; however, those at RT 45 °C with 61 % RH were higher than those with 86 % RH during recovery. There were no significant differences at RT 41.5 °C between with 81 % RH and with 96 % RH. Mean skin temperature was the highest at RT 45 °C 86 % RH case, followed by at RT 41.5 °C 96 % RH, RT 45 °C 61 % RH, RT 41.5 °C 81 % RH, and finally at RT 38 °C 91 % RH. HR change showed the same order as for mean skin temperature. A significant difference in cheek moisture content was observed between RT 41.5 °C with 81 % RH and RT 45 °C with 86 % RH 10 min after the micro mist bathing. There were no significant differences between ratings of thermal sensation at RT 41.5 °C with 81 % RH and at RT 45 °C with 61 % RH and RT 45 °C with 61 % RH and RT 45 °C with 86 % RH. Between RT 45 °C with 86 % RH and RT 41.5 °C with 81 % RH, there was a tendency for interaction (0.05 < p < 0.1). Other cases showed significant higher ratings of thermal sensation at higher room temperature or higher relative humidity. The ratings of sweating sensation 10 min after the mist sauna bathing were significantly higher at higher RT and RH except between RT 41.5 °C 96 % RH and RT 45 °C 86 % RH which exhibited no significant difference. We concluded that the micro mist sauna produced by water crushing method induced more moderate and effective thermal effect during micro mist sauna bathing than the conventional mist sauna bathing. In addition, micro mist sauna is as effective for heating the human subjects as bathtub bathing as well as more moderate thermal and sweating sensations.

Microclimate and development of pressure ulcers and superficial skin changes.

This study aims to evaluate the microclimate and development of pressure ulcers and superficial skin changes. A prospective cohort study was conducted in an acute care ward in Indonesia. Risk factors for pressure ulcers and superficial skin changes were identified based on the Bergstrom Braden conceptual model. Microclimate data were collected every 3 days for 15 days while the development of pressure ulcers and superficial skin changes was observed every day. Pressure ulcers and superficial skin changes were developed in 20 of the 71 participants. Total mean difference in skin temperature was higher for patients with pressure ulcers and superficial skin changes (0·9 ± 0·6°C) compared with controls (0·6 ± 0·8°C) (P = 0·071). Binary logistic regression predictor values for pressure ulcers and superficial skin changes were 0·111 for type of sheet and 0·347 for Braden Scale results. In conclusion, difference in skin temperature seems to be a predictor for pressure ulcer development and superficial skin changes, while synthetic fibre sheets are able to maintain a beneficial microclimate.

Ingestion of hyaluronans (molecular weights 800 k and 300 k) improves dry skin conditions: a randomized, double blind, controlled study.

Hyaluronan (HA) has been increasingly used as a dietary supplement to improve the skin. However, the effect of ingested HA may depend on its molecular weight (MW) because its physiological activities in the body vary with its MW. In this study, we examined the effects of ingested HA with varying MW on the skin. In this randomized, double blind, placebo controlled study, 61 subjects with dry skin received oral HA (120 mg/day), of MWs 800 k and 300 k or placebo, for 6 weeks. The skin moisture contents of the first two groups increased more than those of the placebo group during the ingestion period. In addition, group HA 300 k exhibited significant improvements in skin moisture content 2 weeks after ingestion ended compared with the placebo group. A questionnaire survey about subjective facial aging symptoms showed that the HA treated groups exhibited significantly improved the skin condition compared with the placebo treated group. Furthermore, dermatologists objectively evaluated the clinical symptoms of the facial and whole body skin, showing that no adverse events were related to daily ingestion of HA. This study shows that both of ingesting HAs (MWs 800 k and 300 k) improved the skin condition by increasing the moisture content.

Evaluation of the effect of several moisturizing creams using the low frequency electrical susceptance approach.

Moisturizers are cosmetic compounds designed to increase the moisture content of the skin. There are many types of these products in the market making it difficult for consumers to select the most effective moisturizer according to their age and gender. Hence, the aim of this study was to evaluate the effects of different moisturizers on skin hydration as well as to figure out any dependencies of the effects of these products on age or gender-related differences. We investigated the short-term moisturizing effects of five different skin moisturizers on 60 participants by using a low frequency electrical instrument. Skin surface susceptance was recorded and compared before and after the application of moisturizers. Statistically significant differences were observed in the moisturizing effect among different types of products. However, with respect to gender and age differences, there were insignificant differences in the effects of the moisturizers. Results of this study suggest that some types of moisturizers that exist in the markets are not as effective as required, which calls for a further evaluation of the moisturizers before entering markets and offering them for sale. In addition, findings suggest that gender or age differences are perhaps not important to consider in the application of moisturizers.

The Skin Sebum and Moisture Levels of Children with Allergic Diseases: How Predictive Are They for House Dust Mite Allergy?

The aim was to evaluate the prediction of house dust mite allergy in children diagnosed with allergic disease based on their skin moisture and sebum levels. This is a case-control study including children with asthma, allergic rhinitis (AR), and atopic dermatitis (AD) and a healthy control group. The participants' skin moisture and sebum levels were measured non-invasively using a digital device. A total of 421 patients and 143 healthy children were included. The median value of skin moisture percentage was statistically significantly lower in asthma, AR, and AD patients compared to the control group (p < 0.001 for each). The median value of skin sebum percentage was significantly lower in asthma and AD patients compared to the control group (p = 0.002 and p = 0.003, respectively). ROC analysis was performed to assess the predictive value of skin moisture percentage for house dust mite allergy in respiratory allergic diseases (asthma and AR) and AD separately. Using a cut-off point of 35.5% for skin moisture in asthma and AR patients, the sensitivity and specificity were 81.3% and 56.5%, respectively. Although the specificity is low, the high sensitivity value is promising. The non-invasive measurement of skin sebum and moisture could provide convenience to clinicians in the diagnosis and management of allergic diseases.

Eicosapentaenoic acid supplementation alleviates pruritus, enhances skin moisture, and mitigates depression in maintenance hemodialysis patients.

Background: The objective of this study is to investigate the effects of oral supplementation with eicosapentaenoic acid (EPA) on circulating inflammatory factors, cardiometabolic parameters, skin moisturization, and the consequent symptoms of pruritus and depression in maintenance hemodialysis patients. Materials and methods: A total of 60 maintenance hemodialysis patients with severe pruritus symptoms completed this randomized, placebo-controlled study. Subjects of treatment group (n = 30) were instructed to consume 1000 mg fish oil (>900 mg EPA) and subjects of placebo group (n = 30) were instructed to consume 1000 mg soybean oil twice daily for 3 months. 5-D pruritus scoring, the Beck Depression Inventory (BDI) scale, skin moisture, serum creatinine, inflammatory factors, and cardiometabolic parameters were examined at baseline, and at the first, second, and third month post-supplementation. Results: A significantly decreased pruritus level was observed in the treatment group, whereas an opposite result was observed in the placebo group. Increased skin moisture levels on both the face and arms were observed in the treatment group, but not in the placebo group. Supplementation of EPA significantly decreased serum CRP and IL-6 levels. Significant decreases in total cholesterol (CHO), and triglycerides (TG) levels were observed; however, a decrease in high-density lipoprotein (HDL) level was observed in the treatment group. There was no change in plasma creatinine (CR) observed in both groups. A significantly decreased BDI score was observed, whereas the opposite result was observed in the placebo group. A correlational study showed that the severity of pruritus was significantly associated with skin moisture and serum CRP. The severity of pruritus was also positively correlated with the BDI score. Conclusion: Supplementation of EPA may provide multiple benefits including alleviating pruritus symptoms, addressing skin dryness, and mitigating depression in maintenance hemodialysis patients.