The Spectrum of Sensitive Skin: Considerations for Skin Care in Vulnerable Populations

Sensitive skin is a multifactorial condition, where the underlying pathology is not fully understood, and the clinical signs may not always be present or obvious. Despite this challenge, there has been recent progress to understand the different subtypes of sensitive skin, as well as new methods to measure the sensorial response that may not be obvious from visual examination. Similarly, there has been progress in understanding in the management of symptoms through skin care regimens designed for sensitive skin. The implications of this new research indicate the potential of better clinical outcomes for sensitive skin sufferers, as well as regimens more personalized to different triggers in the full spectrum of sensitive skin. J Drugs Dermatol. 2019;18(1 Suppl):s68-74

Recent Advances in Mild and Moisturizing Cleansers

Mild and moisturizing cleanser technologies, and the science underpinning them, have progressed significantly over the past decade. This includes introduction of amino-acid based milder surfactants into the cleansing arena, a deeper understanding of the roles of stratum corneum lipids and proteins in their interaction with cleanser surfactants, the role of pH in skin cleansing, and the development of improved methodologies for predicting skin irritation and drying potential of cleansers. In this paper, the recent advances in these areas as well as newer technologies are reviewed, and the future directions are outlined. J Drugs Dermatol. 2019;18(1 Suppl):s80-88

Association of Early Clinical Response to Laser Rejuvenation of Photoaged Skin with Increased Lipid Metabolism and Restoration of Skin Barrier Function.

Laser resurfacing treatments for photoaged skin have improved dramatically over the past decades, but few studies have examined the molecular mechanisms underlying differences in clinical response. Seventeen white female participants with moderate-to-severe photoaging received nonablative fractional laser treatment on the face and forearm once monthly for 6 months. Biopsies for microarray analysis were performed at baseline and 7 days after facial treatment and at baseline and 1, 7, 14, and 29 days after forearm treatment in each participant, resulting in 119 total samples. Participants were stratified into fast (n = 11) and slow (n = 6) responders on the basis of the presence of clinical improvement after the first treatment. Microarray analysis revealed the upregulation of genes associated with matrix metalloproteinases, collagen and extracellular components, TGF-ß signaling, double-stranded RNA signaling, and retinoic acid synthesis after treatment that did not differ significantly between fast and slow responders. Cluster and enrichment analyses suggested significantly greater activation of lipid metabolism and keratinocyte differentiation in fast responders, who showed greater upregulation of acyltransferases, fatty acid elongases, fatty acid 2-hydroxylase, fatty acid desaturases, and specific keratins that may contribute to epidermal barrier function. These results create, to our knowledge, a previously unreported atlas of molecular changes that correlate with improvements in photoaging after laser therapy.

Microneedling with a Novel, n-3-PUFA-Rich Formulation Accelerates Inflammation Resolution to Improve Skin Recovery Outcomes in Adults with Healthy Skin.

INTRODUCTION: Microneedling is a cosmetic procedure that leverages the skin's natural ability to heal in order to promote collagen formation and skin rejuvenation. To provide improved results, the technique can be combined with topical formulations. A new formulation of multiple actives, including omega-3 (n-3) polyunsaturated fatty acids (PUFAs), was designed to accelerate the resolution of inflammation and wound healing following micro-injury treatments, while enhancing the visible appearance of procedure results, including erythema, luminosity and skin texture. METHODS: In this randomised, controlled, split-face study, we examined 32 healthy female participants aged 30-70 years for 4 weeks following microneedling treatment with a novel multiple-active-ingredient formulation or conventional microneedling protocol with a hyaluronic acid control serum. Changes in skin condition were assessed by blinded clinical photography and expert evaluation. Measurements were collected at baseline, 1 h, 1 day, 7 days and 28 days post treatment. RESULTS: Significantly greater improvements in expert-assessed erythema, luminosity and skin texture were reported following application of the novel multiple-active-ingredient formulation than the hyaluronic acid control serum. This was confirmed by representative VISIA®-CR imaging. CONCLUSION: These data provide new evidence for the role of a novel multiple-active-ingredient formulation for improving skin outcomes up to 28 days following microneedling in adults with healthy skin when compared with a hyaluronic acid serum. The n-3 PUFA content of this formulation may drive accelerated inflammation resolution and wound healing alongside the complementary action of the other active ingredients, leading to the observed improvements in erythema, luminosity and skin texture.

Cleansing, moisturizing, and sun-protection regimens for normal skin, self-perceived sensitive skin, and dermatologist-assessed sensitive skin.

Acquiring or maintaining healthy skin requires a multifunctional approach: mild cleansing, moisturizing, and sun protection. The clinical benefits of a daily, healthy facial skin-care regimen comprising a mild cleanser and moisturizer were evaluated on normal skin, self-perceived sensitive skin, and dermatologist-assessed sensitive skin for a period of up to 4 weeks. Subjects with normal, healthy skin were photographed with a calibrated, high-resolution digital camera, and the average improvement in overall health was calculated using image morphing and facial averaging techniques, following a 2-week period of product application. In a second study that included subjects with self-assessed sensitive facial skin, changes in skin hydration, skin dryness, and skin sensitivity (determined by means of a lactic acid sting test and subject self-assessment) were monitored during a 3-week regimen of mild cleansing and moisturizing with products designed for sensitive skin. The third study involved dermatologist-assessed highly sensitive skin patients (mostly rosacea with an atopic background in some cases). These patients underwent a 4-week skin-care regimen involving mild cleansing and moisturizing. In all three studies, significant improvements in skin health/quality were observed by means of expert assessments, instrumental evaluations, and subjective self-assessment.