But that doesn’t mean the moisturizing barrier creams are bad. What they found was that it was really much more efficient to use the old-fashioned over-the-counter moisturizers that contain mostly petroleum. There was a rather scathing study, where the researchers did a fancy analysis of moisturizers, basically looking at how much better you get per nickel spent. Because they’re marketed as prescription treatments, even though they’re not a drug, they are priced like a drug. I’ve seen some really amazing results with some of the barrier devices, but we have to think about cost effectiveness. Instead, they go through device testing, which is the same process to test crutches or the material used to make casts.
Some of these manufacturers make drug-like claims, but they are not drugs and they don’t really go through the rigors of drug testing. These include products like EpiCeram, Atopiclair, MimyX and Biafine.
Peter lio skin#
Now perhaps more exciting than just plain old moisturizers are the moisturizing creams that claim to restore the skin barrier.
Peter lio trial#
How are we going to figure out what is best for each person with eczema trial and error because one size, one product, does not fit all. Some people might do well using a moisturizer with ceramides during the day and then something heavy and greasy at night.
I think they’re very promising, particularly as one part of a regimen. The ceramides, or lipid molecules, in some of the new moisturizing barrier creams are really exciting. Some innovations allow us to use moisturizers that are not so greasy, that don’t stain clothes and ruin washing machines. But we don’t have to be married to the greasy stuff now. In the old days, the greasy moisturizers tended to be the best, and I think by and large that’s still true. On the other side, there are the more lotion-y mixtures, which hold onto a lot of water. On one side of the spectrum there is motor oil, which just sits on top of the water. We found a way to spin them each down with water to see how much water they hold onto. We tried to quantify how much water different moisturizers (ointments, creams, lotions, gels, foams, etc.) help us to retain. Moisturizers keep the water in and the bad stuff (like allergens and irritants) out. The take-home point is that no matter what the cause of your eczema, protecting the skin barrier is incredibly important - and that means moisturizing. Your body stops making filaggrin for some reason. But even if you have the normal gene, its presence decreases in the presence of inflammation. We know that if you’re missing this protein, if your gene for filaggrin is not functioning correctly, then you don’t have the same strength between cells, water leaks out, and bad stuff gets in.įor a small group of eczema patients, maybe 10 to 20 percent, the underlying problem, the root cause of their eczema, is this genetic defect. When this protein breaks down naturally over time, it also has a whole second life it is incredibly hygroscopic (absorbs water from the air). MoisturizersĪ lot of eczema research has focused on filaggrin, which is a protein that keeps skin cells tightly bound together. This article was excerpted from a presentation at the National Eczema Association annual patient conference. Peter Lio, M.D., is a practicing dermatologist in Chicago.