Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples, Naples, Italy.
Clinical Skin Research Center, Pierre Fabre Dermo-Cosmétique, Toulouse, France.
J Eur Acad Dermatol Venereol. 2017 Sep;31 Suppl 6:3-18. doi: 10.1111/jdv.14410.
'Fragile skin', or skin with lower resistance to aggressors, can be broadly classified into four causal categories: constitutional (age-dependent or associated with specific vulnerable locations on the body, e.g. eyelids), pathological (related to disease), circumstantial (related to environmental or internal factors, e.g. stress) and iatrogenic (caused by medical interventions or treatments). In this supplement, we focus on the fourth category, the iatrogenic origin of fragile skin and the role that dermo-cosmetics can have in restoring the natural protective function of the skin following treatments for skin diseases and medical interventions. We present epidemiological data on the prevalence of fragile skin in three different geographical regions, and the results of two randomized controlled studies investigating the efficacy and tolerability of dermo-cosmetics in combination with topical acne treatment and following physical skin damage. Overall, we found that prevalence across the three regions (23% in Germany, 41% in UAE, 56% in Taiwan) reflected previous global estimates (24-53%) across skin types, with significant associations found with environmental and lifestyle factors, such as stress, humidity and pollution. The iatrogenic effects of topical acne treatments can result in poor compliance or use of over-the-counter moisturizers, which may reduce treatment efficacy. Dermo-cosmetics were found to aid in restoration of fragile skin caused by the acne topical retinoid treatment adapalene 0.1% gel, by reducing transepidermal water loss and improving skin hydration, as well as reducing the side-effects such as skin irritation that are frequently associated with topical retinoids. Additionally, dermo-cosmetic products were found to accelerate wound closure following skin damage in a laser ablation model and reduced the duration of post-procedural side-effects such as itching and burning.
“脆弱皮肤”，或对刺激物抵抗力较低的皮肤，可以大致分为四大原因：体质性（与年龄相关或与身体特定脆弱部位相关，例如眼睑）、病理性（与疾病相关）、环境性（与环境或内部因素相关，例如压力）和医源性（由医疗干预或治疗引起）。在本增刊中，我们重点关注第四种，即脆弱皮肤的医源性原因，以及在治疗皮肤病和医疗干预后，皮肤护理产品在恢复皮肤天然保护功能方面可以发挥的作用。我们展示了在三个不同地理区域中脆弱皮肤的流行率的流行病学数据，以及两项随机对照研究的结果，这两项研究调查了皮肤护理产品与局部痤疮治疗联合使用以及在物理性皮肤损伤后的疗效和耐受性。总的来说，我们发现三个地区的流行率（德国为 23%，阿联酋为 41%，中国台湾为 56%）反映了之前全球范围内的估计值（24-53%），跨越不同皮肤类型，与环境和生活方式因素（如压力、湿度和污染）存在显著关联。局部痤疮治疗的医源性作用可能导致治疗效果不佳，患者对治疗的顺应性或对外用保湿剂的使用减少。我们发现皮肤护理产品有助于恢复阿达帕林 0.1%凝胶等局部痤疮治疗药物引起的脆弱皮肤，减少经表皮水分流失，改善皮肤水合作用，并减少与局部维甲酸相关的皮肤刺激等副作用。此外，在激光消融模型中，皮肤护理产品还发现能加速皮肤损伤后的伤口闭合，并减少瘙痒和灼热等术后副作用的持续时间。
