Chandan Neha, Rajkumar Jeffrey R, Shi Vivian Y, Lio Peter A
University of Illinois College of Medicine, Chicago, IL, USA.
Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
J Cosmet Dermatol. 2021 Aug;20(8):2425-2430. doi: 10.1111/jocd.14217. Epub 2021 May 22.
Moisturizers traditionally function to replenish both the intercellular lipid lamella and natural moisturizing factors, and form a hydrolipid film on the skin surface to decrease transepidermal water loss and improve hydration. As we continue to identify epidermal lipid imbalance in patients with atopic dermatitis, we turn to the use of bioactive ingredients in moisturizers for improving barrier repair and function.
This review aims to explore the modern use of moisturizers in targeting various components of the skin barrier, dampening immune response, and restoring microbial balance. We conducted a balanced and comprehensive narrative review of the literature. Studies were identified by searching electronic databases (MEDLINE and PubMed), focusing on studies and trials regarding moisturizers that include endocannabinoids, bioactive lipids, anti-inflammatory agents, antioxidants, and microbiome modulators. Only articles published in English language were included.
The aforementioned ingredients exert additional biological effects to improve skin function by upregulating lipid synthesis, decreasing neurosensory transmission of itch signals, reversing oxidative stress, decreasing inflammatory cell activity and cytokine release, and modulating skin microbiota. The shift from traditional moisturizers to those with bioactive ingredients, anti-inflammatory agents, and microbiome modulating effects opens a realm of possible therapeutic options for patients with barrier-defective cutaneous conditions.
Focusing on the disrupted skin barrier as a target for both prevention and treatment and incorporating a combined strategy that utilizes the aforementioned agents to tackle barrier dysfunction from different angles remains a promising area for clinical impact in dermatology.
传统上，保湿剂的作用是补充细胞间脂质层和天然保湿因子，并在皮肤表面形成一层水脂膜，以减少经表皮水分流失并改善皮肤水合作用。随着我们不断发现特应性皮炎患者存在表皮脂质失衡的情况，我们开始在保湿剂中使用生物活性成分来改善屏障修复和功能。
本综述旨在探讨保湿剂在针对皮肤屏障的各个组成部分、减轻免疫反应和恢复微生物平衡方面的现代应用。我们对文献进行了全面且平衡的叙述性综述。通过检索电子数据库（MEDLINE和PubMed）来确定研究，重点关注关于包含内源性大麻素、生物活性脂质、抗炎剂、抗氧化剂和微生物群调节剂的保湿剂的研究和试验。仅纳入以英文发表的文章。
上述成分通过上调脂质合成、减少瘙痒信号的神经感觉传递、逆转氧化应激、降低炎症细胞活性和细胞因子释放以及调节皮肤微生物群，发挥额外的生物学效应来改善皮肤功能。从传统保湿剂向具有生物活性成分、抗炎剂和微生物群调节作用的保湿剂的转变，为患有屏障缺陷性皮肤疾病的患者开辟了一系列可能的治疗选择。
将受损的皮肤屏障作为预防和治疗的靶点，并采用综合策略，利用上述药物从不同角度解决屏障功能障碍，在皮肤病学临床应用中仍是一个有前景的领域。
