Properties

Based on studies that have been initiated by the group of Elias in San Francisco [25,26], and taken further by others as well [8,27,28], insight has been gathered into mechanisms and components involved in skin repair. Although the body of experiments in this direction was carried out on murine skin, evidence is accumulating that qualitatively similar mechanisms are operative in humans [29,30]. This leads to the view that BR products should have properties directed at re-establishing the broken skin barrier, which is accommodated by restoration of the physical integrity via application of missing basic components of the intracellular lipid matrix in combination with occlusive materials to stimulate repair mechanisms (Fig. 6). The function of the skin barrier is reflected by its ability to prevent excessive water loss. Consequently, transepidermal water loss (TEWL) is the parameter of choice to define the status of the skin barrier in this respect [31]. In this respect, criteria for BR products to comply with are based on the ability to accomplish a significant reduction of TEWL, thus stimulating ''early'' and ''late'' recovery [8], e.g., in mouse models [32], and finally in man [30], which go beyond the effect of occlusive products, like petroleum jelly. It should be noted that BR products share some of their purposes with ''emollients'' [33,34,35], although no strict criteria have been defined for the latter products.

Figure 6 Schematic representation of the structure of the skin and strategies for restoring the barrier.

Figure 6 Schematic representation of the structure of the skin and strategies for restoring the barrier.

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