Introduction
Atopic dermatitis (AD) is a chronic inflammatory skin disorder characterized by epidermal barrier dysfunction, leading to increased transepidermal water loss and allergen entry, triggering inflammation. In India, AD affects 2.7% of children aged 6–7 years and 3.6% of adolescents aged 13–14 years. Emollients are crucial in AD management, and this review examined the role of active ingredients such as liquorice extract, niacinamide, sterols, laureth-9-polydocanol, xylitol, and galacto-oligosaccharide (GOS) in restoring the skin barrier, reducing inflammation, and maintaining microbiome balance, thus serving as a valuable adjunct to pharmacological therapies..
Key Findings
- Epidermal Barrier Dysfunction:
- AD is characterized by abnormalities in epidermal proteins and lipid metabolism, compromising the skin’s protective barrier.
- Reduced production of key proteins like filaggrin, claudin-1, involucrin, and caspase-14 contributes to increased susceptibility to allergens and other environmental triggers.
- Importance of Emollients:
- Regular use of emollients is essential in AD treatment, providing steroid-sparing effects when used with topical corticosteroids (TCS) or calcineurin inhibitors (TCI).
- Active Ingredients and Their Benefits:
- Liquorice Extract: Exhibits anti-inflammatory and anti-pruritic properties; inhibits pro-inflammatory mediators.
- Niacinamide: Restores skin barrier function, reduces transepidermal water loss (TEWL), and promotes skin protein production.
- Sterols: Enhance skin barrier function and hydration.
- Xylitol and GOS: Help maintain skin microbiome balance, promoting beneficial microbes while inhibiting harmful bacteria.
- Laureth-9-Polydocanol: Reduces itching, alleviating one of the primary symptoms of AD.
- Mechanisms of Action:
- Each active ingredient works through distinct mechanisms, such as suppressing inflammatory cytokines, enhancing ceramide production, and selectively inhibiting harmful bacterial growth.
- Clinical Efficacy:
- Emollient plus formulations improve skin hydration, reduce pruritus, and extend the interval between flare-ups, highlighting their potential as maintenance therapy.
Conclusion
In summary, emollients enriched with active ingredients are essential for managing atopic dermatitis, as they effectively restore skin barrier function and provide anti-inflammatory and microbiome-regulating benefits. Key components such as liquorice extract, niacinamide, sterols, xylitol, and GOS target various aspects of AD pathophysiology and enhance treatment outcomes. However, variability in individual responses, limited long-term efficacy data, and the need for extensive clinical trials highlight important limitations. Future research should focus on investigating the synergistic effects of active ingredients, conducting longitudinal studies across diverse populations, and exploring novel formulations to further improve management strategies for AD.
Link to the study: https://shorturl.at/Dphsg
