New, Tried, and True: Moisturizer Advice for Your Patients

Patients often ask their dermatologists for recommendations on over-the-counter moisturizers, said Dr. Joshua Zeichner.

The trouble is that "many dermatologists don’t really know what makes a good moisturizer, and are unfamiliar with the latest advances in moisturizing technology," he said at SDEF Las Vegas Dermatology Seminar.

While the purpose of all moisturizers is simple enough – to boost and maintain the water content of the skin – their formulations and the manner of their activity vary widely. Some work by increasing the expression of aquaporins, the water channels in the skin cell membrane; others by replacing skin lipids, temporarily repairing the skin’s barrier function and improving appearance.

Any high-quality moisturizer will contain a mixture of humectant, emollient, and occlusive ingredients, said Dr. Zeichner, director of cosmetic and clinical research in dermatology at Mount Sinai Medical Center in New York.

Among the novel humectants being incorporated into moisturizers today are natural moisturizing factors (NMF), an umbrella term for the naturally occurring humectants glycerol, urea, and lactic acid, along with the amino acids urocanic acid (UCA) and pyrrolidone carboxylic acid (PCA), which are produced by the breakdown of filaggrin.

Many moisturizers contain ceramides, the major lipids that make up the "mortar" between skin-cell "bricks" in the stratum corneum; moisturizers also may contain ceramide precursors.

"Applying a moisturizer with [the ceramide precursor] pseudoceramide 5 has been shown to lead to an increase in ceramide levels in the stratum corneum," Dr. Zeichner said. "However, it’s unclear whether the ingredient is directly incorporated into those ceramides. Regardless, you can see the clinical improvement."

Generally with all moisturizers, he said, "we need more studies to evaluate the long-term effects to the skin beyond just the immediate effect."

Glyceryl glucoside, a modified glycerin molecule that enhances the activity of aquaporin channels, shows promise as a humectant, Dr. Zeichner said.

He described glyceryl glucoside as a "super humectant" whose effect on skin may last longer than that of other humectants.

Dr. Zeichner also tipped his hat to an old school moisturizer ingredient – colloidal oatmeal.

"There’s a lot of talk about all of these exciting new technologies but you don’t want to forget about tried and true colloidal oatmeal," he said. Oatmeal, which has occlusive, humectant, and emollient properties, "serves as the backbone for many skin brands and works very well. Advances in cosmetic chemistry have made oatmeal formulations much more elegant now – they’re not your grandmother’s oatmeal anymore."

Dr. Zeichner disclosed financial relationships with Allergan, Bayer, Beiersdorf, Galderma, Johnson and Johnson, L’Oreal, Medicis, Onset, Pharmaderm, Procter and Gamble, and Valeant.

SDEF and this news organization are owned by Frontline Medical Communications.

Patients often ask their dermatologists for recommendations on over-the-counter moisturizers, said Dr. Joshua Zeichner.

The trouble is that "many dermatologists don’t really know what makes a good moisturizer, and are unfamiliar with the latest advances in moisturizing technology," he said at SDEF Las Vegas Dermatology Seminar.

While the purpose of all moisturizers is simple enough – to boost and maintain the water content of the skin – their formulations and the manner of their activity vary widely. Some work by increasing the expression of aquaporins, the water channels in the skin cell membrane; others by replacing skin lipids, temporarily repairing the skin’s barrier function and improving appearance.

Any high-quality moisturizer will contain a mixture of humectant, emollient, and occlusive ingredients, said Dr. Zeichner, director of cosmetic and clinical research in dermatology at Mount Sinai Medical Center in New York.

Among the novel humectants being incorporated into moisturizers today are natural moisturizing factors (NMF), an umbrella term for the naturally occurring humectants glycerol, urea, and lactic acid, along with the amino acids urocanic acid (UCA) and pyrrolidone carboxylic acid (PCA), which are produced by the breakdown of filaggrin.

Many moisturizers contain ceramides, the major lipids that make up the "mortar" between skin-cell "bricks" in the stratum corneum; moisturizers also may contain ceramide precursors.

"Applying a moisturizer with [the ceramide precursor] pseudoceramide 5 has been shown to lead to an increase in ceramide levels in the stratum corneum," Dr. Zeichner said. "However, it’s unclear whether the ingredient is directly incorporated into those ceramides. Regardless, you can see the clinical improvement."

Generally with all moisturizers, he said, "we need more studies to evaluate the long-term effects to the skin beyond just the immediate effect."

Glyceryl glucoside, a modified glycerin molecule that enhances the activity of aquaporin channels, shows promise as a humectant, Dr. Zeichner said.

He described glyceryl glucoside as a "super humectant" whose effect on skin may last longer than that of other humectants.

Dr. Zeichner also tipped his hat to an old school moisturizer ingredient – colloidal oatmeal.

"There’s a lot of talk about all of these exciting new technologies but you don’t want to forget about tried and true colloidal oatmeal," he said. Oatmeal, which has occlusive, humectant, and emollient properties, "serves as the backbone for many skin brands and works very well. Advances in cosmetic chemistry have made oatmeal formulations much more elegant now – they’re not your grandmother’s oatmeal anymore."

Dr. Zeichner disclosed financial relationships with Allergan, Bayer, Beiersdorf, Galderma, Johnson and Johnson, L’Oreal, Medicis, Onset, Pharmaderm, Procter and Gamble, and Valeant.

SDEF and this news organization are owned by Frontline Medical Communications.

Patients often ask their dermatologists for recommendations on over-the-counter moisturizers, said Dr. Joshua Zeichner.

The trouble is that "many dermatologists don’t really know what makes a good moisturizer, and are unfamiliar with the latest advances in moisturizing technology," he said at SDEF Las Vegas Dermatology Seminar.

While the purpose of all moisturizers is simple enough – to boost and maintain the water content of the skin – their formulations and the manner of their activity vary widely. Some work by increasing the expression of aquaporins, the water channels in the skin cell membrane; others by replacing skin lipids, temporarily repairing the skin’s barrier function and improving appearance.

Any high-quality moisturizer will contain a mixture of humectant, emollient, and occlusive ingredients, said Dr. Zeichner, director of cosmetic and clinical research in dermatology at Mount Sinai Medical Center in New York.

Among the novel humectants being incorporated into moisturizers today are natural moisturizing factors (NMF), an umbrella term for the naturally occurring humectants glycerol, urea, and lactic acid, along with the amino acids urocanic acid (UCA) and pyrrolidone carboxylic acid (PCA), which are produced by the breakdown of filaggrin.

Many moisturizers contain ceramides, the major lipids that make up the "mortar" between skin-cell "bricks" in the stratum corneum; moisturizers also may contain ceramide precursors.

"Applying a moisturizer with [the ceramide precursor] pseudoceramide 5 has been shown to lead to an increase in ceramide levels in the stratum corneum," Dr. Zeichner said. "However, it’s unclear whether the ingredient is directly incorporated into those ceramides. Regardless, you can see the clinical improvement."

Generally with all moisturizers, he said, "we need more studies to evaluate the long-term effects to the skin beyond just the immediate effect."

Glyceryl glucoside, a modified glycerin molecule that enhances the activity of aquaporin channels, shows promise as a humectant, Dr. Zeichner said.

He described glyceryl glucoside as a "super humectant" whose effect on skin may last longer than that of other humectants.

Dr. Zeichner also tipped his hat to an old school moisturizer ingredient – colloidal oatmeal.

"There’s a lot of talk about all of these exciting new technologies but you don’t want to forget about tried and true colloidal oatmeal," he said. Oatmeal, which has occlusive, humectant, and emollient properties, "serves as the backbone for many skin brands and works very well. Advances in cosmetic chemistry have made oatmeal formulations much more elegant now – they’re not your grandmother’s oatmeal anymore."

Dr. Zeichner disclosed financial relationships with Allergan, Bayer, Beiersdorf, Galderma, Johnson and Johnson, L’Oreal, Medicis, Onset, Pharmaderm, Procter and Gamble, and Valeant.

SDEF and this news organization are owned by Frontline Medical Communications.