In eczema (AD) there is an inherent defect of the epidermal barrier in both diseased and disease free skin.
Dry Skin: Eczema-prone skin is dry, irritated and inflamed.
TEWL: Damage or impairment in the barrier layer leads to transepidermal water loss (TEWL).
Dehydration: Skin unable to lock in moisture lacks the integrity to protect against environmental irritants.
When the epidermal barrier is compromised, it may provide an entry point for bacteria and allergens making skin more prone to secondary infections which, in turn, can lead to aggravation of eczematous symptoms.
Repairing the skin barrier or preventing barrier dysfunction is believed to be the cornerstone of eczema management.
Ceramides are naturally occurring lipids in the intercellular "mortar" within the outer layer of the stratum corneum. Ceramides make up 40 - 50% of the lipid component of the lamellar lipids and are integral to epidermal barrier function.
Reduced levels of Ceramides are observed in people with psoriasis, eczema, and other dry skin conditions.
There are 11 identified subfractions of ceramides within the skin. Whilst the molecular structure of most of these Ceramides are very similar their functionality is different.
Ceramide 1 (EOP) is the most deficient in eczema patients.
Transepidermal water loss (TEWL) is predominantly linked to Ceramide 3 (NP).
Ceramides play a key role in epidermal barrier function:
The stratum corneum, is a compromised of corneocytes compressed within a lipid bilayer, which is made up of three major components in the following ratio: 40-50% Ceramides; 25% Cholesterol; 10-15% Free Fatty Acids.
If incorporated in the wrong ratio, barrier repair can be impeded. Ceramides together with cholesterol and saturated fatty acids bind the protein-rich corneocytes into a water impermeable protective barrier.
A deficiency in Ceramides (especially Ceramide 3) results in excessive TEWL, dry skin, and increased permeability to environmental irritants, allergens and microorganisms.
Reduced levels of ceramides have been associated with a number of dermatological disorders, such as atopic dermatitis.
Studies have shown that topical ceramides, if applied in the correct ratio with cholesterol and free fatty acids, can help to normalize the epidermal barrier in people with atopic dermatitis, and thereby reinforce barrier function.
Studies have shown that ceramide-dominant moisturisers and cleansers can provide substantial relief from the symptoms of eczema.
Optimising ceramide delivery ratio is important:
The 3:1:1 Ceramide Dominant Molar Ratio: Ceramides, cholesterol and fatty acids are the predominant lipids in the stratum corneum or skin barrier. Ceramides must be delivered in the correct ratio with cholesterol and free fatty acids in order for ceramide-containing products to have a positive effect on the barrier function.
The optimal molar ratio is 3:1:1, with ceramides dominant. Variations in this ratio can impair skin barrier recovery.
In order for topical ceramide products to be effective, a correct relative molar ratio of ceramides, cholesterol and fatty acids must be formulated into the right delivery system. Hence, knowledge of skin is as important as knowledge of formulation science.
QV Intensive with Ceramides' dual action helps support the skin promote ceramide synthesis whilst helping reinforce the skin barrier.
QV Intensive with Ceramides contains: Two of the most important ceramides: Ceramide 1 (EOP): significantly deficient in eczema patients. Ceramide 3 (NP): predominantly linked to the TEWL experienced by patients with eczema.
Ceramide complex (ceramides, cholesterol and free fatty acids) which delivers ceramides topically in the optimal 3:1:1 molar ratio to help reinforce the epidermal barrier.
Niacinamide (nicotinamide) and lactic acid (L-lactic acid) to help support the skin promote ceramide synthesis.
Low pH formulations help create optimal conditions for enhancement of the body's own ceramide production.
Nicotinamide (Niacinamide) and L-Lactic Acid promote ceramide synthesis from within:
L-Lactic acid is proven to stimulate the biosynthesis of ceramides, which in turn leads to improved barrier function, as well as relief and prevention of dry skin. L-lactic acid was found to be absorbed into keratinocytes and metabolized to acetate which is then used for ceramide synthesis.
Nicotinamide has been shown to stimulate biosynthesis of ceramides which can have beneficial effects on the skin barrier. Nicotinamide promotes greater activity of Serine Palmitoyltransferase (SPT) which is involved in the first step of ceramide biosynthesis.
Clinical evidence for a hydrated skin barrier:
Clinical evidence for QV Intensive with Ceramides; a comparative study of topical products on healthy, intact skin.
A recent trial of several topical eczema management products included 10 healthy subjects, with intact skin: Skin hydration (vs. untreated skin) at 0, 2, 4, 6 and 24 hours post-application.
Trans-epidermal water loss (TEWL; vs. untreated skin) at 0, 2 and 5 days post-application.
QV Intensive with Ceramides locks in moisture:
Skin Hydration (vs. untreated skin) at 0, 2, 4, 6 and 24 hours post-application: (See Figure 1.)
Click on icon to see table/diagram/image
Prevent water loss with QV Intensive with Ceramides:
A comperative study of topical applications on healthy, intact skin: Trans-epidermal Water Loss (TEWL) vs untreated skin at 0, 2 and 5 days post-application: (See Figure 2.)
Click on icon to see table/diagram/image
Reduction in TEWL was observed over 5 days following topical application of QV Intensive with Ceramides Light Moisturizing Cream.