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A novel, extra mild skin cleansing milk synergistically enhances the efficacy of facial moisturizing creams and improves skin condition U. Koop, J. Lorenz, S. Hiddemann, S. Conzelmann, K. Bohnsack, F. Rippke Beiersdorf AG, Research and Development, Hamburg, Germany
Abstract Introduction and Objective: In daily practice, the choice of facial skin cleansing products usually does not receive as much attention as the selection of facial skin care products like moisturizers. In the present study we investigated into the question as to what extent a novel, extra mild skin cleansing milk, compared to a commercial skin cleanser, influences the efficacy of facial moisturizing creams. Materials and Methods: 48 women, aged 24 to 60 years, of whom 50% suffered from dry skin, were included in this double-blind, controlled usage study over 4 weeks. In order to com-
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pare the two different cleansers under realistic conditions, they cleansed their facial skin twice daily either with the extra mild cleansing milk or the commercial skin cleanser in a split face design and then applied a facial moisturizer to the whole face. Volunteers with dry skin used a rich moisturizer and those with normal skin a light formulation.
products in combination. One area served as untreated control. Assessments of skin condition and skin hydration by corneometry were conducted at baseline, after 2 and after 4 weeks. Additionally, self-assessments of the products’ efficacy and skin tolerability were conducted by the volunteers instantly after the first application and after 2 and 4 weeks of regular use.
In order to assess a synergistic effect, a multi-comparative approach was realised on the forearms: Four areas were marked on the volar aspects of the forearms and treated twice daily either with the extra mild cleanser or the moisturizer or both
Results: On facial skin, the combined application of the extra mild cleansing milk plus the moisturizer led to a significant increase in self-assessed skin hydration and decrease of skin roughness after 2 and 4 weeks. After 4 weeks the ef-
Poster No. P241 | 21st EADV Congress Prague, Czech Republic | September 2012
fects of this combination were significantly more pronounced than those of the combination of commercial skin cleanser plus moisturizer. On the volar forearms, the combined application of the extra mild cleanser plus moisturizer increased corneometric skin hydration after 2 weeks and reduced self-assessed skin roughness and dryness after 2 and 4 weeks significantly more than the application of each formulation alone. The selfassessments revealed favorable results for both the extra mild cleansing milk and the moisturizers.
Conclusion: This study confirms the importance of a proper skin cleansing with an extra mild formulation as basis of a facial skin care procedure. The effects of moisturizers can either be intensified or attenuated, depending on the mildness and caring features of the selected skin cleansing formulation.
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A novel, extra mild skin cleansing milk synergistically enhances the efficacy of facial moisturizing creams and improves skin condition Introduction and Objective Skin cleansing, on one hand, has the purpose to remove dust, dirt, germs, sweat, sebum and other oily remnants from skin but should, on the other hand, leave the protective epidermal layer, the stratum corneum, intact. The ability of skin cleansers to fulfill these fundamental requirements mainly depends on the type and quality of the employed surfactants. Cationic surfactants like sodium laureth sulfate are able to cleanse the skin thoroughly and form rich foam but have an intrinsic irritative and cytotoxic potential (1). Nonionic, sugarbased surfactants, e.g.
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Materials and Methods decyl glucoside, are much better tolerated and therefore preferable especially for the cleansing of dry and sensitive skin conditions. As skin cleansing should proceed any skin caring procedure, it also might have an impact on the efficacy and skin tolerance of the subsequently applied skin care products; moisturizing agents applied to skin which has been irritated by a harsh cleanser might not be tolerated as well as by intact skin. The hydrating effect as well might be minimized by the prior application of a desiccating cleansing agent. The practical relevance of
such potential interactions nevertheless remains to be elucidated. Therefore we set out to compare the clinical and biophysical effects of a novel, extra mild facial skin cleansing milk and an ordinary, commercial cleanser on the efficacy of facial moisturizers.
Poster No. P241 | 21st EADV Congress Prague, Czech Republic | September 2012
A controlled, double-blind usage study was carried out on healthy female subjects who all provided written, informed consent: 48 women, 24 to 60 years of age, approx. 50% demonstrating dry skin and 50% demonstrating normal skin according to pre-evaluation. Subjects were not allowed to change their facial make-up routine or to use personal facial cleanser or personal caring products during the trial. Comparison of facial skin cleansers: The effects of both cleansers on the subsequent application of a moisturizer was assessed on the facial skin. The extra mild cleanser (Eucerin® Der-
matoClean Skin Cleansing Milk) and the commercial cleanser were used in splitface design twice daily before a moisturizer (Eucerin® Aquaporin Active) was applied on the entire face; volunteers with dry skin used the rich version of the moisturizer and those with normal skin the light version. The first treatment was carried out under supervision, followed by a 4-week in use application at home. Synergistic efficacy of skin cleansing and moisturizing care: Furthermore, the potential synergistic effect of the extra mild cleanser and the moisturizer was assessed. The treatments were made on the inner
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The investigations regarding skin condition and compatibility were performed as shown in tab. 1. A significance level of 0.05 was chosen for statistical analysis (analysis of variance), based on two-sided hypotheses. 3|6
Face
after 4 weeks
after 2 weeks
Measurements of superficial skin moisture (Corneometer) Self-assessment of skin condition Roughness and dryness (10-point scale) Self-assessment questionnaire (confirmation of compatibility and efficacy statements)
Forearm
forearms and compared to an untreated control over a 4-week period: the extra mild cleansing milk was used in the morning and evening on one test site, the face care cream was used in the morning only on another site and on a third site, the two products were used in combination (morning: cleansing milk first, followed by face care cream; evening: cleansing milk only).
instantly
Investigations regarding skin condition and compatibility were performed as follows:
baseline
A novel, extra mild skin cleansing milk synergistically enhances the efficacy of facial moisturizing creams and improves skin condition
Fig. 1
Self-Assessment of Skin Moisture and Roughness Scores, differences to baseline
Measurements of superficial skin moisture (Corneometer) Self-assessment of skin condition Roughness and dryness (10-point scale) Self-assessment questionaire (confirmation of compatibility and efficacy statements)
Results Comparison of facial skin cleansers The self-assessment of skin moisture and roughness yielded significant improvements for both cleansers in conjunction with the respective moisturizer compared to baseline. After 4 weeks of treatment, the combination of extra mild cleansing milk plus moisturizer was sig nificantly superior to the
combination of commercial cleanser plus moisturizer (fig. 1). Also the objective assessment of skin hydration by corneometry proved significant improvements for all treatments at all time points compared to baseline. Here a significant superiority of the combination extra mild skin cleanser plus moisturizer was found in the subgroup with normal skin (fig. 2).
Poster No. P241 | 21st EADV Congress Prague, Czech Republic | September 2012
Moisture
3
1
Roughness *
*
*
*
-1
*
*
-3 2 weeks
4 weeks
2 weeks
4 weeks
Fig. 2
Objective Measurement of Skin Hydration Corneometry; differences to baseline and control All subjects
25
Subgroup with normal skin
20 15 10
* * *
*
* * *
*
5 0
2 weeks
4 weeks
extra mild cleansing milk + moisturizer
2 weeks
4 weeks
commercial cleanser + moisturizer
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A novel, extra mild skin cleansing milk synergistically enhances the efficacy of facial moisturizing creams and improves skin condition Fig. 3
Self-Assessment of Product Performance: Cleansing Milk (Confirmation Rate [%]) The subjective rating of the product performance yielded favorable results for both the extra mild skin cleanser alone (fig. 3) and its combination with the moisturizers (fig. 4).
100
Cleanses especially gently
91 96
exceptional quality
93 94
has a moisturing efficacy
89 87
has a deep cleansing effect
91 98
is especially skin compatible
96 79
does not irritate the delicate eye area
2 weeks
prepares the skin optimally for the subsequent care
4 weeks
also suitable for sensitive skin
87 94 87 96 93
0
50
100%
Fig. 4
Self-Assessment of Product Performance: Combination of Cleansing Milk and Face Care (Confirmation Rate [%]) 89 89
pleasant feeling of hydration 85
tangibly smooth and supple
87 80 81
provides optimal moisture
83 85
nourishes / cares intensively 78
noticeably longlasting care effect
81 91
protects against external influences
79 87
mild to the skin
96 96
compatible
98
0
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Poster No. P241 | 21st EADV Congress Prague, Czech Republic | September 2012
50
100%
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A novel, extra mild skin cleansing milk synergistically enhances the efficacy of facial moisturizing creams and improves skin condition
Fig. 6
Fig. 5
Synergistic efficacy of skin cleansing and moisturizing care The twice daily application of the extra mild skin cleanser as well as the once daily treatment with the moisturizer led to comparable, significant improvements of skin hydration, whereas the combined application of both products was significantly superior (fig. 5).
Objective Measurement of Skin Hydration
Self-Assessment of Skin Dryness
Corneometry; differences to baseline and control
Ranking: the lower, the better 5
10
*
8
*
4
*
*
*
6
3
*
4
2
2
1 0
0
2 weeks
4 weekss moisturizer, once daily
cleansing milk, twice daily
combi
Fig. 7
Self-Assessment of Skin Roughness Similarly, the subjective rating of skin dryness (fig. 6) and roughness (fig. 7) resulted in significantly improved values for all treatments compared to the untreated control area; again, the combination produced significantly predominant results. 5|6
Ranking: the lower, the better 5 4 3 2
*
* *
* *
*
* *
*
1 0
instant insta nstaant extra mild cleansing milk
weeks 2 wee w eekss moisturizer
weeks 4 wee w eekss combi
control
Poster No. P241 | 21st EADV Congress Prague, Czech Republic | September 2012
*
*
*
* *
*
instant insta nstaant extra mild cleansing milk
* *
* weeks 2 wee ekss moisturizer
weeks 4 wee ekss combi
control
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A novel, extra mild skin cleansing milk synergistically enhances the efficacy of facial moisturizing creams and improves skin condition
Discussion and Conclusion A mild but effective skin cleansing is an essential prerequisite not only for the application of topical treatments, e.g. in atopic dermatitis (2) or acne (3), but also of facial moisturizers in the care of normal or dry skin conditions. In the present study we proved that the selection of a well suited skin cleansing product which does not compromise skin barrier function is crucial for the efficacy of a subsequent skin moisturizing treatment. Both, the subjectively assessed skin dryness and roughness as well as the objective evaluation of skin hydration revealed favor-
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able results for the combination of the extra mild skin cleansing milk containing nonionic, sugarbased surfactants, and the respective moisturizer based on aquaporin technology (4). The combination of extra mild skin cleansing milk plus moisturizer proved to be superior to commercial cleanser plus moisturizer; furthermore, the application of the mild skin cleansing milk significantly increased the moisturizing efficacy of the cream.
Poster No. P241 | 21st EADV Congress Prague, Czech Republic | September 2012
Taken together, these results emphasize the importance of a well aligned cleansing and care product regimen for the daily moisturizing face care.
References 1. Corazza M, Lauriola MM, Zappaterra M, Bianchi A, Virgili A. Surfactants, skin cleansing protagonists. J. Eur. Acad, Derm. Venereol. 2010, 24: 1-6 2. Cheong WK, Gentle cleansing and moisturizing for patients with atopic dermatitis and sensitive skin. Am. J. Clin. Dermatol. 2009, 10 (Suppl. 1): 13-17 3. Goodman G. Cleansing and moisturizing in acne patients. Am. J. Clin. Dermatol. 2009, 10 (Suppl. 1): 1-6 4. Schrader A, Siefken W, Kueper T, Breitenbach U, Gatermann C, Sperling G, Biernoth T, Scherner C, Stäb F, Wenck H, Wittern KP, Blatt T. Effects of glyceryl glucoside on AQP3 expression, barrier function and hydration of human skin. Skin Pharmacol. Physiol. 2012, 25:192–199
