Hydration of the skin is important for the treatment of hyperkeratotic skin disorders because it increases hydolytic enzyme activity which promotes desquamation, according to Dr. Ron Vender. He spoke about the treatment of hyperkeratotic skin disorders during a presentation at the 2nd annual Skin Spectrum Summit in Toronto on Apr. 16, 2016.
The mainstream prevention and treatment measures for mild cases of ichthyosis and xerosis are emollients and keratolytic products, said Dr. Vender, dermatologist who practices in Hamilton, Ont. He is the founder and director of Dermatrials Research Incorporated and Venderm Innovations in Psoriasis.
Dr. Vender discussed cleansing, emollients, moisturizers, topical steroids, and topical calcineurin inhibitors for the treatment and prevention of hyperkeratotic and dry skin conditions.
Cleansers tend to remove pollutants and bacteria from the skin, noted Dr. Vender, who recommended that patients use non-soap cleansers containing ceramides.
Emollients aid in closing fissures by filling spaces and sealing moisture into the skin, said Dr. Vender.
“Emollients are really like oils and waxes. If you have a nice oil type of barrier and water underneath then that may decrease transepidermal water-loss,” he said.
“Moisturizers act as humectants, and hydrate the stratum corneum through a hygroscopic effect, increasing its elasticity,” Dr. Vender said.
“The best moisturizers contain a humectant with an emollient. So you add water to the skin and then you put a thin layer of this type of emollient on top to prevent transepidermal water-loss.”
Topical calcineurin inhibitors
“Topical steroids can help take away inflammation,” said Dr. Vender, but some patients prefer not to use them. An option may be a topical calcineurin inhibitor such as tacrolimus or pimecrolimus.
“When ceramides are combined with topical calcineurin inhibitors, then that can certainly improve inflammation and make someone feel better.”