Episode 18 - Emollient with physiological lipids improves skin function

In this episode of BJD Talks, Sam and Meera discuss the article ‘Topical supplementation with physiological lipids rebalances the stratum corneum ceramide profile and strengthens skin barrier function in adults predisposed to atopic dermatitis’ by Andrew et al. The full article can be accessed at https://doi.org/10.1093/bjd/ljaf200 

*This podcast was generated by an AI tool created by 67Bricks for the British Association of Dermatologists* 

Transcript

SPEAKER_01 0:00

Welcome to BJD Talks, the official podcast of the BJD. I'm Sam.

SPEAKER_00 0:04

And I'm Mira. In this episode, we will be discussing the article by Paul Andrew et al. Topical supplementation with physiological lipids, rebalances the stratum corneum ceramide profile and strengthens skin barrier function in adults predisposed to atopic dermatitis, published in May 2025 and included in the October 2025 issue.

SPEAKER_01 0:27

Let's dive in. Atopic dermatitis is a chronic skin condition that affects millions. Symptoms like dryness, itching, and sensitivity all trace back to a core problem: skin barrier dysfunction. What's notable is the crucial role that lipid composition of the stratum corneum, the outermost layer of the skin, plays.

SPEAKER_00 0:48

Exactly. The stratum corneum acts as the skin's defence shield made up of corneocytes within a lipid matrix of ceramides, cholesterol, and fatty acids. This study by Andrew and colleagues investigates replenishing ceramides through topical application to reinforce the barrier at a molecular level.

SPEAKER_01 1:07

The researchers compared two emollients. First, a multivasicular emulsion mixed with physiological lipids and glycerine called MVE plus Gl. Second, a traditional oil and water formulation with glycerine or OW plus G. 58 adults with a history of eczema applied each product to opposite sides of their body for 28 days.

SPEAKER_00 1:29

This intra-participant controlled approach was clever, reducing between subject variability. Key outcomes included skin barrier integrity, measured with transepidermal water loss, or TEWL after tape stripping, skin sensitivity to sodium lauryl sulfate, and ceramide profile changes assessed via lipidomics.

SPEAKER_01 1:51

The results were striking. For MVE plus GL, TEWL after tape stripping fell from 38 to just under 30 grams per square meter per hour, a reduction of 22% in skin barrier damage. Meanwhile, the oil and water emollient showed no significant TEWL changes.

SPEAKER_00 2:09

MVE plus GL also reduced sensitivity to irritants. Post-exposure to sodium, lauryl sulfate, participants using MVE plus GL experienced notable reductions in TEWL and erythema. Skin dryness improved more rapidly and thoroughly with MVE plus GL compared to OW plus G, showing superior hydration.

SPEAKER_01 2:33

At the molecular level, the study was especially revealing. MVE plus GL boosted ceramide levels, particularly those with an 18-carbon sphingoid base, which are essential for lipid layer organization and barrier strength.

SPEAKER_00 2:47

Indeed, the increased balance of non-hydroxyphytosfingocine ceramides correlated with improved barrier function, while other ceramides like non-hydroxy dihydrous fingacine negatively correlated with skin integrity. This underscores the importance of targeting specific lipid compositions.

SPEAKER_01 3:06

There were limitations such as focusing solely on adults with a history of eczema. We're left wondering how these findings might translate to children or patients with severe active disease. Future research could delve into those areas.

SPEAKER_00 3:20

True, but the takeaway here is compelling. Emollients with physiological lipids, especially ceramides, can do more than hydrate. They strengthen the barrier itself. This has real potential to reshape how clinicians evaluate and recommend emollients.

SPEAKER_01 3:37

Precisely. It's not just about moisturizing anymore, it's about targeted molecular level repair. A benchmark has been set for assessing emollient efficacy.

SPEAKER_00 3:47

For clinical practice, understanding emollient formulations could help tailor treatments for conditions like atopic dermatitis. And that wraps up this episode of BJD Talks.

SPEAKER_01 3:57

Thanks for listening. Until next time, stay curious and keep pushing the boundaries of dermatological science.