Moisturisers have an influence on skin microcirculation: a laser speckle contrast imaging assessment study

Ignace DeDecker², Tanja Klotz¹, Peter Vu³, Kimberly De Mey², Anse Beeckman², Henk Hoeksema², Marijn Speeckaert², Phillip Blondeel², Stan Monstrey², Karel E.Y. Claes²,
¹Royal Adelaide Hospital, Adelaide, South Australia, Australia
²Burn Centre, Ghent University Hospital, Ghent, Flanders, Belgium
³SA Pharmacy, Queen Elizabeth Hospital, Woodville, South Australia, Australia

Abstract

Non-invasive scar management typically involves pressure therapy using customized pressure garments, combined with silicones or moisturizers for hydration and UV protection. Scar dehydration caused by impaired skin barrier function can lead to increased fibroblast activity and the formation of hypertrophic scars. Abnormal scar formation is partly attributed to increased microcirculatory perfusion in scars. Pressure therapy aims to reduce microcirculatory perfusion, fibroblast activity, and the release of TGF-β1, which can lead to myofibroblast differentiation. However, the influence of topical moisturisers on microcirculation remains unknown and was the focus of this experimental study.
The study involved 40 healthy volunteers, and increased trans epidermal water loss (TEWL) was induced by tape stripping. Five moisturizers and a silicone gel were tested, including TEDRA®, TEDRA® NT1, TEDRA® NT3, Alhydran®, Lipikar, and BAP Scar Care silicone gel. TEWL, cumulative hydration, and blood flow were assessed using specific instruments at different time points up to 4 hours after application.
Results showed an immediate increase in TEWL in the tape-stripped areas, while the control areas remained stable. Among the tested products, BAP Silicone Gel performed poorly in terms of occlusion and hydration, while Alhydran® reduced blood flow the most, and Lipikar stimulated blood flow. TEDRA®, TEDRA® NT1, and TEDRA® NT3 provided good occlusion and high hydration values
The study demonstrated that moisturisers can influence skin microcirculation, but their effect on scar outcome remains unclear. Reducing blood flow is desirable to minimize erythema, itching, and overall scar activity, aligning with the use of pressure garments. Further research is needed to determine the clinical effects of moisturizers on scars.

Biography

Tanja has been working as a Burns OT for the past 20 years. After completing a Master of Clinical Science, which included conducting a systematic review on the impact of moisturizers on scars, she discovered that the available evidence was insufficient to guide clinicians dealing with burn scars. Consequently, she is currently pursuing a PhD to shed light on the effects of basic and commonly recommended moisturizers on burn scars. Alongside her academic endeavors, Tanja remains committed to her work on the burn unit at Royal Adelaide Hospital.