Dewmis Medical

7/27/2019 Dewmis Medical

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Dewmis Medical


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Skin The skinis the outer covering of the body

Skinlayers: Epidermis,

Dermis It contains the hair follicles, sweat glands, sebaceous

glands, lymphatic vessels and blood vessels. , Subcutis

Epidermis is divided into several layers.

The outermost layer of the epidermis consists of 25 to 30layers of dead cells


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Sebum Secreted from the SEBACEOUS GLANDS

Complex oily substance which forms along with sweat

Provides a occlusive film on the skin surface to prevent (TEWL)

Factors responsible for maintaining

Skin Hydration
http://www.scf-online.com/english/24_e/images24_e/sebum_2_24_big.jpg


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Natural moisturizing factor (NMF) Contained in the Stratum corneum

Mixture of hydroscopic substances that are capable of

absorbing large quantities of water and retaining moisture


Skin Hydration


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Intercellular cement substance Consists of various lipids (e.g. ceramide) & proteins

Found in between the corneocytes & is important for preserving

the moisture within the Stratum corneum


Skin Hydration


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DRY SKIN means

dehyd rated skin, or

skin which has lost

a certain amount of

moisture

The Stratum corneum of normal skin contains

1030 % of water.

In DRY SKIN, the level fal ls.

Dry Skin


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Dry skin affects 1 in every 2 women in the UK

Incidence of Dry skin


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Consequences of

dry SKIN


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The causes of dry skin

Solar radiation(sun burn)

Climate variations(cold weather &low humidity air

conditioning/central heating)

Chemical exposure(Harshdetergents & solvents)

Drug induced(Retinoid)

Non pathological(fragile skin orsenile skin)

Pathological(as a sign of diseaseeg. eczema, seborrhoeic dermatitis,

psoriasis etc)

Acquired Const i tu t ional
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Xerosis :Dry skin

Causes

1. Inherited

2. Metabolic - Hypothyroidism

3. Increasing age

4. Cool weather with low humidity.

5. Heating

6. Excessive bath

7. Contact with soap, detergents and solvents.

As the skin loses moisture it cracks.This condition is called "xerosis" or Dry Skin".

Symptoms:Dry and Rough appearance of skin


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Atopic dermatitis

Eczema

Psoriasis

Ichthyosis

Senile pruritus

Environment induced dry skin & Xerosis

Contact dermatitis

Hand EczemaAl l condi tions have dry and scaly skin appearance and all have itching.

Types of dry skin disorders


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Atopic dermatitis / Eczema

Symptoms:- Rash & Dryness- Itchy papules which become

excoriated & lichenified

Its an itchy, chronic or chronically relapsing,

inflammatory skin condition.

30% of average skin consultations are Atopic Dermatitis

Occurrence:5-15 % in children below 7years2-10% in adults

Female adults & male children are affected more

Cause: Inherited, immunological abnormality

Aggravating Factors:- Hot weather

- Dust & Cats Allergy / Fur allergy

- Emotional stress

- Foods/detergents / Wollen Clothing


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ATOPIC ECZEMA isdivided into phases:

INFANTILE PHASE

occurs from birth to the 2ndyear. frequently occur on the face

with the child begins to crawl, the

exposed surfaces are involved

Eliciting factors

causing

exacerbation of

Atopic

Dermatitis

FACTORS

Related to AGE

CLINICAL FEATURES

ATOPIC

DERMATITIS

CHILDHOOD PHASE after the 2ndyear up to the 12thyear

sites commonly involved are the flexures of

the elbows, knees, neck, wrists & ankles

may also become more generalized

ADULT PHASE

is essentially similar to that of late childhood.


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CLINICAL FEATURES

Clinically it presents as red rash &

vesicles, usually with scaling &

associated with itch.

Acute stage : Redness, oozing

Subacute : Oozing, Crusting

Chronic : Lichenification,

scaling, altered pigmentation

ECZEMAaffects the LARGEST proportion of the population of all

skin diseases.

Many different forms have been classified according to

the CAUSE,

the LOCATION &

the specif ic NATURE of the lesions

ECZEMA


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Psoriasis

It is a non contagious skin disorder thatmost commonly appears as inflamed,edematous skin lesions covered with asilvery white scale

Cause- abnormal immune response

Skin is the main organ affected

Joints affected in 10%

genetic

Less common tropics and in darkpersons

CLINICAL FEATURES

Psoriasis


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Dry, Rough skin, Persistent visiblescaling as like fish scales

This condition depicts a life long

pattern in congenital ichthyosisCongenital Ichthyosis

Occurs as a result of Malabsorption,

Chronic hepatic and renal disease,

Hyperthyroidism etc. Dry & scaly

skin is seen all over.

Aquired Ichthyosis

A DISORDER OF KERATINIZATION ANDCORNIFICATION

Abnormal epidermal differentiation

and metabolismCause

CLINICAL FEATURES

Ichthyosis


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Also known as 7thage itch or old age pruritus.

With age the skin tends to loose moisture and natural

lubricating oil which makes it more vulnerable to attack by

environment

Dry and cracked skin which

itches too.

Predominantly dryness is thefeature, attributed to lack of

moisture & oil.

Symptoms

CLINICAL FEATURES

Senile pruritus


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Environment induced Xerosis

Winter

Dry working

environment

Air-conditions


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Irritant contact dermatitis

Results from acute toxic insults to the skin as with accidentalexposure to acids, alkalis etc.,

May arise from repeated & cumulative damage from irritants,

both physical & chemical

Examples:

-Hand Dermatitis

-Napkin Dermatitis

-Phototoxic

Dermatitis


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Allergic contact dermatitis

Allergic reaction to a substance Irreversible condition

Repeated exposure will then continue to stimulate the

reaction

Allergic contact dermatitis from

toluenesulfonyl urea in nail varnish II


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Hand Eczema

Common and distressing condition Can be associated with increased sweating and stress

Contact dermatitis often exacerbates this condition


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Moisturization & Gentle Cleansing

are indispensible in Dry skin

managementAAD


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FEATURES

Skin Cleansing is an essential part of the skin care.

Cleansers contains some form of surfactant that interact withproteins & lipids of the stratum corneum.

Surfactants adhere to the skin & facilitate the removal of dirt& debris from the skin surface.

CLEANSING


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Importance

Removes dust, perspiration & some of the

breakdown products of sebum.

Helps to maintain a healthy & attractivelooking skin.

CLEANSING


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Moisturizing formulation

MOISTURIZERS are products which aim to retain or add

water to the skin

Different moisturizing formulations

Liquid bathBath additive oils

CreamFor localized dryness

LotionFor all over body dryness with advantage of spreadability

SoapOffers cleansing & moisturizing benefits


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Occlusive action

These hydrophobic agents form an occlusive film on the skin

Reduces TEWL by preventing evaporation of water from the

stratum corneum.

May also help to restore the lipid barrier of the skin. e.g.Petrolatum, beeswax, lanolins and oils.

Moisturization principles


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Humectant agents

Attracts waterto the skin from the deeper dermis or from the

environment

The hydration of the stratum corneum normalizes the

intercellular lipids & the natural desquamation process. e.g.Glycerine, Urea, amino acids, lactic acids & propylene

glycol

Moisturization principles


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Normal Skin:Balanced TEWL

Dry Skin: Excess TEWL

TEWL - Trans-epidermal water loss

It is the measurement of the quantity of water

that passes from inside a body through the

epidermal layer (skin) to the surrounding

atmosphere via diffusion and evaporation

processes.

What is TEWL?


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Bar soaps

Lipid free cleansers

Cleansing creams

Astringents and toners

Abrasive scrubs

Facial masks

Types Of Cleansers

Source: http://www.skincareguide.ca/skincare_basics/cleansers/skin_cleansers_overview.html


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Bar soaps are essentially salts of fatty acids

Most commonly used cleansers. A number of components can be added to soaps like:

Moisturizers, Fragrances & perfumes, Preservatives & Colouring agents

Moisturizers:

Counteract the drying effect of soaps. The loss of the protective oil layer increases the chances of irritation.

e.g. glycerin, vegetable fats, or lanolin

Fragrances:

Used to mask the odours of the raw ingredients of soaps. Some individuals will be sensitive and become allergic to these

products.

Bar soaps


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Liquid cleansers which do not contain any fat/Soap.

To be applied to the skin & then wiped away or rinsed off with water.

Contains Glycerin, Cetyl alcohol, sodium or sulphate, or propyleneglycol.

Leaves a very fine moisturizing film on the skin.

Effective in removing cosmetics

Useful for individuals with sensitive skin or in older, drier skin.

Lipid free cleansers


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Used to both wash the skin and to moisturize it

Contain a mixture of mineral oil, petroleum,water & some waxes.

Also known as cold creams, 1stapplied to the

skin & then washed off.

Recommended for dry skin, but not useful forthose with oily skin or individuals with acne.

Not used as moisturizers, as they are likely to

cause irritation if left on for some time.

Cleansing creams


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These are perfumed or fragranced alcohol-based solutions

Designed to remove oil from the skin

Produces a tight feeling to the skin.

Astringents helps in removing alkaline soaps that tend tostick to the skin.

Astringents are available for oily, normal and dry skin.

High concentration of alcohol certainly removes sebumespecially in those with oily skin

Used to control T zone oiliness.

Astringents and toners


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Helps in the rubbing off or exfoliation of the surface of theskin

Available either as an abrasive sponge or an abrasivescrub which has small granules within a cream base.

Used to remove skin scales, they work throughmechanical means rather than through chemical action.

Cannot be tolerated on a daily basis

If used excessively they can cause damage of the stratumcorneum.

Abrasive scrubbers


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Are applied to the skin in a thick layer & are left on for 15-30 minutes

Also known as facials.

Produces skin tightening as well as deep cleaning of the hair folliclesand pores.

Cleansing action through superficial peeling of the skin.

A mask that is peeled off will be vinyl or rubber based & forms into atransparent sheet which to be removed.

Medicated facial masks that are used for acne will absorb oil from theskin & can be integrated with Sulpha & Benzoyl peroxide.

Facial masks


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What is SOAP?

Soaps are water-soluble sodium or potassium salts of

fatty acids.Soaps are made from fats and oils, or their fatty acids,

by treating them chemically with a strong alkali.

http://www.sdahq.org/sdalatest/html/soapchemistry1.htm

SOAPS

Chemical Nature

THE STRUCTURE OF SOAP


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Every soap molecule contains 2 different ends

The hydrocarbon tail is nonpolar and hydrophobic (water hating).

The ionic head is polar and hydrophilic (water loving).

THE STRUCTURE OF SOAP


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The term Surfactantis a blend of surface acting agent.

Surfactantsare wetting agents

Lowers the surface tension of a liquid, allowing easier spreading &

lower the interfacial tension between two liquids. Also reduces the interfacial tension between oil and water by

absorbing at the liquid-liquid interface.

Classified into four primary groups

Anionic

Cationic

Non-ionic

Zwitterionic (dual charge)

Surfactants

Components of soaps
http://upload.wikimedia.org/wikipedia/commons/b/b7/MicelleSchematic.png


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Hardening agents prevents soap from dissolve in water

keeps soap in great shape

Helps to reduce cracking.

E.g. Stearic Acid, Polyethylene / Polythene, NaOH

(Caustic soda)

Hardening Agent

Components of soaps


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Types of Soap

Glycerin Soaps/Transparent Soap

Baby Soaps

Medicated Soaps Moisturizing Soaps


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Glycerin Soaps

Also known as Transparent soap

Glycerine is a normally produced during the soap making

process.

It is a humectant, which means it attracts water.

Tends to make skin feel moister.

Glycerine soaps tend to have more water in them and

attract water from the atmosphere, therefore 'sweating' in

humid conditions.
http://en.wikipedia.org/wiki/File:Pears-Soap-barbox.jpg


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Baby Soaps

Factors consider for Baby soap

soap that is gentle

soap that is hypoallergenic soap that is non-toxic

soap that sls free

Contains Coconut oil


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Medicated Soaps

Those containing additional ingredients, usually for the

treatment of skin disorders, e.g. keratolytics, antiseptics,

antipruritics, anti-bacterial.

eg Tetmosol, Ketoconazole


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Moisturizing Soaps

Offers high Moisturizing benefits

Gentle on Skin

Retain skins natural moisturizer

Their features include the following: Rich creamy lather

Moisturizing

Conditioning


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Standard

TFM content

Bureau of Indian Standards (BIS)

Requirement for Toilet soap as per IS : 2888 - 1983

(Clauses 4.4,6.3,1 &7.1)

Requirement for

bathing bar as per

IS : 13498 - 1997

Characteristics Requirement for: Bathing Bar

Grade I Grade II Grade III

Total fatty matter

(TFM) Min. 76 70 60 40


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TFM - Total fatty matter

It is ratio of mass of the fatty content to the mass of the soap.

Soaps are graded on the basis of the fatty matter

Soaps with TFM more than76% - Grade 1

Soaps with TFM more than 70% and below 76% - Grade 2

Soaps with TFM more than 60% and below 70% - Grade 3

Most soaps contain sodium and potassium salts as the keyingredients.

The formula for soap is:

Fatty acid (oil) + Base = "A Salt" (soap)

Importance

TFM content


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Low TFM bar comprising a low amount of total fatty matter

Provides for cleaning like a conventional bar

Not compromising on properties such as high lather

Suitable for personal washing applications.

It has been determined in the past that this high level of totalfatty matter is not required for cleaning purposes.

Sufficient cleaning can be obtained with a much lower amountof total fatty matter.

Role of TFM Cleansing

Lathering and

Smoothening

Importance

LOW TFM content


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How Does Soap Clean?

Excellent cleanser because of its emulsifying ability

An emulsifier disperses one liquid into another

immiscible liquid.

Means oil (which attracts dirt) doesn't naturally mix with

water, soap can suspend oil/dirt in such a way that it can

be removed

http://chemistry.about.com/library/weekly/aa081301a.htm


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Healthy skin is somewhat acidic with a pH of 5.5

Acid mantle - fine film with a slightly acidic pH on the surface of the

skin.

Integral part of the barrier function of the stratum corneum.

The acid mantle:

Supports the formation & maturation of epidermal lipids, and thereforethe maintenance of the barrier function

Prevents loss of moisture.

Provides indirect protection against invasion by microorganisms.

Provides direct protection against alkaline substances (alkalineutralizing-capacity).

Importance of the skin pH


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If acid mantle is disrupted or damaged, the skin is

prone to damage and infection

The entire skin surface pH is increased/disruptedin people with atopic dermatitis/ Dry skin disorders

Importance of the skin pH


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Soaps (pH -around 9.5 or alkaline) can cause the loss of acid mantle.

This alters the stratum corneum barrier function

Increased skin pH leads to increase in S.aureus colonization,

worsening of dry skin disorders.

Leading to sensitization of T cells& exacerbations in atopicdermatitis.

Alkaline pH soap also causes irritation/itching to skin

pH of soap and its importance

Ideal soap for Dry skin should match skin pH of 5.5


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volution of personal cleansingtechnology

Dermatologic Therapy, Vol. 17, 2004, 1625

Progress in skin care technology of cleansers

Toilet

Soap

Milder GlycerineSoap Bar

SyndetBars

Liquids

Advanced Skin careBars & Liquids

1950s

1950+

1957s

1990s/

1980s

2000+


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Oatmeal = Avena. or Avena sativa

Oatmeal is a natural remedy, used since ages for skin care by Arabs & Egyptians

The benefits of oatmeal are: Moisturization

Cleansing

Soothing of dry and itchy skin.

Anti-inflammatory properties

Colloidal oatmeal is a finely grounded and powdered oatmeal

Colloid nature holds the water molecules.

Recognized by the FDA as a skin protectant

COLLOIDAL OATMEAL as Skin Protector


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Relieves dry skin: Adheres to surface irritants

Get gently rinsed away, promoting relief.

Soothes itchy, irritated skin:

Provides temporary skin protection Relieves minor itching and irritation due to rashes & eczema

Moisturizes skin:

Leaves a protective barrier on the skin Prevents water loss to help maintain moisture

COLLOIDAL OATMEAL


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Skin is itchy and irritated, its pH may be higher.

Colloidal Oatmeal helps bring the pH back to normal levels

High concentration in starches & beta-glucan is responsible for theprotective and water-holding functions of oatmeal.

Different types of phenols offers antioxidant and anti-inflammatoryactivity

Some of the oat phenols are also strong ultraviolet absorbers.

The cleansing activity of oat is due to saponins.

Mechanism of action


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Dewmis Bar


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Dewmis Bar

Composition:

Colloidal Oatmeal5%

25% moisturizing formula (soap base contains 25%moisturizing cream)

TFM40%


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Dewmis Bar

Colloidal Oatmeal

Ensures gentle cleansing

Gently exfoliates the skin Absorbs dirt & Oil

Leaves skin feeling smooth & soft

Relieves from itching & irritation


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Dewmis Bar

25% moisturizing formula

Added advantages over other soap

No dryness unlike ordinary soaps Hydrates skin

Replenishes & retains natural moisture

Provides rich, creamy lather

Minimal TEWL


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Dewmis Bar

TFM content 40%

Ensures milder cleansing

Enhanced fragrance performance

pH 5.5*

Protects acid mantle

* Under standard climate condition


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Dewmis bar Cetaphil Bar

Colloidal Oatmeal & 25%

moisturizing formula

Sweet Almod oil 8%

pH 5.5 not revealed

TFM content40% TFM content76%

Dewmis Vs Cetaphil Bar


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Dewmis Aquasoft

Colloidal Oatmeal &

25% moisturizing formula

Soap base not known

pH 5.5 pH8 alkaline

Disrupts acid mantle

TFM content40% TFM contentGrade I

soap

Dewmis Vs Aquasoft Bar

De mis Vs Z ndet Bar


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Dewmis Zyndet



Syndet Base CU 0033

pH 5.5 pH5.5

TFM content40% Synthetic cleanser

As a daily moisturizing bath Promoting as an antiseptic

cleanser for atopic Dermatitis

Liquifies slowly Liquifies fast

Dewmis Vs Zyndet Bar


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Dewmis Vs Oatkin Bar

Dewmis Oatkin



Mineral oil, oat flour &

Vit.E

pH 5.5 pHalkaline

Disrupts acid mantle

TFM content40% TFM content76%

Highest moisturizing content No special moisturizing

content

Dewmis Medical

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