The water barrier function of the skin in relation to the water content of stratum corneum, pH and skin lipids. The effect of alkaline soap and syndet on dry skin in elderly, non-atopic patients

Clinical dryness of the skin is a common problem among elderly, dermatological patients. In the present investigation, hydration, surface lipids, skin pH and water barrier function as expressed by the transepidermal water loss (TEWL) were studied in both dry and normal skin. Using these parameters, a comparison of the local effects of acid and alkaline cleansing products was made. In non-atopic elderly patients with dry skin, the TEWL values were lower than in the younger control group but higher than in the older controls. Following one week's topical therapy, the TEWL values in the patient group decreased further and approached the lower values of the older control group. At the same time the skin hydration values increased, indicating a beneficial effect on the skin barrier. An inverse relationship was demonstrated between TEWL and skin hydration. The study indicates that high TEWL values are frequently correlated with high pH, low hydration of the stratum corneum and reduced skin surface lipid content. Despite the intensive use of an acid syndet and lotion, the pH-readings increased but were still within the 'confidence limits' of the control groups.