New innovation of moisturizers containing non-steroidal anti-inflammatory agents for atopic dermatitis

Table 1 Type of anti-inflammatory agents

Herbal extracts

Licorice

Glycyrrhiza inflate (Licochalcone A)

Glycyrrhiza glabra (Glycyrrhetinic acid)

Chamomile

Matricaria recutita (Bisabolol, chamazalene, apigenin)

Vitamins and minerals

Provitamin B5 (Dexpanthenol)

Vitamin B3 (Niacinamide)

Zinc

Lipids

Natural sources of lipids

N-palmitoylethanolamide extracted from palm oil

Linoleic acid extracted from:

Shea butter (Butyrospermum parkii)

Canola oil

Argar oil

Kernel oil

Spent grain wax

Portulaca oleracea Linn

Phytosterol extracted from shea butter

Synthetic lipids

Ceramides

Pseudoceramides

Table 2 Evidence of the clinical studies on the effectiveness of moisturizers containing anti-inflammatory agents

Ref.	Active ingredients	Design + Population + Age	Outcome measurement	Results
Udompataikul et al[6]	Licochalcone A, LA	Randomized controlled-investigator blind; n = 28, mean age = 5.8 yr old (2-15 yr old)	SCORAD score	Response rate 73.33% The effective- ness of LA was equal to 1% HC
Wananukul et al[7]	Licochalcone A, LA	Randomized, double-blind, split-side, study n = 55, age 3 mo-14 yr old	SCORAD score, TEWL	The effectiveness of LA was equal to 1% HC
Angelova Fischer et al[8]	LALDM	Randomized controlled-investigator blind, study; n = 20 mean age = 26.2 yr old	SCORAD score, TEWL, skin -conductance, Staphylococcus aureus colonization	LALDM was equal to 1% HC, and LALDM can reduce Staphylococcus aureus colonization
Abramovits et al[10]	Glycyrrhetinic acid, shea butter (MASO63DP)	Randomized, vehicle-controlled study; n = 218, age 18-84 years old	EASI score, IGA	The effectiveness of MASO63DP was more effective than vehicle
Boguniewicz et al[11]	Glycyrrhetinic acid, shea butter (MASO63DP)	Randomized, vehicle-controlled study; n = 142, age 18-84 yr old	EASI score, IGA	The effectiveness of MASO63DP was more effective than vehicle
Udompataikul et al[20]	Dexpanthenol, petrolatum	Open label; n = 30 mean age 7.19 yr old	SCORAD score	The effectiveness of dexpanthenol ointment was equal to 1% HC
Eberlein et al[30]	PEA, phytosterol ceramide in dermal membrane structure	Multicenter study (moisturizers as adjuvant treatment) n = 2456 (adult 1533, children 923)	Clinical and pruritic VAS	Pruritus reduction (VAS), Improvement of sleep quality, Reduction of previous use of topical corticosteroid were significant difference
Udompataikul et al[20]	Linoleic acids from Spent grain wax, shea butter, argan oil; phytosterols (LP)	Randomized investigator blind; n = 31, age = 4.24 yr old	SCORAD score	The effectiveness of LP was equal to 1% HC
Lee et al[40]	Multilamellar emulsion – pseudoceramide, type III synthetic ceramide (PC)	An open crossover study	Clinical	PC cream was more effective than urea cream

LA: Linoleic acid; SCORAD: Score of Atopic Dermatitis; EASI: Eczema Area and Severity Index; IGA: Investigator’s Global Assessment; TEWL: Transepidermal Water Loss; VAS: Visual Analogue Scale; LALDM: Licochalcone A, linoleic acid, decanediol menthoxypropanediol; PEA: N-palmitoyl ethanolamine.