Local treatment with topical creams featuring a mild alkaline pH could be helpful in reducing eczema-related skin inflammation in patients with mild atopic dermatitis (AD), a study published in the Journal of Cosmetic Dermatology suggests.

The single-arm, open-label study enrolled 25 patients (median age, 22.5 years) with mild AD and eczema who were not using topical or systemic glucocorticoids and/or antihistamines. Treatment consisted of Alkaline Build Up Caring Cream INTENSIVE and Alkaline Build Up Caring Cream PLUS+ (Siriderma®) for 8 weeks. The patented INTENSIVE cream product contains 25% zinc oxide and 1% sulfur and are combined in a mild alkaline environment with high levels of multiunsaturated fatty acids. Likewise, the AC PLUS+ product contains small amounts of both zinc oxide and colloidal silver.

At baseline and at 8 weeks, patients underwent dermatological, biochemical, and questionnaire-based examinations. Intensity and extension of AD were assessed using the objective SCORAD index, skin pH was measured using a skin planar glass electrode pH meter, and blood samples were taken to examine inflammatory markers.


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At baseline, the mean pH on the skin surface was 5.96. There was a small and insignificant 3.8% increase in pH after 8 weeks of treatment with the alkaline creams (P =.15). The researchers noted that this finding was important, given the role of pH in maintaining the outermost skin barrier function as well as the skin microbiome.

At 8 weeks, there was an approximately 30% decrease in total eczematous-affected skin area (P =.025). There were also significant reductions in average severity scores for erythema (P <.001), desquamation (P <.001), and lichenification (P <.001) by 8 weeks. In addition, there was a small increase in interleukin-8 by 8 weeks (7.48 vs 8.52 pg/mL; P =.037).

Patients also reported a 62.8% decrease in itching (P <.001), a 68.1% decrease in redness (P <.001), a 59.6% decrease in skin dryness (P <.001), and a 66.7% decrease in skin cracking (P =.002) by the end of treatment.

Limitations of this study included its lack of a control arm, the small sample size, and its open-label design.

The investigators concluded that this topical “local therapy alone or in combination with other anti-inflammatory drugs might represent an interesting and beneficial option for this diagnosis for which, to date, no curative treatment is available.”

Reference

Jurecek L, Rajcigelova T, Kozarova A, et al. Beneficial effects of an alkaline topical treatment in patients with mild atopic dermatitis. J Cosmet Dermatol. doi:10.1111/jocd.13936