Dermoscopy for the Evaluation of Skin Barrier Repair

skin cancer dermoscopy
Female dermatologist (30s, mixed race, Asian / Caucasian) examining male patient (30s) with dermascope, looking for signs of skin cancer. Focus on woman.
Characteristic image changes under the dermoscope and the relationship with skin physiological indexes in skin barrier damaging and repairing process were investigated.

Dermoscopy may be an effective means of evaluating the process of skin barrier repair after damage, suggests study data published in the Journal of Cosmetic Dermatology. Although dermoscopy is typically used for the visual assessment of dermatologic disorders, it may also have utility in assessing skin barrier integrity and function.

This preliminary study enrolled 25 healthy patients with normal forearm skin from the dermatology clinic of a major hospital in Guangzhou, China. Patients underwent repeated tape-stripping to remove the stratum corneum, followed by examination with the dermoscope to observe skin repair. Patients were divided into groups based on the number of repetitions for the tape stripping process: 30, 35, and 40 times for group A,group B, and group C, respectively. For the stripping process, sterilized tapes were applied to a marked test area then removed with sterile forceps. Dermoscopy was performed before tape stripping, immediately after tape stripping, and at follow-up visits on days 3, 7, 14, and 21. Skin surface hydration and transepidermal water loss (TEWL) were also assessed at these time points.

All 25 patients completed the study. Mean age was 36.52 ± 8.29 years, and the majority (n=20; 80%) were women. Immediately after 30 tape stripping repetitions (group A), a small amount of cuticle cells could be identified via dermoscopy. In group B, dermoscopic images had no cuticle cell residue, instead displaying “blurry vessels.” In group C, branching vessels with no cuticle cell residue were observed immediately after stripping. The researchers noted that 3 days after tape stripping, vessels were no longer visually apparent in any group. At day 7, keratin was most apparent in group C compared to other groups. During the repair process, scab formation occurred by day 14, day 7, and day 3 for groups A, B, and C, respectively.

Mean TEWL values were significantly different between groups A and B immediately after skin stripping, with group B experiencing more TEWL (P =.02). However, groups B and C did not have significantly different TEWL values at any time point. When patients were stratified according to skin surface hydration, those with higher hydration had unique visual dermoscopy characteristics. Specifically, patients with greater skin surface hydration had no cuticle cell residue immediately after stripping, and “blurry vessels” were visually apparent. Micro-scabs formed by day 7 in the lower hydration group and day 3 in the higher hydration group.

These data suggest that dermoscopy may provide useful information about skin barrier repair in patients with healthy skin. Physiological changes in skin barrier could be clearly observed with the dermoscope.  “By combining dermoscopy and skin indexes assessing technologies, the skin barrier integrity and function [can] be observed and evaluated more accurately and precisely,” investigators wrote.


Ye C, Yi J, Lai W, Zheng Y. Skin barrier damaging and repairing process: A new application field of dermoscopy [published online September 6, 2020]. J Cosmet Dermatol. doi: 10.1111/jocd.13643