A prospective, randomized, controlled double-blind study of a moisturizer for xerosis of the feet in patients with diabetes. Evaluation of the moisturizer Pédimed(®) in the foot care of diabetic patients. Xerosis of the feet: a comparative study on the effectiveness of two moisturizers. Comparison of salicylic acid and urea versus ammonium lactate for the treatment of foot xerosis. A randomized, double-blind, clinical study. A comparative study of lactic acid 10% and ammonium lactate 12% lotion in the treatment of foot xerosis. Fungal chitin-glucan scaffold for managing diabetic xerosis of the feet in menopausal women Ammonium lactate 12% lotion versus a liposome-based moisturizing lotion for plantar xerosis. A double-blind comparison study. The influence of a humectant-rich mixture on normalz skin barrier function and on once- and twice-daily treatment of foot xerosis. A prospective, randomized, evaluator-blind, bilateral and untreated-control study. An urea, arginine and carnosine based cream (Ureadin Rx Db ISDIN) shows greater efficacy in the treatment of severe xerosis of the feet in Type 2 diabetic patients in comparison with glycerol-based emollient cream. A randomized, assessor-blinded, controlled trial A double-blind clinical trial comparing the efficacy and safety of pure lanolin versus ammonium lactate 12% cream for the treatment of moderate to severe foot xerosis. Long-term emollient therapy improves xerosis in children with atopic dermatitis. Clinical Evaluation of 40% Urea and 12% Ammonium Lactate in the Treatment of Xerosis Can early skin care normalise dry skin and possibly prevent atopic eczema? A pilot study in young infants. Electrostimulating device in the management of xerostomia. A pilot study on the effects of a polyherbal formulation cream on diabetic foot ulcers Use of Nanotechnology-Designed Footsock in the Management of Preulcerative Conditions in the Diabetic Foot: Results of a Single, Blind Randomized Study Efficacy of topical 10% urea-based lotion in patients with ichthyosis vulgaris: a two-center, randomized, controlled, single-blind, right-vs.-left study in comparison with standard glycerol-based emollient cream
Xerosis is frequently noted in the feet of people with diabetes . The presence of xerosis increases the risk of complications , including infection and ulceration , making it imperative to counteract its effects . A prospect i ve , r and omized , controlled double-blind study was conducted to compare the efficacy of a test moisturizer containing 10 % urea and 4 % lactic acid versus its emulsion base vehicle in the treatment of  xerosis of the feet in patients with diabetes . Forty patients ( mean age 62 + /- 11 years ) with diabetes and moderate-to-severe xerosis of both feet were enrolled .  Xerosis severity was assessed using a nine-point Xerosis Assessment Scale . The tested moisturizer was applied to one foot and the vehicle to the other , twice a day , for 4 weeks . The regression of xerosis also was evaluated 2 weeks following discontinuation of the treatments . Progress was noted weekly with photographs and examination . Feet treated with the vehicle cream ( control ) had an initial mean xerosis grading of 6.17 ( + /- 0.79 ) and a final xerosis grading of 4.38 ( + /- 2.20 ) . In the treatment group , mean xerosis grading diminished from 6.13 ( + /- 0.73 ) to 3.19 ( + /- 2.23 ) after 4 weeks ( P < 0.01 ) . The difference between control and treatment remained statistically significant following discontinuation of cream application . In this study , regular use of a moisturizer was found to be beneficial in the treatment of moderate-to-severe xerosis of the feet in patients with diabetes . The cream containing 10 % urea and 4 % lactic acid provided faster and better improvement with significantly less xerosis regression AIM Xerosis is one of the most common abnormalities observed in the diabetic foot , promoting ulceration through the development of fissures and hyperkeratosis . Its treatment is therefore paramount and must be implemented early on . The objective of this study was to assess the moisturizing properties of Pédimed ( ® ) cream in the treatment of foot xerosis in diabetic patients . METHODS In this r and omized double-blind study , Pédimed ( ® ) and its placebo were r and omly allocated to the right/left foot of each patient ( one active/one control side ) . Products were applied twice daily for 4 weeks . Xerosis was assessed using the clinical Xerosis Assessment Scale ( XAS ) , corneometry ( skin hydration measurement ) and D-Squame ( ® ) ( scale sample analysis ) after 14 ( D14 ) and 28 ( D28 ) days of treatment . RESULTS Twenty-four men and 30 women , aged 57.0±12.7 years , with type 1 or type 2 diabetes and moderate-to-severe foot xerosis were included . A dramatic decrease in XAS score that was more marked with Pédimed ( ® ) than with placebo was observed from D14 ( 38.1 % vs 20.9 % , P<0.0001 ) , reaching 61.9 % vs 34.9 % at D28 ( P<0.0001 ) . The number of feet with fissures was greatly reduced with Pédimed ( ® ) compared with placebo at both D14 ( 11.1 % vs 22.2 % , P=0.031 ) and D28 ( 5.6 % vs 18.5 % , P=0.039 ) . Skin hydration increased by 48.9 % with Pédimed ( ® ) vs 31.7 % with placebo at D14 ( P=0.0002 ) , reaching 57.3 % vs 36.5 % at D28 ( P<0.0001 ) . All D-Squame ( ® ) parameters showed greater improvement with Pédimed ( ® ) . Product tolerability was excellent . CONCLUSION Vali date d clinical and para clinical tools demonstrated the efficacy  of Pédimed ( ® ) in improving xerosis and reducing fissures of the feet in diabetic patients The treatment for xerosis ( dry skin ) is the repeated use of moisturizers to hydrate the skin . Their use is based on sound evidence of the importance of maintaining the skin 's water content . Although the skin on the plantar surface of the foot is very thick , it is highly visco-elastic and copes with high levels of frictional , compressive and shear stresses applied to it by being supple and well hydrated . Problems arise when the skin becomes dry and loses its elastic properties . Fissures can occur which are often painful and can act as portals for infection . This article describes a double-blind clinical study to evaluate and compare the effectiveness of two commonly used moisturizers and to see if one was significantly better than the other at hydrating the skin of the feet . The two creams used were Aqueous Cream BP and CCS Foot Care Cream .  Skin hydration levels were measured before any application of moisturizer and again after two weeks of twice daily application . Results showed that the regular use of both moisturizers had a significant hydrating effect on the skin . However , CCS Foot Care Cream had a significantly greater hydrating effect than Aqueous Cream BP Xerosis is defined as dehydration of skin characterized by redness , dry scaling , and fine crackling that may resemble the crackling of porcelain . The present double-blind trial was a r and omized paired comparison study evaluating the keratolytic effect of 5 % salicylic acid and 10 % urea ointment ( Kerasal ) on one foot and 12 % ammonium lactate lotion ( Lac-Hydrin ) on the other foot in mild-to-moderate xerosis . Seventy patients were initially enrolled in the trial . Fifty-four patients were evaluated after 2 weeks of treatment ; of those 54 patients , 39 were evaluated after 4 weeks of treatment . Although there was significant improvement in severity of xerosis after 2 and 4 weeks of treatment , there was no statistically significant difference between treatment groups . Irrespective of the mechanism of action , this study shows that both Kerasal and Lac-Hydrin 12 % lotion result in reduction in the severity of xerosis after 4 weeks of therapy Xerotic skin is a pattern of reaction to a variety of disorders that have abnormalities of desquamation in common . This double-blind , r and omized clinical trial investigated the effect of Lactinol ( Pedinol Pharmaceuticals , Farmingdale , New York ) versus Lac-Hydrin 12 % ( Bristol-Myers Squibb , Princeton , New Jersey ) lotion in mild to moderate foot xerosis .  Clinical assessment of xerosis was performed at baseline visit , and the design ated sites were evaluated at 2 and 4 weeks after treatment began . Of the 53 patients enrolled , 18 were excluded from analysis . Although both treatment groups had significantly improved xerosis scores after 2 and 4 weeks of treatment , no statistically significant difference was observed . Of the 44 % of patients who did express a preference , 72 % preferred Lactinol , which may account for the 20 % increase in its overall use in the study Background : Corneocyte accumulation ( hyperkeratosis , xerosis ) commonly occurs in the stratum corneum ( SC ) of the feet of diabetic patients , as well as menopausal women . Objective : To compare the effects of a 1.5 % chitin-glucan formulation with its placebo , and commercially available glycerol formulations . Methods : This two-step controlled double-blind , r and omized , intra-individual study was performed in 30 type 1 and 2 diabetic menopausal women suffering from xerosis of the feet . The formulations were applied once daily for 3 weeks . Electrometric assessment s were performed on three sites of the feet at entry in the study , at weekly intervals during the treatment phase , and in a 2-week follow-up out of treatment . Positive controls consisted in two commercially available formulations enriched in glycerol . Results : Data revealed an unequivocal benefit provided by the 1.5 % chitin-glucan formulation compared with placebo . The electrometric values were significantly higher at each evaluation time during both treatment and follow-up phases . The two glycerol-enriched formulations showed slightly different kinetics of SC moisturization . A steep increase was followed by a plateau level and a rapid decline after stopping the treatments . Conclusion : The increased moisturization of the SC of the sole probably improves the desquamation process and reduces xerosis of the soles Two emollients , ammonium lactate 12 % lotion and a liposome-based moisturizing lotion , were compared in a double-blind test for efficacy in the treatment of plantar xerosis . A total of 43 out of 57 participants ( 75 % ) with bilateral plantar xerosis followed instructions completely and applied the lotions ( one to each foot ) twice daily for 4 weeks . Each participant was evaluated once a week for 6 weeks ( the final 2 weeks for evaluation of post-treatment regression ) to determine xerotic grade ( degree of dryness ) and treatment effectiveness . With both lotions , significant improvement began during the second week of treatment and continued into the fourth week . There were no significant differences between the two lotions in the 6-week patterns of either xerotic grade or treatment effectiveness BACKGROUND Moisturizers are often used to overcome dry skin conditions . However , cosmetic moisturizers may lack in efficiency and may also deteriorate skin barrier function . The objective of this study was to generate data on a new humectant-rich formulation ( 15 % alfahydroxy acids and 15 % urea ) in the treatment of normal skin as well as in dry feet with hyperkeratosis and cracked skin with fissures . Changes in permeability and effectiveness of the product after once- and twice-daily applications to the feet will be monitored . METHODS The study was r and omized , bilateral , controlled and evaluator-blind . The first part of the study included 12 healthy volunteers and the second part 50 patients with hyperkeratotic feet . The changes in the skin was evaluated by an expert , the patients and using non-invasive biophysical measurements of skin barrier function ( transepidermal water loss , TEWL ) , erythema , thickness ( ultrasound ) and hydration ( conductance ) . RESULTS The humectant-rich formulation increased skin hydration , removed scales and reduced thickness of hyperkeratotic skin . Skin barrier function was improved in normal skin , but no changes in TEWL were noted in the feet . No difference between once and twice-daily applications was found . Some smarting and stinging was noted . CONCLUSION The humectant-rich formulation efficiently relieved the xerosis on the feet without inducing any weakening of the skin barrier function . Instead the normal skin became more resistant to external insults by the treatment Background Xerosis is a common skin disorder frequently observed in diabetic patients . An effective hydration of foot skin in diabetics is a relevant preventive strategy in order to maintain a healthy foot . Urea is considered an effective hydrating and emollient topical product . The aim of the present study was to evaluate the efficacy of topical urea 5 % with arginine and carnosine ( Ureadin Rx Db , ISDIN Spain ) ( UC ) in comparison with glycerol-based emollient topical product ( Dexeryl , Pierre Fabre ) ( EC ) , in Type 2 diabetic patients . Methods We assessed the effect of UC on skin hydration in a r and omized , evaluator-blinded comparative study in 40 type II diabetic patients , aged 40–75 years , treated with UC or the comparator for 28 days with a twice-daily application . The principal outcomes were the Dryness Area Severity Index ( DASI ) Score and the Visual Analogue Score ( VAS ) for skin dryness evaluated at baseline and at the end of study period by an investigator unaware of treatment allocation . Results UC induced significantly greater hydration than EC with an 89 % reduction in DASI score ( from 1.6 to 0.2 ; p < 0.001 ) in comparison with baseline values . After 4 weeks , compared with the control group , DASI score in UC treated group was significantly lower ( 0.2 vs. 1.0 ; p = 0.048 ) . VAS score ( high values mean better hydration ) significantly increased in both groups during treatment . VAS score at the end of treatment period was significantly higher in UC group in comparison with EC group ( 9.8 vs. 8.2 ; p = 0.05 ) . Conclusion Application of urea 5 % , arginine and carnosine cream increases skin hydration and alleviates the condition of skin dryness in Type 2 diabetic patients in comparison with a control glycerol-based emollient product . ( Dutch Trials Register trial number 3328 ) Xerotic skin is a pattern of reaction to a variety of disorders ( eg , winter xerosis , hereditary ichthyosis ) with abnormalities of desquamation in common . The trial described in this article was a double-blind r and omized-comparison clinical trial investigating the effect of pure lanolin versus ammonium lactate 12 % cream in treating moderate to severe foot xerosis . Xerosis was clinical ly assessed at baseline visit , and design ated sites were reevaluated after 1 , 2 , and 4 weeks of therapy . Ninety-two patients were enrolled ; 41 of these were excluded from analysis ( 25 were lost to follow-up , 8 were noncompliant , 1 was discharged from study because of an adverse event after visit 1 , and 7 were noncompliant after visit 2 ) . Although there was significant improvement in xerosis scores for both treatment groups after 2 and 4 weeks of treatment , no differences were statistically significant . Used twice daily for 4 weeks , pure lanolin and ammonium lactate cream were both effective in treating moderate to severe xerosis BACKGROUND Hydration with topical emollients forms the backbone of treatment for mild atopic dermatitis ( AD ) , but few r and omized controlled trials have assessed their efficacy in young children . OBJECTIVES Assess the efficacy and tolerability of long-term emollient therapy in the treatment of moderate to severe xerosis in young children with AD . METHODS This was a phase III , multicentre , double-blind , r and omized , vehicle-controlled trial . Children ( n = 251 ) aged 2 - 6 years with AD-associated xerosis were r and omized 1 : 1 to a 28-day treatment with an emollient combining glycerol and paraffin or its vehicle . Non-responders at the end of the double-blind period were treated open label with emollient until day 84 . Responders stopped treatment until re assessment on day 56 . Those who relapsed after stopping treatment were treated open label with emollient until day 84 . RESULTS During the double-blind period , xerosis score ( XS ) of the scoring atopic dermatitis ( SCORAD ) index , objective SCORAD and visual analogue score decreased and skin hydration increased more in the emollient group than in the vehicle group ( P < 0.001 for all measures ) . More patients were responders with emollient than with vehicle ( 66.1 % vs. 45.6 % , P < 0.001 ) . During the open-label period , stopping emollient treatment led to relapse but improvement returned if treatment was restarted with emollient . Regular use of the emollient also yielded improvement in children who did not initially respond . Adverse events were similar in the two groups , and no treatment-related severe adverse events were reported . CONCLUSIONS Long-term therapy with emollient is effective and well tolerated for the treatment of xerosis in children with atopic dermatitis Abstract Background : Urea and ammonium lactate are used for the treatment of xerosis , with different degrees of success . This study compares the clinical effectiveness of these two agents . Objective : To compare the effectiveness and tolerance of a 40 % urea topical cream (Carmol ® 40)1 from Doak Dermatologics , a subsidiary of Bradley Pharmaceuticals , Inc. , and 12 % ammonium lactate topical lotion ( Lac-Hydrin ® 12 % ) from Westwood Squibb , a division of Bristol-Myers Squibb . Methods : A r and omized , double-blind , bilateral paired comparison study was conducted involving 25 men and women who were undergoing treatment for moderate to severe xerosis . The study included evaluations upon initiation of the study , after a 14-day treatment period and treatment follow-up on day 28 . Results : Eighteen study participants completed the entire 28-day evaluation period . Evaluation of treatment benefit was based on instrumental measurement of water loss from the skin surface , skin capacitance , skin desquamation , skin roughness , subject self assessment of skin and investigator evaluation . Results indicated that clinical observation ratings by patients and investigators , as well as instrument measures , show differences between the two treatments . Most measures show that improvement is achieved in less time with 40 % urea cream than with 12 % ammonium lactate lotion . On day 14 , the 40 % urea cream was superior to the 12 % ammonium lactate lotion as measured by skin roughness , fissure reduction , thickness and dryness . Discussion : At day 14 of treatment , 40 % urea cream was superior to 12 % ammonium lactate for most of the instrumental and clinical assessment BACKGROUND Atopic eczema ( AE ) affects approximately 20 % of children in Northern countries . Onset during early infancy is common and is characterised by altered skin barrier , increased water loss and defective lipid layer . Restoration of skin barrier by emollients and /or oil baths is an important part of AE treatment , but its role in preventing xerosis and AE is unknown . The present pilot study aim ed to assess if xerosis , and possibly AE , could be reduced at six months of age by early introduction of frequent oil baths/facial fat cream in infants with dry skin . METHODS A controlled intervention pilot study included 56 six-week-old infants with xerosis , but not AE .  Skin quality score ranging from 0 ( normal skin ) to 4 ( probable AE ) , was assessed at inclusion , three and six months of age , with skin quality at six months as main outcome . One well baby clinic was recruited for intervention , frequent skin care ( oil bath ( 0.5 dl ) and facial fat cream , five well baby clinics recruited for observation only . RESULTS The intervention group ( n=24 ) had more often normal skin ( 75 % ) at six months than the observation group ( 37.5 % ) ( p<0.001 ) , and less often probable AE ( 4.0 vs. 19.0 % , respectively , ns ) . Oil baths were performed regularly , 2 - 4 up to 5 - 7 times/week in the intervention group , vs. fewer oil baths with sparse volume of oil in the observation group . No adverse reactions were reported . CONCLUSION Regular oil baths in infants seem to reduce xerosis and may possibly reduce atopic eczema INTRODUCTION The present study was undertaken to evaluate the safety and effectiveness of a recently developed electrostimulating device mounted on an individualized intra-oral removable appliance . MATERIAL S AND METHODS The device , containing electrodes , a wetness sensor , an electronic circuit and a power source , was tested on patients with xerostomia in a crossover , r and omized , sham-controlled , double-blinded , multicenter study .  Electrical stimulation and also sham were delivered during 10 min to the oral mucosa , in the m and ibular third molar region . Oral dryness was measured by the sensor . As the primary outcome , sensor dryness and xerostomia symptom changes as a result of device wearing were assessed , and compared between active and sham modes . In addition , side-effects were recorded . RESULTS Electrostimulation result ed in a significant decrease in sensor dryness , leading to a beneficial effect on patients ' subjective condition . No significant side-effects were observed Background & objectives : Diabetic foot ulcers are the most common cause of non-traumatic lower extremity amputations in developing countries . The aim of this pilot study was to evaluate the safety of using a polyherbal formulation in healing diabetic foot ulcers in comparison with st and ard silver sulphadiazine cream among patients with type 2 diabetes . Methods : A total of 40 ( M : F=29:14 ) consecutive type 2 diabetes patients with foot ulcers were enrolled in this study . They were r and omly assigned to two groups of 20 each ; Group 1 was treated with polyherbal formulation and group 2 with silver sulphadiazine cream . All the patients were followed up for a period of 5 months . The baseline ulcer size was noted and photograph of the wound was taken at the baseline and at each follow up visit . Number of days taken for healing of the wound was recorded . Results : The mean age of patients , duration of diabetes and HbA1c% were similar in both the study groups . The mean length and width of the ulcers was also similar in both the groups at baseline visit . There was a significant decrease in the size of the wound ( length and width ) in both the study groups ( P<0.001 ) . The mean time taken for the healing of the ulcer was around 43 days in both groups . Interpretation & conclusions : Diabetic wound cream prepared by using polyherbal formulation was found to be effective as well as safe in healing diabetic foot ulcers like the st and ard silver sulphadiazine cream The Difoprev system constituted by a sock loaded with nanocapsules containing a hydrating agent in the diabetic foot is tested . A total of 30 neuropathic out patients with foot anhydrosis were r and omized into group A , treated with the application of the sock with the nanocapsules , and group B wearing only the socks without the nanocapsules . Patients were blindly evaluated with a clinical score , hygrometry , transepidermal water loss , skin temperature , and skin hardness at baseline and after 6 weeks . No difference between the groups emerged at baseline . Although group B showed no changes at the end of the treatment , group A significantly ( P < .05 ) improved in all the parameters evaluated . No adverse events were recorded in both groups during the study . The use of hydrating agents carried by nanocapsules-loaded socks is safe and effective for the neuropathic diabetic foot Abstract Background : Ichthyoses are genetic disorders of keratinization which are uncomfortable due to their conspicuous scaling , itching and cosmetic problems . Ichthyoses can lead to social discrimination and psychological problems . Ichthyosis vulgaris ( IV ) is the most common form of these geno-dermatoses . IV is a chronic disorder that often requires continuous therapy . Emollient and keratolytic products are the mainstay treatments of IV . It is important that efficient , safe and well tolerated therapies should be available . Direct comparative data regarding efficacy of different emollient products in IV patients are very few . Objective : The aim of the study was to investigate the keratolytic and moisturizing properties as well as the tolerance of a new urea topical formulation ( Ureadin Rx10 ) when applied to hyperkeratotic and dry skin in patients with ( IV ) in comparison with a st and ard emollient cream . Methods : The study was conducted as a two-center , r and omized , controlled , single-blind , intra-patient ( right-vs.-left ) trial design . A total of 30 patients with IV between 8 and 65 ( mean age : 25 years ) treated with a 10 % urea-based lotion , Ureadin Rx 10 * Ureadin RX 10 is a registered trade name of ISDIN , Spain . ( URx ) , for 4 weeks or a glycerol-based emollient cream , Dexeryl †Dexeryl is a registered trade name of Pierre Fabre Dermatologie . ( DC ) , in a right-vs.-left study design . Primary outcome was a 5-point SRRC Index score ( evaluating scaling roughness , redness and cracks ) evaluated at baseline and after 2 and 4 weeks of treatment . As secondary endpoints patients evaluated also the global efficacy ( GE ) and global tolerability ( GT ) scores with the help of a 10 cm visual analogue scale ( 0 = no efficacy at all/very bad tolerability ; 10 : excellent efficacy/excellent tolerability ) . Results : At baseline the mean ( SD ) SRRC score was 9.5 ( 1.9 ) in the URx treated sites and 9.5 ( 1.9 ) in the DC treated sites . A total of 27 patients ( 90 % ) concluded the study period . Three patients were withdrawn prematurely because of itching and burning sensation after DC application ( 1 patient ) or URx application ( 2 patients ) . At week 4 , in comparison with baseline values , both treatments were shown to be clinical ly effective : SRRC significantly ( p = 0.0001 ) decreased to 3.3 ( 1.8 ) after URx ( a 65 % relative reduction ) and to 5.7 ( 2.5 ) after DC ( a 40 % relative reduction ) . SRRC was significantly lower in URx treated regions in comparison with DC both after 2 and 4 weeks of treatment ( p = 0.0005 ) . Mean GE score in areas treated with URx was significantly ( p = 0.0001 ) higher than in the areas treated with the DC ( 8.9 vs.7.3 ) . Both treatments were in general well tolerated . GT score was 8.1 ( range 10 to 3 ) with URx and 8.4 ( range 10 to 3 ) with DC application ( p = ns ) . The two main limitations of this trial are the study design ( single blind ) , and the small sample size which is not adequate for an evaluation of safety . Conclusion : Ureadin Rx 10 lotion has shown a greater efficacy on ichthyosis vulgaris in term of reduction of scaling , roughness , redness and cracking in comparison with a glycerol-based emollient cream . Tolerability of the two topical treatments was comparable . Further studies with larger sample sizes are needed for the evaluation of safety and tolerability of urea 10 % lotion in this clinical setting
Conclusions No conclusive recommendations were possible due to wide variation in study quality , method ologies and outcome measures .
A synthesis of available literature suggests that treatments containing urea as a primary active ingredient have been the most research ed .
Background Xerosis , literally dryness of the skin , of the foot is a common condition encountered clinical ly , which can lead to discomfort and predisposition to infection .
Currently , there are no evidence -based recommendations on which moisturiser formulations best alleviate xerotic symptoms .
The aim of this review was to guide clinical practice in the treatment of primary and diabetes related foot xerosis , by identifying from the existing literature the most effective ingredient or formulation of topical treatments for symptoms of primary foot xerosis in the general population .