Xerosis treatment

Fig. i4.8a-d. Melasma of the face before and after combined peeling with 25% salicylic acid and 10% TCA gel. Note in c skin xerosis 2 days after the first treatment... 

Treatment of ichthyosis vulgaris and xerosis PO Apply sparingly and rub into area thoroughly ql2h. 

Nowicki and Bara ska-Rybak (2007) studied the protective effect of shark liver oil. They observed a significant protection against bacterial and fungal infections by shark liver oil treatment which contains mostly squalene and alkylglycerol. Further, this treatment showed improved effects on xerosis and skin lesion-induced atopic dermatitis. This antibacterial and antifungal effect could be accounted for the high-squalene-including composition of the shark liver oil however, detailed studies are needed to be carried out for reputed activity of squalene as an anti-infectant. 

Although treatment of xerosis and scaling is a sine qua non in LI therapy, other skin symptoms also need to be taken care of. Thus, ectropion, alopecia, and finger contractions are usually unresponsive to medical treatment, and only occasional patients with anhidrosis will improve the sweating capacity when using potent oral drugs for LI.36... 

Xerosis with itch is present in more than 20% of patients with HIV infection, and most commonly is localized on the lower extremities.19 One study revealed the cutaneous neural tissue density within the papillary dermis and epidermis to be significantly decreased in HIV infected patients versus healthy controls.20 The study also reported significant differences in neuropeptide concentrations within HIV infected individuals. For example, calcitonin gene-related peptide (CGRP) was reduced in the epidermis in both the upper arms and legs, whereas substance P was found to be reduced only in the upper arms of HIV patients with itch. Dry skin and itch can also be induced iatrogenically via commonly prescribed medications for HIV such as indinavir etc. The standard in HIV treatment involves protease inhibitors, such as indinavir, which have been shown to induce dry skin and itch in over 40% of patients.21... 

Topical application of Cathepsin D-like enzyme from mushroom extract (Actizyme) has also been shown to be beneficial for the treatment of xerosis.47 In dry skin SC turnover is reduced. This parameter can be measured in vivo using the dansyl chloride test. Addition of this enzyme to a formulation increased SC turnover by about 30%. This was of similar order to the effect of hydroxyacids, retinol, and mechanical scrubbing. In contrast to these treatments use of the enzyme did not impair barrier function nor increase stinging scores. 

Treatment of xerosis on the plantar surface of the feet for two weeks gave more pronounced improvement in skin roughness, fissures, and dryness by a 40% urea cream (Carmol 40) than from a 12% ammonium lactate lotion (Lac-Hydrin).40 No change in transepidermal water loss (TEWL) was noted from urea-treatment. Both therapies showed sustained benefit during the next two weeks. Furthermore, a cream containing 10% urea and 4% lactic acid provided faster and better improvement with significantly less xerosis regression in patients with diabetes.41... 

Figure 29-1. Two views of eye symptoms for a boy aged 3 years and 8 months with vitamin A deficiency (case study 1). Bitot s spot and corneal xerosis are present in these views. Following treatment with vitamin A for 14 days, the eye symptoms returned to normal.

AHAs have been prescribed for a long time in the treatment of xerosis, ichthyosis and sometimes warts. Dry and rough skins are an excellent indication for AHA creams and peels. 

Keratolytics are available in a multitude of formulations for treating skin diseases. Prolonged use of salicylic acid preparations over large areas, especially in children and patients with renal and hepatic impairment, can result in salicylism. Irritation is a common side effect with higher concentrations. Lactic acid (Lac-hydrin, others) is an emoUient that contains 12% lactic acid, which is an effective moisturizer indicated for the treatment of xerosis and ichthyosis vulgaris. 

Glycolic acid is marketed in multiple cosmetic preparations (4 to 10%) and is used for the treatment of xerosis, ichthyosis, and photoaging. 

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