Concepts in skin care maintenance

The correct use of moisturizers and cleansers is an integral component of the skin care regimen for any patient with dermatologic disease. As discussed in this article, moisturizers that contain certain ingredients, including occlusives and humectants, offer the most complete benefits with regard to repair of the damaged stratum corneum. When used appropriately, these products not only improve skin hydration by reducing transepidermal water loss (TEWL) but also help to restore the skin barrier and improve the aesthetic appearance of the skin, which is an important concern from the patient's perspective. The use of skin cleansers also is a central consideration in patients with dermatologic disease, but these agents vary widely and must be selected carefully on the basis of the patient's clinical presentation. In most cases, syndets, combars, and lipid-free cleansers offer clear advantages over true soaps. In addition, a variety of cleansing implements such as mesh sponges, particulate abrasive scrubs, and woven face cloths are available, though most are not well suited for use by patients with barrier damage. Because improper skin care can worsen the condition or impede the treatment outcome, proper moisturizing and cleansing are essential components of an overall treatment plan to ensure a satisfactory therapeutic outcome in patients with any barrier defect.