SATURDAY

October 19

SESSION 4

4:10 – 4:30

Neil Shear

Cutaneous cleansers should remove bacteria and dirt with minimal disruption to the skin. Cutaneous cleansers are an important adjunct to skin health and the role of cleansing is particularly important in compromised skin. Cleansing is a complex interaction between the moisture skin barrier, environmental dirt, bacteria, body secretions and a detergent. Cleansers solubilize dirt and oil on the skin surface so that it can be easily removed.  The ultimate goal of cleansing is the gentle removal of micro-organisms and oil without irritating or damaging the skin. New research has revealed a complex interaction between the stratum corneum, cellular humectancy and skin pH.  Cleansers can cause damage to both the lipid and protein structures in the stratum corneum altering its barrier properties.  The composition and function of the cleanser determines its effect on the skin barrier and whether it will cause a skin reaction.  Detergents and preservatives are the primary cause of inflammatory skin reactions. Soap, the most commonly used cleanser, can raise the pH of the skin by 2-3 units, thereby disrupting the function of the skin barrier. Increased pH may lead to an increase in bacteria on the skin and ultimately skin infections. Acidic cleansers can regulate bacterial properties and reduce bacterial counts on the skin. Evidence based studies indicate that traditional detergents, such as sodium lauryl sulphate and soap salts, disrupt the moisture skin barrier leading to an increase in transepidermal water loss.  Cleansers differ not only in their composition and function but also in their interaction with the moisture skin barrier. The ideal skin cleanser would remove debris and oil without removing or disrupting the constitutive lipids that form the moisture skin barrier.