Title : Application of nano size hyaluronic acids on sensitive facial skin eruptions
Acute sensitive facial skin eruption secondary to cosmetics and aesthetic procedures are common problems in clinic setting. Steroid phobia and anxiety of the distressed patients needed prompt effective management in gaining patient’s confidence. We reported using Nano size hyaluronic acid (N – HA) base serum rapidly relieving signs and symptoms.
Methods: In August, 2018, five patients with diagnosis of acute sensitive facial skin eruption were recruited with consents. All reported history of sensitive skin and completed a validated Sensitive Skin – 10 (SS – 10) items questionnaire. Patients requested treatment with steroids are excluded. The product used was called Hyalo-Oligo R; a N - HA with molecular weight of 7000 by conversion to intrinsic viscosity. Average molecular size of the hyaluronic acid is 15 – 25 nm. The serum contained 1% of N-HA in the form of Hyalo-Oligo R. A finger- tip size of 0.5 ml serum was gently message to the face and after 5 minutes, cotton gauze pads soaked with sterile normal saline was compressed to the treated areas for a further 10 minutes. The results measurements included patients’ subjective and physician objective assessments through a Visual Analogue Scale of signs and symptoms with documented pre and post treatment photographs. The SS – 10 questionnaire post treatment was also recorded. Results: Noticeable improvement of signs and symptoms were observed with no reported adverse reactions. A significant improvement of subjective and objective mean scores of 7.5 + 1.5 and 8 + 1.0 respectively were reported (p < 0.05). Post compared to pre-treatment photographs showed subsiding of erythema. The post SS -10 questionnaire was reported to show a reduction of sensitive scores. Conclusion: Gap among cells of stratum corneum is 40-50 nm. We hypothesized N – HA was delivered through these gaps via a direct, indirect trans epidermal and trans appendageal routes through percutaneous absorption. The normal saline with the N-HA may make the epidermal keratinocyte more permeable to the humectants. Propose mechanisms of N-HA were blockage of barrier defects, reduction of trans epidermal water loss through humectant effects, increase keratinocyte cell membrane permeability, modulation of inflammation with early tissue repairs. N-HA may rapidly subside acute sensitive facial skin eruption worth further investigation. A better designed controlled prospective trial will be carried out to observe the effects of N – HA on skin repair and healing. This may provide insights on the management on other chronic recalcitrant skin disease like chronic atopic eczema which have an aberrant epidermal defect and infrastructures.
Audience take away:
- N - HA may have a therapeutic effect on skin conditions especially during its acute presentation.
- N – HA is a safe non-pharmacological clinic-based procedure convenient to carry out to alleviating symptoms and signs of inflammatory skin conditions.
- N- HA mechanism on intracellular keratinocyte function especially in its barrier and hydration functions worth further scientific investigation.
- Better designed, large scale clinical and experimental study are mandated in future to study the effect of N -HA and other nano size micro molecules on keratinocyte function and regulation.
- Water in form of sterile normal saline seem to be an effective deliverance of N – HA which increase the keratinocyte permeability.