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Skin's Tight Junctions May Hold Secret to Offering Relief for Eczema With Exclusive Commentary from Joel Schlessinger, MD

Posted: December 20, 2010

NOTE: Only on SkinInc.com: Exclusive spa-focused commentary by leading dermatologist Joel Schlessinger, MD, follows this news item explaining what this finding may mean for the future of skin care for clients with eczema.

Like a fence or barricade intended to stop unwanted intruders, the skin serves as a barrier protecting the body from the hundreds of allergens, irritants, pollutants and microbes people come in contact with every day. In patients with eczema, or atopic dermatitis, the most common inflammatory human skin disease, the skin barrier is leaky, allowing intruders—pollen, mold, pet dander, dust mites and others—to be sensed by the skin and subsequently wreak havoc on the immune system.

Although the upper-most layer of the skin, the stratum corneum, has been pinned as the culprit in previous research, a new study published in the Journal of Allergy and Clinical Immunology found that a second skin barrier structure, consisting of cell-to-cell connections known as tight junctions, is also faulty in eczema patients and likely plays a role in the development of the disease. Tightening both leaky barriers may be an effective treatment strategy for eczema patients, who often have limited options to temper the disease.

"Over the past five years, disruption of the skin barrier has become a central hypothesis to explain the development of eczema," says Lisa Beck, MD, lead study author and associate professor in the department of dermatology at the University of Rochester Medical Center. "Our findings challenge the belief that the top layer of the skin or stratum corneum is the sole barrier structure: It suggests that both the stratum corneum and tight junctions need to be defective to jumpstart the disease."

Currently, there are no treatments that target skin barrier dysfunction in eczema. To treat eczema, which causes dry, red, itchy skin, physicians typically prescribe anti-inflammatory drugs, like prednisone, and a variety of topical anti-inflammatory creams and ointments. But, modest benefit, negative side effects and cost concerns associated with these therapies leave patients and doctors eagerly awaiting new alternatives.