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Emollient use can be critical to the comfort of atopic
dermatitis patients, noted Dr. Stephen P. Stone, Associate
Professor of Dermatology at the Southern Illinois School of
Medicine. While it is well accepted that patients will do
better with limited bathing and application of a greasy
substance such as petroleum jelly, the practice is not without
drawbacks, Dr. Stone reported here. According to Dr. Stone,
petroleum jelly is not particularly effective if it is applied to
skin that is already dry. He added, “basically, you are sealing
out the moisture rather than sealing it in.”
By comparison, Vernix is composed of natural
ingredients that appear to recreate the natural physiology of
skin protection found in the newborn period.
“In my 22 years of practice in dermatology, this is my
favourite formula to moisturize and rebuild the natural
protective barrier of the skin,” Dr. Sylvestre remarked.
Integrating Emollients
Emollients can be an integral part of a well-rounded management
program for atopic dermatitis, said Dr. Richard G. Fried, Adjunct
Professor of Dermatology at Thomas Jefferson University,
Philadelphia, Pennsylvania, who spoke on non-pharmacologic
treatment of psychocutaneous problems. “It’s a pretty wide
spectrum according to the patient and the clinical setting,” he
reported. “It takes a very low level (of support) in terms of
offering some hope for the patients and some good education
so they will comply with everything from emollients to
corticosteroids.”
However, corticosteroids are known to produce a wide
range of side effects locally over the long term, including
thinning of the skin, striae, persistent erythema, atrophy
and telangiectasias. It is known that a host of other
complications can occur, including growth inhibition in
children, if steroids become systemically available via
percutaneous absorption.
Dermatologists familiar with Vernix said that in clinic,
the cream has helped patients reduce their dependence on
corticosteroids or eliminate their use entirely. Dr. Charles
Lynde, Assistant Professor of Dermatology at the University
of Toronto, Ontario, said he has used Vernix to treat
approximately 100 patients with atopic dermatitis—in
particular, hand dermatitis. In one case, the hand dermatitis
of a hairdresser in her early 20s was resolved in four weeks
using Vernix. She discontinued steroids completely, having
previously been recalcitrant to 15 or more steroid preparations.
“The patients were quite surprised,” Dr. Lynde commented,
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and added, “These were people who had been using steroids
for a long time.”
In other cases, patients with mild atopic dermatitis were
asked to apply a topical steroid to one lesion and apply Vernix
to a lesion on the opposite side of the body. In general, the
lesions treated with Vernix improved to a greater degree than
those treated with steroids. A similar protocol has been
described in the literature by researchers at the Department of
Child Health in Manchester, U.K., who concluded that differing
topical treatments compared simultaneously on opposite sides
of the body can help discern optimal therapy options for
patients with atopic dermatitis.
“Obviously, this was not a double-blind, prospective
trial, but many of these patients have already tried a lot of
other products and have not had benefit,” Dr. Lynde said.
According to Dr. Sylvestre, many eczema patients have
been able to use less topical steroid since starting with Vernix.
In addition, while Vernix will not eliminate inflammation like
corticosteroids do, regular usage has resulted in fewer lesions,
more comfort and less itching and inflammation as it eliminates
the dryness component of the disease.
“The results are remarkable,” Dr. Sylvestre said. “Some
people completely stop using topical steroids when before
they were addicted.”
Benefits Elucidated
The use of Vernix is not limited to atopics. Dermatologists
report successfully using the emollient to treat nipples chapped
from breast feeding, dry skin eczema, and skin dried out from
skiing and other outdoor winter activities. The cream has proven
helpful for preserving and protecting elderly skin, preventing
diaper rash, and softening the skin of the abdomen, hips
and breasts of pregnant women, possibly reducing the risk
of associated stretch marks. At the University of Cincinnati,
Dr. Steven Hoath, Pediatrics Professor and Director of The
Skin Sciences Institute is using Vernix to treat pediatric patients
with severe burns and plans to determine whether the product
is useful for treating wound infections.
Other uses aside, Vernix has clearly found a place in the
armamentarium of some Canadian dermatologists who are
helping their patients manage atopic dermatitis. “If you find
something that can keep things under control, can be used as
an adjunct and can even be used as a steroid sparer, that’s a
great thing to have,” Dr. Lynde said.
More studies involving Vernix are planned or underway,
including one examining its mechanism of action.
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