Commonly recommended moisturising products: effect on transepidermal water loss and hydration in a scar model
Tanja Klotz, H. M. Moran, Peter Vu, Guy J. Maddern, Marcus Wagstaff
Abstract
BACKGROUND: Moisturizing is a widely recommended and accessible approach to scar management, yet objective evidence supporting the efficacy of commonly used products remains limited. Research suggests that moisturizers may reduce hypertrophic scar activity by normalising transepidermal water loss (TEWL) and enhancing skin hydration. AIM: This study aimed to provide insights into the effect of generic moisturizers on TEWL and hydration in a scar model, helping clinicians make informed recommendations for scar treatment. METHODS: The performance of eight moisturizing products were evaluated using a tape-stripping method on normal skin to simulate the elevated TEWL conditions observed in active scars. Thirty participants were recruited based on power calculations, with TEWL and hydration measurements recorded at baseline and hourly for four hours. Untreated tape-stripped areas served as controls for each participant. RESULTS: Eucerin demonstrated the highest efficacy, significantly increasing hydration and normalising TEWL. Sorbolene ranked second, showing notable improvements in both hydration and TEWL regulation. Alhydran produced mixed results, effectively normalizing TEWL but reducing hydration. QV Lotion increased hydration but had minimal impact on TEWL. Aqueous Cream exhibited a non-significant trend toward TEWL normalisation. The silicone gel sheet provided high hydration levels but caused elevated TEWL after removal due to rapid evaporation of retained moisture. Liquid silicone (Strataderm) and BioOil performed poorly, with negligible effects on hydration and TEWL. CONCLUSION: These findings reveal significant variability in the effectiveness of common scar management products, emphasising the limited utility of liquid silicones compared to basic moisturizers. Products with balanced formulations of humectants, emollients, and occlusives showed objective evidence to indicate efficacy in managing hypertrophic scars during their active phase. This study offers evidence-based guidance for clinicians and highlights the need for further research to optimise formulations for scar management.