What is the body’s largest organ? Popular answers are the liver, brain, or lungs. But this coveted title goes to an external organ that accounts for about 16% of our body mass…the skin (1). Besides its aesthetic purpose, our skin serves many important functions. For example, it safeguards us from the sun, pollution, and germs; stores vitamin D and water; helps with managing body temperature; and takes in sensory data that allows us to understand what is happening in our environment (1). As such, maintaining the health and condition of our skin is vital, especially as we age.
Aging brings with it changes and challenges for our skin—such as increased dryness, stiffness, and risk of tears and bedsores (2-5). A variety of topical, non-drug treatments are available to help us address skin-related issues and preserve the quality of our skin. But do these treatments, which are applied directly to the skin, work? One systematic review did a deep dive into these skin care strategies to find out (2).
What the research tells us
The review looked at several non-drug treatments that fall under two main categories. The first is leave-on moisturizing products such as creams, lotions, or emollients—namely, urea-based products, glycerin-based products, plant-based products, and petrolatum. The second category is cleansing strategies, meaning washing or bathing procedures—namely, the use of disposable wash gloves and whirlpool or ultrasound tubs.
How do these different treatments stack up when compared to placebo, no treatment, usual care, or each other in people aged 50 or older who present signs of aging skin?
Let us start by tackling leave-on creams, lotions, or emollients. Compared to placebo or no treatment, urea-based products, glycerin-based products, and plant-based products may decrease skin dryness and enhance skin hydration. Glycerin-based products may also reduce peeling of the skin vs. placebo, as well as skin tears vs. usual care, while plant-based products may decrease peeling, itching, and scratch marks vs. no treatment. Furthermore, the evidence suggests that urea-based products may be superior to glycerin-based products for lessening skin dryness and peeling but may yield similar results when it comes to relieving skin itch. Lastly, folks with diabetes may be able to repair the cracked skin on their heals by using urea, glycerin, and petrolatum products, but only in the very short-term (at 2 weeks).
Moving on to cleansing strategies. Here, we see that using disposable wash gloves may lead to better skin hydration vs. usual methods of washing. Interestingly, it appears that bathing in a whirlpool or ultrasound tub, with or without specialized soap, may be no better than bathing in still water with standard soap.
Despite some positive results, it is important to note that they are based on a limited number of small studies and low to moderate quality evidence. This means that there is some uncertainty and that future, higher-quality research is needed and may yield different results (2). A greater understanding of how products directly compare to one another is also necessary.
With so many strategies to choose from and so much information to unpack, it can be easy to get overwhelmed. Lean on your health care team for support in identifying and addressing your skin concerns or those of someone you are caring for. Once an appropriate diagnosis has been made, discuss the available treatment options, weighing the pros and cons and tailoring treatment to your specific skin needs.
