WASHINGTON - A new facial moisturizer formulated with a complex of vitamins is an excellent choice for ancillary skin care in rosacea patients, Zoe D. Draelos, M.D., said at the annual meeting of the American Academy of Dermatology.

In a study enrolling 48 adult females with mild-to-moderate rosacea, the product was well tolerated by all patients and also caused positive alterations in skin barrier function that translated clinically into marked improvements in patient- and physician-rated features of skin appearance.

"Selection of an appropriate moisturizer for rosacea patients can be difficult. This new product, which I evaluated, does not just contain moisturizing ingredients but it is designed to improve the skin barrier and texture. Maintaining the skin barrier in excellent condition is critical for rosacea patients in whom exposure to an irritant can induce a cycle of erythema that may persist for days. The ability of this moisturizer to improve skin appearance is probably due in part to its improvement of barrier function, which helped to reduce the risk of irritation from cosmetics and other products being applied to the face, said Dr. Draelos, clinical associate professor of dermatology, Wake Forest University Medical School, Winston-Salem, N.C.

The product tested contains niacinamide (vitamin B3), which increases exfoliation, tocopheryl acetate (vitamin E), which has emollient properties and helps to smooth the skin surface as well as reduce moisture loss, and panthenol, a good humectant acting to increase skin hydration. And this combination has been shown to improve barrier function. Another unique feature is its packaging. The new moisturizer is a cream but is dispensed as a lotion through a novel pump delivery system.

"Rosacea patients often prefer lotions over creams as the latter type of products may increase any shine that tends to be present already. However, lotions can be irritating because they may be formulated with propylene glycol and evaporate rapidly. This new product provides patients with the desired cosmetic features of a lotion while avoiding the drawbacks of that formulation type," Dr. Draelos said.

The study she conducted evaluating the effects of adjunctive use of the new facial moisturizing product enrolled women with advanced stage I or stage II rosacea. Patients were excluded if they were using any oral or topical corticosteroids or had more than 10 inflammatory lesions.

"This moisturizer product is also a good choice for use by patients with more severe rosacea in addition to prescription therapy targeted at treating their underlying disease. However, benefits on skin appearance, especially with respect to erythema, are likely to occur more rapidly in women whose condition is characterized by less of an acne component," Dr. Draelos commented.

Baseline measurements were made after a two-week washout period during which other prescription medications for rosacea were continued while women washed with a synthetic detergent-based product and used a bland moisturizing lotion. Thereafter, the moisturizer was switched to the new vitamin-containing product while other rosacea care was maintained.

In addition to applying the moisturizer to the face, participants were instructed to apply it to the dorsal surface of one randomly selected forearm twice daily. The patients were unaware of the moisturizer product's identity and Dr. Draelos was blinded as to which forearm was selected for moisturizer application.

The assessments included investigator and patient ratings of the severity of a variety of rosacea signs and symptoms as well as inflammatory lesion counts and global ratings of appearance. In addition, barrier function of the face and forearms was determined by measuring hydration and transepidermal water loss and with ratings of reaction to various concentrations of DMSO (forearms only).

All but two women enrolled in the study completed the four-week treatment phase. Benefits of using the moisturizer product were seen early. At the two-week visit, about 80 percent of women were rated by the investigator as showing global improvement in their rosacea condition, and by study completion, 96 percent were judged as improved.

While all individual facial attributes were rated as improved, reduction in erythema, dryness, and scaling/peeling were most notable. For example, erythema was judged as moderate or severe in more than 50 percent of women at baseline, whereas at study completion, erythema was considered absent to mild in the vast majority of women and severe in none. Similarly, patients consistently rated themselves as improved in the various outcome parameters, with mean responses for each item falling in the range of "moderately better."

Use of the new moisturizer product resulted in reduction of transepidermal water loss from the facial skin compared with baseline. At study completion, transepidermal water loss was significantly lower from the treated versus untreated forearm. In addition, mean wheal and erythema responses to the DMSO probes were significantly lower on the treated versus untreated forearms.

The product tested is marketed by The Procter & Gamble Co, Cincinnati, as Olay Total Effects Moisturizer. The study was performed under an unrestricted educational grant from Procter & Gamble. Dr. Draelos has no financial interest in the company.