Top

Published in:

01-05-2013 | Original Paper

Transepidermal water loss in young and aged healthy humans: a systematic review and meta-analysis

Authors: Jan Kottner, Andrea Lichterfeld, Ulrike Blume-Peytavi

Published in: Archives of Dermatological Research | Issue 4/2013

Abstract

Transepidermal water loss (TEWL) is regarded as one of the most important parameters for characterizing skin barrier function but an agreed upon definition of what a “normal” TEWL is does not exist. In order to determine generalizable TEWL values for healthy adults, a systematic review and meta-analysis was conducted. The databases MEDLINE and EMBASE and publication lists were screened. After full-text appraisal of 398 studies, 231 studies were excluded due to unclear or insufficient reporting. 167 studies providing data about 50 skin areas were included in the final data synthesis. Pooled sample sizes ranged from n = 5 for the left cheek and the left lower back to a maximum of n = 2,838 for the right midvolar forearm area. The lowest TEWL of 2.3 (95 % CI 1.9–2.7) g/m²/h was calculated for the breast skin, the highest TEWL of 44.0 (39.8–48.2) g/m²/h for the axilla. TEWL in individuals being 65 years and above was consistently lower compared to the group of 18- to 64-year-old individuals. The quality of reporting TEWL in humans should be increased in future studies.

Available only for authorised users

Agner T (1992) Noninvasive measuring methods for the investigation of irritant patch test reactions. A study of patients with hand eczema, atopic dermatitis and controls. Acta Derm Venereol Suppl 173:1–26

Alikhan A, Wilhelm K-P, Alikhan FS, Maibach HI (2010) Transepidermal water loss and aging. In: Farage MA, Miller KW, Maibach HI (eds) Textbook of Aging Skin. Springer, Berlin, pp 695–703CrossRef

Baker H, Kligman AM (1967) Measurement of transepidermal water loss by electrical hygrometry. Instrumentation and responses to physical and chemical insults. Arch Dermatol 96(4):441–452PubMedCrossRef

Barel AO, Clarys P (1995) Study of the stratum corneum barrier function by transepidermal water loss measurements: comparison between two commercial instruments: evaporimeter and Tewameter. Skin Pharmacol 8(4):186–195PubMedCrossRef

Berardesca E, Fluhr JW (2010) Corneocyte size and cell renewal: effects of aging and sex hormones. In: Farage MA, Miller KW, Maibach HI (eds) Textbook of Aging Skin. Springer, Berlin, pp 271–275

Berardesca E, Maibach HI (1990) Transepidermal water loss and skin surface hydration in the non invasive assessment of stratum corneum function. Derm Beruf Umwelt 38(2):50–53PubMed

Blaak J, Lüttje D, John SM, Schürer NY (2011) Irritability of the skin barrier: a comparison of chronologically aged and photo-aged skin in elderly and young adults. Eur Geriatr Med 2:208–211CrossRef

Bock M, Wulfhorst B, John SM (2007) Site variations in susceptibility to SLS. Contact Dermat 57(2):94–96. doi:10.1111/j.1600-0536.2007.01159.x CrossRef

Chilcott RP, Farrar R (2000) Biophysical measurements of human forearm skin in vivo: effects of site, gender, chirality and time. Skin Res Technol 6(2):64–69PubMedCrossRef

10.

Cohen JC, Hartman DG, Garofalo MJ, Basehoar A, Raynor B, Ashbrenner E, Akin FJ (2009) Comparison of closed chamber and open chamber evaporimetry. Skin Res Technol 15(1):51–54PubMedCrossRef

11.

De Paepe K, Houben E, Adam R, Wiesemann F, Rogiers V (2005) Validation of the VapoMeter, a closed unventilated chamber system to assess transepidermal water loss vs. the open chamber Tewameter((R)). Skin Res Technol 11(1):61–69PubMedCrossRef

12.

DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7(3):177–188PubMedCrossRef

13.

Dharmarajan TS (2008) Aging and the skin: the geriatrician’s perspective. In: Norman R (ed) Diagnosis of Aging Skin Diseases. Springer, London, pp 5–10

14.

Elkeeb R, Hui X, Chan H, Tian L, Maibach HI (2010) Correlation of transepidermal water loss with skin barrier properties in vitro: comparison of three evaporimeters. Skin Res Technol 16(1):9–15PubMedCrossRef

15.

Elsner P, Fluhr JW, Gehring W, Kerscher MJ, Krutmann J, Lademann J, Makrantonaki E, Wilhelm KP, Zouboulis CC (2011) Anti-aging data and support claims—consensus statement. J Dtsch Dermatol Ges 9:S1–S32PubMed

16.

Farahmand S, Tien L, Hui X, Maibach HI (2009) Measuring transepidermal water loss: a comparative in vivo study of condenser-chamber, unventilated-chamber and open-chamber systems. Skin Res Technol 15(4):392–398PubMedCrossRef

17.

Firooz A, Sadr B, Babakoohi S, Sarraf-Yazdy M, Fanian F, Kazerouni-Timsar A, Nassiri-Kashani M, Naghizadeh MM, Dowlati Y (2012) Variation of biophysical parameters of the skin with age, gender, and body region. Sci World J 2012:386936. doi:10.1100/2012/386936 CrossRef

18.

Fluhr JW, Feingold KR, Elias PM (2006) Transepidermal water loss reflects permeability barrier status: validation in human and rodent in vivo and ex vivo models. Exp Dermatol 15(7):483–492PubMedCrossRef

19.

Ghadially R, Brown BE, Sequeira-Martin SM, Feingold KR, Elias PM (1995) The aged epidermal permeability barrier. Structural, functional, and lipid biochemical abnormalities in humans and a senescent murine model. J Clin Invest 95(5):2281–2290. doi:10.1172/JCI117919 PubMedCrossRef

20.

Grove G, Grove MJ, Zerweck C, Pierce E (1999) Comparative metrology of the evaporimeter and the DermaLab TEWL probe. Skin Res Technol 5(1):1–8CrossRef

21.

Harvell JD, Maibach HI (1994) Percutaneous absorption and inflammation in aged skin: a review. J Am Acad Dermatol 31(6):1015–1021PubMedCrossRef

22.

Imhof RE, De Jesus ME, Xiao P, Ciortea LI, Berg EP (2009) Closed-chamber transepidermal water loss measurement: microclimate, calibration and performance. Int J Cosmet Sci 31(2):97–118PubMedCrossRef

23.

Kerscher M, Williams S, Dubertret L (2007) Cosmetic dermatology and skin care. EJD 17(2):180–182PubMed

24.

Kobayashi H, Tagami H (2004) Distinct locational differences observable in biophysical functions of the facial skin: with special emphasis on the poor functional properties of the stratum corneum of the perioral region. Int J Cosmet Sci 26(2):91–101PubMedCrossRef

25.

Kobayashi H, Tagami H (2004) Functional properties of the surface of the vermilion border of the lips are distinct from those of the facial skin. Br J Dermatol 150(3):563–567PubMedCrossRef

26.

Machado M, Hadgraft J, Lane ME (2010) Assessment of the variation of skin barrier function with anatomic site, age, gender and ethnicity. Int J Cosmet Sci. doi:10.1111/j.1468-2494.2010.00587.x

27.

Marks R (1981) Measurement of biological ageing in human epidermis. Br J Dermatol 104(6):627–633PubMedCrossRef

28.

Mayrovitz HN, Bernal M, Brlit F, Desfor R (2012) Biophysical measures of skin tissue water: variations within and among anatomical sites and correlations between measures. Skin Res Technol. doi:10.1111/srt.12000

29.

Menon GK, Kligman AM (2009) Barrier functions of human skin: a holistic view. Skin Pharmacol Physiol 22(4):178–189. doi:10.1159/000231523 PubMedCrossRef

30.

Mohammed D, Matts PJ, Hadgraft J, Lane ME (2012) Variation of stratum corneum biophysical and molecular properties with anatomic site. AAPS J 14(4):806–812. doi:10.1208/s12248-012-9400-3 PubMedCrossRef

31.

Moher D, Hopewell S, Schulz KF, Montori V, Gotzsche PC, Devereaux PJ, Elbourne D, Egger M, Altman DG (2010) CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. J Clin Epidemiol 63(8):e1–e37. doi:10.1016/j.jclinepi.2010.03.004 PubMedCrossRef

32.

Panisset F, Treffel P, Faivre B, Lecomte PB, Agache P (1992) Transepidermal water loss related to volar forearm sites in humans. Acta Derm Venereol 72(1):4–5

33.

Pinnagoda J, Tupker RA, Agner T, Serup J (1990) Guidelines for transepidermal water loss (TEWL) measurement. A report from the Standardization Group of the European Society of Contact Dermatitis. Contact Dermat 22(3):164–178CrossRef

34.

Rawlings AV, Matts PJ (2005) Stratum corneum moisturization at the molecular level: an update in relation to the dry skin cycle. J Invest Dermatol 124(6):1099–1110. doi:10.1111/j.1523-1747.2005.23726.x PubMedCrossRef

35.

Roberts WE (2006) Dermatologic problems of older women. Dermatol Clin 24 (2):271–280, viii. doi:10.1016/j.det.2006.01.012

36.

Rogers J, Harding C, Mayo A, Banks J, Rawlings A (1996) Stratum corneum lipids: the effect of ageing and the seasons. Arch Dermatol Res 288(12):765–770PubMedCrossRef

37.

Rogiers V (2001) EEMCO guidance for the assessment of transepidermal water loss in cosmetic sciences. Skin Pharmacol Appl Skin Physiol 14(2):117–128PubMedCrossRef

38.

Rosado C, Pinto P, Rodrigues LM (2005) Comparative assessment of the performance of two generations of Tewameter: TM210 and TM300. Int J Cosmet Sci 27(4):237–241. doi:10.1111/j.1467-2494.2005.00270.x PubMedCrossRef

39.

Shah JH, Zhai H, Maibach HI (2005) Comparative evaporimetry in man. Skin Res Technol 11(3):205–208. doi:10.1111/j.1600-0846.2005.00099.x PubMedCrossRef

40.

Shlivko IL, Petrova GA, Zor’kina MV, Tchekalkina OE, Firsova MS, Ellinsky DO, Agrba PD, Kamensky VA, Donchenko EV (2012) Complex assessment of age-specific morphofunctional features of skin of different anatomic localizations. Skin Res Technol. doi:10.1111/j.1600-0846.2012.00613.x

41.

Steiner M, Aikman-Green S, Prescott GJ, Dick FD (2011) Side-by-side comparison of an open-chamber (TM 300) and a closed-chamber (Vapometer(™)) transepidermal water loss meter. Skin Res Technol. doi:10.1111/j.1600-0846.2011.00509.x

42.

Tagami H (2008) Functional characteristics of the stratum corneum in photoaged skin in comparison with those found in intrinsic aging. Arch Dermatol Res 300(Suppl 1):S1–S6. doi:10.1007/s00403-007-0799-9 PubMedCrossRef

43.

Tagami H, Kobayashi H, Kikuchi K (2002) A portable device using a closed chamber system for measuring transepidermal water loss: comparison with the conventional method. Skin Res Technol 8(1):7–12PubMed

44.

Tagami H, Kobayashi H, Zhen XS, Kikuchi K (2001) Environmental effects on the functions of the stratum corneum. J Investig Dermatol Symp Proc 6(1):87–94. doi:10.1046/j.0022-202x.2001.00016.x PubMedCrossRef

45.

Takema Y, Yorimoto Y, Kawai M, Imokawa G (1994) Age-related changes in the elastic properties and thickness of human facial skin. Br J Dermatol 131(5):641–648PubMedCrossRef

46.

Vandenbroucke JP, von Elm E, Altman DG, Gotzsche PC, Mulrow CD, Pocock SJ, Poole C, Schlesselman JJ, Egger M (2007) Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. PLoS Med 4(10):e297PubMedCrossRef

47.

Waller JM, Maibach HI (2005) Age and skin structure and function, a quantitative approach (I): blood flow, pH, thickness, and ultrasound echogenicity. Skin Res Technol 11(4):221–235. doi:10.1111/j.0909-725X.2005.00151.x PubMedCrossRef

48.

Xiao P, Imhof RE (2012) Two dimensional finite element modelling for dynamic water diffusion through stratum corneum. Int J Pharm 435(1):88–92. doi:10.1016/j.ijpharm.2012.01.047 PubMedCrossRef

Title: Transepidermal water loss in young and aged healthy humans: a systematic review and meta-analysis
Authors: Jan Kottner
Andrea Lichterfeld
Ulrike Blume-Peytavi
Publication date: 01-05-2013
Publisher: Springer-Verlag
Published in: Archives of Dermatological Research / Issue 4/2013
Print ISSN: 0340-3696
Electronic ISSN: 1432-069X
DOI: https://doi.org/10.1007/s00403-012-1313-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Transepidermal water loss in young and aged healthy humans: a systematic review and meta-analysis

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 4/2013

High-definition optical coherence tomography: adapted algorithmic method for pattern analysis of inflammatory skin diseases: a pilot study

Association of angiotensin-converting enzyme gene insertion/deletion polymorphism with decreased risk for basal cell carcinoma

Optical coherence tomography imaging of telangiectasias during intense pulsed light treatment: a potential tool for rapid outcome assessment

Ultrasonographic staging of cutaneous malignant tumors: an ultrasonographic depth index

Protection against TGF-β1-induced fibrosis effects of IL-10 on dermal fibroblasts and its potential therapeutics for the reduction of skin scarring

Sirtuins in dermatology: applications for future research and therapeutics