Could this be a TEWL for Early Identification and Prevention of Eczema?

(If you read to the end of the blog post you’ll understand this really good pun.)

Sometimes we like to show off how researchers are trying to help families and doctors and give them tools for early screening mechanisms.

TEWL, which stands for Transepidermal Water Loss, is exactly what it sounds like. The skin is comprised of three primary layers: the epidermis, the outermost layer; the dermis or middle layer; and the hypodermis, the undermost layer. When water passes from the dermis through the epidermis and evaporates from the skin’s surface, this is known as transepidermal water loss. While water loss is a normal process that your skin naturally regulates, people with eczema seem to have a tougher time regulating it correctly.

TEWL Water loss in eczema.png

Filaggrin is a protein that is vital for skin cells to mature properly. Studies have shown that lack of the filaggrin protein in the skin causes a dry skin condition that is strongly linked to the development of atopic eczema. People with filaggrin loss of function are 3.3 times more likely to have atopic dermatitis (AD). Regular use of emollients can help skin that lack filaggrin as we discussed in another eczema post.

TEWL measurements are a possible way to non-invasively measure the breakdown in skin function caused by lack of filaggrin. A study of almost 2000 newborns at Cork University Maternity Hospital took TEWL measurements of babies when they were 2 days old, 2 months, and 6 months. The babies were followed until they were 12 months old, and the results of those TEWL measurements were used to see if an early TEWL assessment could predict future AD. They found that a high TEWL score at 2 days old was significantly predictive of AD at 12 months, and a low score was significantly predictive of no AD at 12 months.

The basic idea or conclusion is that very early on, using totally non-invasive or painful methods, you may be able to assess a babies risk for the “atopic march” or progression from atopic dermatitis to rhinitis, food allergies and so on.

While the early results are exciting for parents who have a family history of eczema or allergies, this screening method isn’t in use yet, but it could possibly really help parents, as it has been shown that starting the use of emollients right from birth can prevent atopic dermatitis in children. FYI, our favorite emollient is Cerave (note: no relationship with Lil Mixins) as it works great and feels great on.


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