Petrolatum: Barrier repair and antimicrobial responses underlying this "inert" moisturizer

J Allergy Clin Immunol. 2016 Apr;137(4):1091-1102.e7. doi: 10.1016/j.jaci.2015.08.013. Epub 2015 Oct 1.

Abstract

Background: Petrolatum is a common moisturizer often used in the prevention of skin infections after ambulatory surgeries and as a maintenance therapy of atopic dermatitis (AD). However, the molecular responses induced by petrolatum in the skin have never been assessed.

Objective: We sought to define the cutaneous molecular and structural effects induced by petrolatum.

Methods: Thirty-six healthy subjects and 13 patients with moderate AD (mean SCORAD score, 39) were studied by using RT-PCR, gene arrays, immunohistochemistry, and immunofluorescence performed on control skin, petrolatum-occluded skin, and skin occluded with a Finn chamber only.

Results: Significant upregulations of antimicrobial peptides (S100A8/fold change [FCH], 13.04; S100A9/FCH, 11.28; CCL20/FCH, 8.36; PI3 [elafin]/FCH, 15.40; lipocalin 2/FCH, 6.94, human β-defensin 2 [DEFB4A]/FCH, 4.96; P < .001 for all) and innate immune genes (IL6, IL8, and IL1B; P < .01) were observed in petrolatum-occluded skin compared with expression in both control and occluded-only skin. Application of petrolatum also induced expression of key barrier differentiation markers (filaggrin and loricrin), increased stratum corneum thickness, and significantly reduced T-cell infiltrates in the setting of "normal-appearing" or nonlesional AD skin, which is known to harbor barrier and immune defects.

Conclusions: Petrolatum robustly modulates antimicrobials and epidermal differentiation barrier measures. These data shed light on the beneficial molecular responses of petrolatum in barrier-defective states, such as AD and postoperative wound care.

Keywords: Petrolatum; antimicrobial peptides; atopic dermatitis; barrier; innate immunity; moisturizer; occlusion; patch tests; skin surgeries.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Cutaneous
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Infective Agents / pharmacology*
  • Anti-Infective Agents / therapeutic use
  • Biomarkers / metabolism
  • Case-Control Studies
  • Dermatitis, Atopic / drug therapy*
  • Dermatitis, Atopic / immunology
  • Dermatitis, Atopic / metabolism
  • Emollients / pharmacology*
  • Emollients / therapeutic use
  • Female
  • Filaggrin Proteins
  • Humans
  • Intermediate Filament Proteins / metabolism
  • Male
  • Membrane Proteins / metabolism
  • Middle Aged
  • Petrolatum / pharmacology*
  • Petrolatum / therapeutic use
  • Skin / drug effects*
  • Skin / immunology
  • Skin / metabolism
  • Young Adult

Substances

  • Anti-Infective Agents
  • Biomarkers
  • Emollients
  • FLG protein, human
  • Filaggrin Proteins
  • Intermediate Filament Proteins
  • Membrane Proteins
  • loricrin
  • Petrolatum