The Effect of a Moisturizing Cream with Saccharide Isomerate and

Ceramide on Increasing Skin Hydration

Vlorensia

, Helen Hartini

, Hairus Abdullah

, Ahmad Raif Martinus

, Refi Ikhtiari

1,2*

Laboratory of Biomolecular Chemistry, Graduate School of Biomedical Science

Universitas Prima Indonesia

Laboratory of Materials Chemistry, Faculty of Industrial Engineering,

Universitas Prima Indonesia

Keywords: Moisturizer, saccharide isomerate, ceramide, skin hydration

Abstract: Normal skin profile and function show that the water content in the stratum corneum must be greater than

10%. If the fluid balance in the skin is disrupted, it can cause the skin to become dry and sensitive to various

physical and chemical influences. The study aimed to determine the effectiveness of saccharide isomerate and

ceramide moisturizing creams in improving skin hydration. The subjects of the study were intervention group

1 who received treatment using saccharide isomerate moisturizer and intervention group 2 who received

treatment using ceramide moisturizer. The moisturizing creams have been applied in the forearms and lower

legs of the subjects. The number of subjects is 15 people for each group. Data analysis used the Friedman test.

The results showed that moisturizing creams containing saccharide isomerate and ceramide were effective in

improving skin hydration. The average of skin hydration after treatment is 24.46% with a standard deviation

of 3.83. The average of skin hydration after treatment is 24.62% with a standard deviation of 2.81.

1 INTRODUCTION

Skin has a very important role. The main function of

the skin is to ensure survival, besides that the skin has

other meanings in aesthetics, race, and systemic

indicators (Wasiatmadja, 2010). There are three

layers of skin structure, namely: epidermis, dermis

and subcutaneous. The epidermis is mostly composed

of keratinocytes, a small portion of melanocytes and

dendritic cells like langer hans cells. The skin in the

nucleated epidermal layer contains nerve fibers that

supply impulses. There are three layers, namely basal

stratum (stem cells and postmitotics), intermediate

cells (called transiently amplifying cells), stratum

spinosum (sweat layer), stratum granulosum, and

stratum corneum (Menon, 2015).

Skin is said to be healthy and normal when the

outer layer of skin contains more than 10% water.

This is due to the regulation of fluid balance in the

skin (Baumann, 2009). Normal skin profile and

function show that the water content in the stratum

corneum must be greater than 10%. Water content can

be reduced through the process of evaporation to the

environment with conditions of low air humidity and

must be replaced again by water from the layer below

(Draelos, 2011). “As we age, the skin is less capable

of maintaining moisture, and age-related loss of

moisture can cause more dryness over time,” explains

Dr. Hellman, who suggests moisturizing more

frequently as you get older to help offset the damage.

There are a variety of factors that play into one’s skin

type, so the precise cause of one person’s dry skin

may be different from someone else’s. “Some people

have blue eyes and some people have brown eyes.

Different people [have different] skin,” Dr. Hellman

says, noting how some of the factors that come into

play for parched skin are hereditary and due largely

to genetics.

Voegeli et.al (2019) has reported that

remarkable gradients of skin hydration, TEWL, skin

surface pH and sebum exist within short distances

across the face and the gradients are distinctive

among different ethnic groups. In addition, these

studies have demonstrated that darkly‐ pigmented

individuals do not necessarily have a better skin

barrier function than their less‐ pigmented

counterparts and that Caucasians have a lower facial

skin surface pH compared with more pigmented

subjects. Overall, there are no correlations between

capacitance, TEWL and skin surface pH including

individual topology (Voegeli et. Al 2019).

428

Vlorensia, ., Hartini, H., Abdullah, H., Martinus, A. and Ikhtiari, R.

The Effect of a Moisturizing Cream with Saccharide Isomerate and Ceramide on Increasing Skin Hydration.

DOI: 10.5220/0009837504280435

In Proceedings of the International Conference on Health Informatics and Medical Application Technology (ICHIMAT 2019), pages 428-435

ISBN: 978-989-758-460-2

If the fluid balance in the skin is disrupted, it

can cause dry skin to be sensitive to various physical

and chemical influences (Partogi, 2008). Dry skin is

a disorder on the surface of the skin due to reduced

fluid or oil content in the skin so that the moisture on

the surface of the skin layer decreases (Nuzantry,

2015). Skin hydration decreases due to decreased

stratum corneum barrier function and increased water

loss through diffusion through the epidermis or

TEWL (Black et al., 2005). According to the US

Census Bureau estimated in the United States in 2004,

there were 3.1% or 8.4 million people suffering from

skin dryness. It is estimated that the Indonesian

population who suffered skin dryness amounted to

7,392,041 in 2004. This data was obtained by

statistical extrapolation based on data in the United

States, the United Kingdom, and Australia (Health

Grade, 2009).Dry skin is a problem that is often faced

by almost all people in all parts of the world. Dry skin

will look dull, feel rough, scaly, wrinkled, and less

elastic than normal skin (Draelos, 2018).

Skin hydration decreases due to decreased

barrier function of the stratum corneum and increased

diffusion of water loss through the epidermis or

TEWL (Black et al., 2005). Skin hydration has a

major effect on maintaining homeostasis on the

surface of the skin and maintaining its elasticity.

Low-hydration skin elasticity will be reduced, the

skin will become dry and the surface is easily

damaged. However, changes in the epidermal fat

component of the skin can also cause xerosis. Some

experts believe that the incidence of dry skin has

increased in recent years because people often take a

shower using hot water, foaming cleansers, bubble

baths, and bath salts, which damage the skin barrier

by stripping the lipid component on the surface of the

skin. Soap, detergent, and hard water can eliminate a

healthy and normal skin barrier (Baumann, 2009).

Various studies have been carried out to obtain

optimal dry skin management. One of them is by

producing moisturizers that effectively increase the

water content in the stratum corneum and hydrate it.

Nuzantry et al., (2015) investigated aloe vera extract

and olive oil as a basic ingredient in moisturizing base

formulations and reported that the mixture of aloe

vera extract and olive oil in moisturizing formulations

is effective in skin dryness. Moisturizers are complex

formulations designed to improve the hydration

mechanism of the skin and maintain the structure and

function of the skin from various influences such as

dry air, sunlight, old age, temperature, various skin

diseases and diseases that can accelerate water

evaporation (Nuzantry, 2015).

Moisturizers has been generally used to

relieve dry skin by increasing barrier repair, creating

temporary artificial barriers, and restoring skin

softness. Scientifically, moisturizing treatment

involves four processes, namely repairing the skin

barrier, increasing water content, reducing trans

epidermal water loss (TEWL), and restoring lipid's

water barrier function (Klein, 2005). The basic

components of a moisturizer consist of an occlusive,

humectant and emollient. Occlusive is a substance to

coat the stratum corneum and reduce TEWL.

Humectants are useful for the skin hydration process.

While emollients are substances that are added to

cosmetics to make skin soft and smooth. Other

components are antioxidants, vitamins, essential fatty

acids, lipoic acid, linoleic acid and herbal extracts

(Lodén, 2011).

Previously have been reported that four

commercial moisturizer products of different brands

were tested on volar forearm region of healthy human

female volunteers. This study was conducted for a

period of 30 days with 0, 7, and 30 days as time points

of analysis. The results of this study clearly indicate

that not all the moisturizer products hydrate the skin

to the expected levels, and this extent of skin

hydration varies with duration of application of these

products (Tippavajhala et. al. 2018). Another studies

by Engebretsen 2018 reported that Epidermal

deficiency of filaggrin, and the derived natural

moisturizing factors (NMFs), is associated with

increased risk of atopic dermatitis (AD). While

filaggrin gene mutations cause filaggrin deficiency,

there is limited insight into the causative

environmental factors. NMFs levels are decreased

along with increased secretion of various skin

cytokines in healthy individuals. Our data highlight

environmental factors that might play a role in AD

pathophysiology (Engebretsen et.al.2018).

Saccharide isomerate (SI) is a muco-

polysaccharide carbohydrate complexes that are

similar as those found in the human skin's stratum

corneum. The active ingredient saccharide isomerate

in the epidermis will form hyaluronic or hyaluronic

acid. Saccharide isomerate is one of the answers to

the development of glycobiology. Saccharide

isomerate can retain moisture by increasing the water

content in the stratum corneum even in low air

humidity. Saccharide isomerates can also bind to the

skin even in very low pH conditions (Pentapharm,

2009).

The phenomenon of peeling skin manifests

itself as one of the conditions such as dehydrated skin,

loss of moisture retention and natural protective film

possibly due to the use of strong cleansing products

or harmful effects of the environment, i.e. chemicals.

When this corneocyte layer is damaged, they will lose

their ability to bind, losing NMF leading to the

phenomenon of peeling in each section and an

opportunity for more harmful thing to enter into our

bodies possibly causing different types of atopic

dermatitis. Extending the time of injury due to

The Effect of a Moisturizing Cream with Saccharide Isomerate and Ceramide on Increasing Skin Hydration

429

dehydration, our skin will become a desert, even if

you drink a lot of water it will be too late at this point

as it will quickly evaporate. This is where Saccharide

Isomerate (SI) will became our saving grace

SI is a carbohydrate complex that is similar in

structure to natural carbohydrates found in NMF,

acting as a magnet for water-retention. When the SI

is inserted into the skin, it will replace the lost natural

carbohydrates, and now when the water is added to

the skin to be absorbed into these carbohydrates, we

can help prevent the water from evaporating so

quickly. SI acts as an emollient, water retention agent,

and also has the ability to bind to skin proteins

closely, capable of remaining on the skin longer than

conventional softeners. Simultaneously, SI use for a

long time also helps to develop filaggrin proteins,

loricrin, and develop the skins increase hyaluronic

acid production.

The outstanding properties of Saccharide

Isomerate:

 Instant water supply, deeply moisturizing

lasting up to 72 hours.

 Reduces irritation, reduces AHA’s side effects

by 22% because the skin is making its own

exogenous AHA’s.

 In 3 minutes SI has 38% higher moisturizing

ability than glycerin.

 Stimulate gene expression to a create skin

protection barrier keeping inflammatory skin

issues at bay.

 Improve the effectiveness of peeling and bring

soft and moisturized skin.

There are several studies on the effects of

using SI on moisturizing formulations that have been

published both by the producers of SI products and by

academic researchers. Research from the

manufacturer of SI products shows that SI has a much

higher skin moisture retention capacity compared to

glycerin (Pentapharm, 2009). Dewi in 2010 examined

the addition of 5% Saccharide Isomerate in a

moisturizing formulation to improve skin hydration

compared to ordinary moisturizers. His research

found that the addition of 5% saccharide isomerate in

moisturizing formulations can improve skin

hydration higher and can maintain higher skin

hydration after the administration is stopped

compared to ordinary moisturizers.

Another moisturizer that is thought to help

skin hydration is ceramide. Ceramide helps skin

retain water and soften dry skin. Ceramide is

synthetic which can mimic natural substances in the

outer layers of the skin to help maintain moisture

(Octavia, 2017). Another study reported by Spada

et.al. 2018 that topical application of the Ceramide

cream moisturizer leads to increased skin hydration

and decreased TEWL making it suitable to help

restore xerotic skin. Maintenance of skin barrier

function is vital to mitigate the skin’s susceptibility to

irritants, allergens, and microbes (Spada et.al. 2018).

Ceramide naturally found in the skin will

decrease with aging and other factors that have an

impact on dry skin. Giving ceramide synthesis can

overcome skin dryness through improved skin barrier

function (Wertz et al., 2000). Ceramide is a

compound of phytosphingosine that is naturally

present in the skin around the stratum corneum which

has the effect of maintaining skin moisture.

Ceramides found in the skin will naturally decrease

with aging and other factors that cause the skin to

become dry (Jafar, 2015). Ceramide is a component

that plays an important role in the function of the skin

barrier. Currently, commercially available products

containing ceramide and filaggrin break down

products have been specifically designed for patients

with sensitive skin (Eric et al., 2012).

Ceramides are the main component of SC

(stratum corneum) intercellular lipids and contain a

lot of linoleic acids. The bond between ceramide and

water will form a smooth emulsion so that it appears

smooth and soft. The administration of ceramide-

containing emollients has been carried out in cases of

atopic dermatitis, which is caused by impaired skin

barrier function. Research shows that ceramide does

not only improve TEWL and erythema severity, but

also increases levels of endogenous ceramide in the

stratum corneum (Partogi, 2008).

With a complexion short on ceramides, things

like seasons and environmental factors will zap your

already diminishing supply of these good fats because

you don’t have the (fatty) defenses you need to keep

that stuff at bay. One small Dutch study found a

particularly steep drop in ceramide levels among

participants between summer and winter. You’ve be

warned. The weather, dry central heating and general

low-humidity environments, air pollution, UV rays

and sun damage, it sort of feels like simply being alive

depletes ceramides in the skin, and that’s not even

considering hormonal and genetic issues or diseases

that affect skin integrity, like diabetes

Ishikawa and his colleagues conducted a study

whose results showed that indicators of dry (dry,

rough and scaly) skin were closely related to

ceramide levels in 2013. Associated with this study,

formulization of seramite in moisturizing creams

studied was a solid lipid nanoparticle formulation

(SLN) . According to Ekambaran and friends, SLN

has many advantages such as good biocompatibility,

low toxicity, good physical stability of the system and

incorporation of hydrophilic and lipophilic drugs

(Ekambaram et al., 2012). SLN is a nano-sized

particle with a solid lipid matrix. SLN consists of oil

droplets (lipids) which are at room temperature and

stabilized by surfactants. SLN has an occlusive nature

ICHIMAT 2019 - International Conference on Health Informatics and Medical Application Technology

430

so it is good to be used as a daily cosmetic skin cream

product (Puri et al., 2010).

Hanzola et al., (2015) studied the effect of the

use of aloe vera masks on dry facial skincare on the

skin moisture indicator showed the highest score in

the fourth and fifth treatments with an average score

of 4.0 categorized as very moist. Prima's research

(2017) which found that dry face skincare without

using watermelon white skin masks in the control

group did not show a better change in results, for the

1x3 day experimental group there were significant

changes as well as the 1x7 day treatment group

showed significant results on the indicator of

moisture and brightness of facial skin. Based on

research results prove the watermelon white skin

mask as a dry facial skincare mask with the best use

frequency of 1 x 3 days. Previous research was

conducted using various natural ingredients to treat

dry skin or improve skin hydration, such as

Eucalyptus extract, aloe vera masks, and watermelon

white skin masks. This research is different from the

two studies above, which is trying to use isomerate

saccharide which is a complex compound of

carbohydrate mucopolysaccharide and ceramide

synthesis formulated in the form of solid lipid

nanoparticles.

Skin hydration and TEWL are important of

non-invasive measurements in dermatology and

cosmetology because the measurement values of

TEWL and the water level of the stratum corneum can

be used to assess and compare the efficacy of various

products applied to the skin, especially moisturizers

(Pedersen and Jemec, 2006). TEWL reflects the

evaporation of the skin surface. One characteristic of

healthy skin is a proportional comparison between

TEWL and skin hydration (Primavera et al., 2005).

TEWL measurements are only valid within the

boundary layer that has diffused in the human body

whose depth is around 10-30 μm under normal

conditions. Instrument sensitivity can also interfere

with TEWL measurement results. TEWL

measurement uses an evaporimeter. This tool has a

probe that measures the pressure of partial

evaporation of water at two locations above the

surface of the skin, 3 mm and 9 mm with the help of

two pairs of humidity transducers and thermistors.

The difference in partial evaporation water pressure

at the two locations is then calculated and expressed

as gr/m2 per hour. Normal TEWL values are between

2-5 gr/m2 per hour. The value can reach 90-100

gr/m2/hour after stripping the skin or in the presence

of atopic dermatitis lesions (Black et al., 2005).

The age parameter does not affect TEWL very

much, but in certain life periods there can be

significant changes, for example in premature infants

who are less than 30 weeks pregnant will experience

epidermal barrier disorders but within a few days

after birth, there will be skin barrier maturation

(Primavera et al., 2005).

Based on research background, this study

aimed to determine the effect of saccharide isomerate

and ceramide moisturizing creams in improving skin

hydration.

2 METHOD

The research subjects in this study were divided

randomly into intervention group 1 who were treated

by using saccharide isomerate moisturizer and

intervention group 2 who were treated using ceramide

moisturizers. The number of samples is 15 people for

each group (intervention groups 1 and 2). The

research material consisted of a moisturizing cream

containing saccharide isomerate namely Pentavitin

which contained >50% saccharide isomerate

produced by DSM Nutritional Products Ltd and

moisturizing cream containing ceramide in a solid

lipid nanoparticle formulation namely CeraVe

Moisturizing Cream. The moisturizing creams have

been applied in the forearms and lower legs of the

subjects. The research instrument used to measure

skin hydration was Digital Moisture Monitor for Skin

(SK-IV). The data of skin hydration measurements

were processed using Statistical Package for the

Social Sciences (SPSS) version 17.0. Data analysis

used the Friedman test.

3 RESULTS AND DISCUSSION

3.1 Analysis of Subjects Characteristics

The characteristics of subjects from intervention

group 1 (saccharide isomerate moisturizer) according

to age, the majority are 30-35 years old 73.3%,

according to ethnicity, the majority are Chinese

ethnic 46.7%, according to marital status, the

majority have not married 80.0%, according to the

type of work, all private employees are 100% and

according to location work, all work indoors 100%.

Subject characteristics of intervention group 2

(ceramide moisturizer), according to the age of the

majority of 30-35 years old 66.7%, according to

ethnicity, the majority of Javanese are 60.0%,

according to marital status, all are not married 100%,

according to the type of work all employees are 100%

and according to location works, all work indoors

100%. Furthermore, based on the literature studies,

the age parameter does not affect TEWL very much,

but in certain life periods there can be significant

changes, for example in premature infants who are

The Effect of a Moisturizing Cream with Saccharide Isomerate and Ceramide on Increasing Skin Hydration

431

less than 30 weeks pregnant will experience

epidermal barrier disorders but within a few days

after birth, there will be skin barrier maturation

(Primavera et al., 2005). The details of group

intervention are presented in the Table 1.

Table 1: Subjects characteristics based on ages, ethnics,

marital status, occupation and working location.

Subject

Characteristic

Group 1

(n = 15)

Group 2

(n = 15)

Age

a. 30-35 years

73,3

66,7

b. 36-40 years

26,7

33,3

Etnic

Chinese

46,7

13,3

Batak

40,0

26,7

Java

13,3

60,0

Marital Status

a. Single

80,0

100

b. Married

20,0

Occupation

Private

employee

100

Working location

Indoor work

100

To evaluate the application of SI and S on the forearm

and lower limbs, the average value (%) of skin

hydration has been monitored as of before, during and

after treatment. The data presented statistically in

order to obtain comprehensive understanding on the

skin hydration at forearm and lower limbs. The data

of skin hydrations (%) are presented in Table 2.

3.2 Analysis of Average Skin Hidration

Effects of SI and S Applications on the

Forearm and Lower Limbs as of

before, During and after Treatments

Data from Table 2 shows the average of skin

hydration in intervention group 1 (saccharide

isomerate/SI) on the forearm before treatment, is

15.08% with a standard deviation of 4.80. The

average of skin hydration during treatment for 1

week, in measurement I is 18.82% with standard

deviation of 4.19 and in measurement II is 22.31%

with standard deviation of 4.06. The average of skin

hydration after treatment is 24.46% with a standard

deviation of 3.83.

Table 2: Average of skin hydration as of before, during and

after treatment with SI and S on the forearm and lower

limbs.

Locatio

Average Skin Hydration (%)

Before

(%)

During Treatment

After

(%)

Measure

ment I

(%)

Measure

ment II

(%)

Forearm

15,08 ±

4,80

19,82 ±

4,19

22,31 ±

4,06

24,46 ±

3,83

Lower

limbs

18,68 ±

4,36

23,51 ±

4,15

26,84 ±

3,69

28,37 ±

3,54

Forearm

14,46 ±

2,80

16,70 ±

3,18

18,94 ±

2,80

20,75 ±

2,70

Lower

limbs

17,20 ±

3,48

20,10 ±

2,83

22,88 ±

2,73

24,62 ±

2,81

The average of skin hydration in intervention

group 2 (ceramide moisturizer/S) on the forearm

before treatment is 14.46% with a standard deviation

of 2.80. The average of skin hydration during

treatment for 1 week in measurement I is 16.70% with

a standard deviation of 3.18 and in measurement II is

18.94% with a standard deviation of 2.80. The

average of skin hydration after treatment is 24.62%

with a standard deviation of 2.81. To evaluate the

normality of data distribution, the data of skin

hydration was evaluated as shown in the Table 3.

The normality test used the Shapiro-Wilk test

on skin hydration of the subjects of the intervention

group 1 before treatment using SI moisturizer at the

forearm (LB0) and lower limb (TB0) the significance

value was <0.05, meaning the data was assumed to be

normally distributed. Subject skin hydration in the

intervention group 2 before treatment using S

moisturizer on the forearm (LB0) and lower limb

(TB0) the significance value was >0.05, this means

the data is assumed to be normally distributed.

To evaluate the normality of data distribution,

the data of skin hydration on the wholebody, forearm

and lower limbs, were evaluated as shown as in the

the Table 4.

Skin hydration in both intervention groups SI

and S at the time of treatment in the forearm (LB1 and

LB2) and lower limbs (TB1 and TB2) both at the first

measurement and the second measurement

significance value >0.05, this contains the meaning of

data assumed to be normal distribution. Skin

hydration in the two intervention groups SI and S

after treatment was measured in the forearm (LB3)

and lower limb (TB3) the significance value was

>0.05, this meant the data was assumed to be

normally distributed.

ICHIMAT 2019 - International Conference on Health Informatics and Medical Application Technology

432

Table 3: Normality test of skin hydration as of before,

during and after treatment with SI and S on the wholebody,

forearm and lower limbs.

Location

Groups

Sig

note.

Whole body

ST0 (before)

0,004

Not normal

0,542

Normal

ST1 (during)

0,363

Normal

0,000

Not normal

ST2 (during)

0,819

Normal

0,109

Normal

ST3 (after)

0,532

Normal

0,178

Normal

Forearms

LB0 (before)

0,009

Not normal

0,300

Normal

LB1 (during)

0,463

Normal

0,167

Normal

LB2 (during)

0,219

Normal

0,320

Normal

LB3 (after)

0,263

Normal

0,316

Normal

Lowerlimbs

TB0 (before)

0,015

Not normal

0,993

Normal

TB1 (during)

0,363

Normal

0,167

Normal

TB2 (during)

0,368

Normal

0,320

Normal

TB3 (after)

0,700

Normal

0,143

Normal

Table 4. Homogeneity test of skin hydration as of before,

during and after treatment with SI and S on the wholebody,

forearm and lower limbs.

Location

Sig

note

Whole body

ST0

0,523

Homogen

ST1

0,088

Homogen

ST2

0,144

Homogen

ST3

0,383

Homogen

Forearms

LB0

0,291

Homogen

LB1

0,648

Homogen

LB2

0,389

Homogen

LB3

0,615

Homogen

Lowerlimbs

TB0

0,783

Homogen

TB1

0,144

Homogen

TB2

0,216

Homogen

TB3

0,203

Homogen

Based on the homogeneity test using Levene's

test as shown in the Table 4, both intervention group

SI (Saccharide Isomerate moisturizer) and

intervention group S (Ceramide moisturizer) at the

time before treatment using moisturizers, when

treated with moisturizers and after treatment, the

significance value is <0.05. This means that the data

is assumed to be homogeneous.

3.3 Effectiveness of SI and S

Applications on the Forearm and

Lower Limbs as of before, During

and after Treatments

To evaluate the effectiveness of SI and S on the

forearm and lower limbs as of before, during and after

treatment. The significance values have been

statistically considered by the the mean value of skin

hydration (%) (Table 5).

Our data showed the average of skin hydration in

intervention group 1 on the forearm and lower limbs

during treatment using SI moisturizer for 1 week and

after treatment tended to increase. The results of the

Friedman difference test to determine the differences

in skin hydration at both locations before, during and

after treatment showed a significance value of 0,000,

which means that there was an effect of using SI

moisturizer on skin hydration.

Table 5. Effectiveness of Moisturizing Cream Containing

SI and S on Hydrating Skin in Subject’s Forearms and

Lower Legs Before, During and After Treatment.

Location

Mean

Rank

Sign

Mean

Rank

Sign

Forearms:

LB0

(before)

1,00

0,000

1,00

0,000

LB1

(during)

2,00

LB2

(during)

3,00

LB3 (after)

4,00

Lower

Legs:

TB0

(before)

1,00

0,000

1,00

0,000

TB1

(during)

2,00

2,07

TB2

(during)

3,00

3,07

TB3 (after)

4,00

3,87

Based on data from Table 5 above, the effect

of using SI moisturizer on the forearm before, during

and after treatment using SI and S moisturizers, with

a significance value of 0,000. There is an effect of the

use of SI moisturizers in the lower limbs before,

during and after treatment with a significance value

of 0,000. There is the effect of using S moisturizer on

the forearm before, during and after treatment with a

The Effect of a Moisturizing Cream with Saccharide Isomerate and Ceramide on Increasing Skin Hydration

433

significance value of 0,000. There is the effect of

using SI on the lower limbs before, during and after

treatment with a significance value of 0,000.

This study is in accordance with the results of

previous study which together examined the effect of

saccharide isomerate on skin hydration. Dewi's

(2010) study also found that the addition of 5%

saccharide isomerates in moisturizing formulations

can improve skin hydration higher and can maintain

higher skin hydration after the administration is

stopped compared to ordinary moisturizers.

We also showed the average of skin hydration in

intervention group 2 in the forearm and lower limbs,

during treatment using ceramide moisturizer for 1

week and after treatment tended to increase. The

results of the Friedman difference test to determine

the differences in skin hydration at both locations

before, during and after treatment showed a

significance value of 0,000, which means that there

was an effect of using sakarida isomerate moisturizer

on skin hydration.

The results of this study are also supported by

previous studies that also examined the effects of

ceramide on skin hydration. Research conducted by

Ishikawa and colleagues in 2013 showed that

Indicators of dry (dry, rough and scaly) skin were

closely related to ceramide levels. Partogi (2008) also

supports the results of this study with his statement

that ceramide administration not only improves

transpidermal water loss (TEWL) and erythema

severity, but also increases levels of endogenous

ceramide in the stratum corneum.

4 CONCLUSION

Based on the data analysis, we conclude that there

was an significant effect of moisturizing cream

containing saccharide isomerate on skin hydration

and there was the effect of moisturizing cream

containing ceramide in solid lipid nanoparticles

formulations on skin hydration

ACKNOWLEDGEMENTS

This research was supported by Ministry of Research,

Technology and Higher Education by Funding

Contract No. 7/E/KPT/2019 and No.

T/63/L1.3.1/PT.01.03/2019.

REFERENCES

Baumann L. 2009. Understanding and Treating Various

Skin Types: The Baumann Skin Type Indicator.

Black, D., Josse, G., Rouvrais, C., Lagarde, J.M. 2005. Skin

care products for normal, dry and greasy skin. In :

Baran, R., Maibach, H.I., Taylor and Francis, editors.

Textbook of Cosmetic Dermatology. Third Ed. Boca

Raton USA: Tailor and Francis. p. 203-223.

Dewi, Dian Andriani Ratna. 2010. Addition of 5%

Saccharide Isomerates in Moisturizing Formulations

Increases Skin Hydration Higher Than Ordinary

Moisturizers. Thesis. Postgraduate Program at Udayana

University Denpasar.

Draelos Z. 2018. The science behind skin care:

Moisturizers. Journal of Cosmetic Dermatology

Volume 17, Issue 2.

Draelos Z. 2011. New treatments for restoring impaired

epidermal barrier permeability: skin barrier repair

creams. Libgen.

Ekambaram, P., A.Abdul Hasan Sathali., K.Priyangka.

2011. Solid Lipid Nanoparticles: A. Rivew “Scientific

Reviews & Chemical Comunication, 80-102.

Engebretsen KA, Kezic S, Jakasa I, Hedengran A,

Linneberg A, Skov L, Johansen JD and Thyssen JP.

2018. Effect of atopic skin stressors on natural

moisturizing factors and cytokines in healthy adult

epidermis. British Journal of Dermatology 179: 560-

561.

Ishikawa K, et al. 2013. Cell growth control by stable

Rbg2/Gir2 complex formation under amino acid

starvation. Genes Cells 18(10):859-72.

Klein K. 2005. Humectants: more than meets the eye (or

skin). Cosmetics & Toiletries. 2005;30.12.

Loden M. 2012. Effect of moisturizers on epidermal barrier

function. Clinics in Dermatology 30, 286-296.

Menon, M., Resnick & Martin, I. 2002. Urinary lithiasis:

Etiologi and endourologi, in: Chambell’s urology. 8 th

edn. Vol 14, W.B. Saunder Company. Philadelphia.

pp:3230-3292.

Nuzantry, Juny Kurnia. 2015. Effectiveness of Mixture of

Aloe Vera Extract and Olive Oil in Moisturizing

Formulations against Skin Dryness. Journal. Semarang:

FK Diponegoro University.

Octavia, Sherly Ika. 2017. Treatment for Dry Skin,

http://corporate. kimiafarmaapotek.co.id.

Partogi, Donna. 2008. Dry skin. Medan: USU FK and Skin

Health Sciences.

Primavera G, Berardesca E. 2005. Sensitive skin:

mechanisms and diagnosis. International Journal of

Cosmetic Science 27 (1).

Pedersen L. Jemec GBE. 2006. Mechanical Properties and

Barrier Function of Healthy Human Skin. Acta

Dermato-Venerologica. 86 (4), 308-311.

Pentapharm. 2009. Pentavitin.

http://www.centerchem.com.

Spada F, Barnes TM, Greive KA. 2018. Skin hydration is

significantly increased by a cream formulated to mimic

the skin’s own natural moisturizing systems. Clinical,

ICHIMAT 2019 - International Conference on Health Informatics and Medical Application Technology

434

Cosmetic and Investigational Dermatology (11) 491-

497.

Tippavajhala VK. 2018. In Vivo Determination of

Moisturizers Efficacy on Human Skin Hydration by

Confocal Raman Spectroscopy. AAPS PharmSciTech

(19) 3177–3186.

Voegeli R, Gierschendorf J, Summers B, Rawlings AV.

2019. Facial skin mapping: from single point bio‐

instrumental evaluation to continuous visualization of

skin hydration, barrier function, skin surface pH, and

sebum in different ethnic skin types. International

Journal of Cosmetic Science 41 (5).

Wasiatmadja, BC. 2010. Skin and Venereal Diseases. 6th.

Djuanda A, editor. Jakarta: Faculty of Medicine,

University of Indonesia. 3-8 p.

Wertz PW. 2000. Lipids and barrier function. Acta

Dermato-Venerologica. Supp 208: 7-11.

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