Effcacy of skin care in medical compression therapy: Infuence of evening creaming and compression stockings with integrated skin care on the skin barrier

Background: Monitoring of skin moisture, skin roughness, and tran‐sepidermal water loss (TEWL) of the skin at the lower limb under com‐pression therapy in two randomized groups with and without evening skin care and testing of special stockings with integrated skin care. A special textile fnishing as emolient with 5% urea (Venotrain micro Bal‐ance 1$sup$®$/sup$ and its advancement “Venotrain micro Balance 2$sup$®$/sup$, Bauerfeind, Zeulenroda”) was compared to medical compression stockings (MCS) without skin care (Venotrain micro$sup$®$/sup$, Bauerfeind). Methods: Three randomized controlled studies were performed. 1$sup$st$/sup$ RCT: healthy volunteers and patients with CVD wore compression stockings, CCL 2 (23mmHg‐32mmHg). Randomization into two groups‐with and without evening skin care. 2$sup$nd$/sup$ RCT: patients with proven CVD were recruited to test the “Balance 1” and were randomized to test the Balance 1 and MCS without skin care. 3$sup$rd$/sup$ RCT: Evaluation of the “Balance 2” on healthy subjects with daily standing of at least 8 hours and identifed orthostatic edema. Balance 2 and MCS without skin care were worn consecutively. Measurement of skin moisture, skin roughness, TEWL before and after the wear period in all cohorts of all three trials. In ad‐dition, the volume of the leg was measured in two of the three RCT's. Results: Transepidermal water loss (TEWL) increased without even‐ing skin care (P<0,05). Skin moisture was improved with skin care (P=0,000) and retained with application of Balance 1 (P=0,08) and Bal‐ance 2 (P<0,001). Skin roughness decreased signifcantly in patients and healthy volunteers with evening skin care, (P<0,05) and stayed un‐changed with Balance 1 (P=0,109) and Balance 2 (P=0,002). Volume reduction of the lower leg was achieved by means of the compression stockings in all cohorts of the three RCT's. Conclusions: The barrier function of the skin is impaired by use of com‐pression therapy Since skin hydration was reduced, waterloss (TEWL) was increased and the roughness of the skin was increased. Both by the application of ointment in the evening and by the use of compression stockings with integrated skin care these undesired side effects of com‐pression stocking are prevented. Consecutive itching of the skin does not occur.