Pons-Giraud A: Dry skin in dermatology: a complex pathophysiology.J Eur Acad Dermatol Venereol 21: (suppl):104. ,2007. .
Wilson D, Nix D: Evaluation of a once-daily moisturizer used to treat xerosis in long-term care subjects.Ostomy Wound Manage 51::52. ,2005. .
Barco D, Gimenez-Arnau A: Xerosis: a dysfunction of the epidermal barrier [in Spanish].Acta Dermosifiliogr 99::671. ,2008. .
Pavicic T, Korting HC: Xerosis and callus formation as a key to the diabetic foot syndrome: dermatologic view of the problem and its management.J Dtsch Dermatol Ges 4::935. ,2006. .
Ademola J, Frazier C, Kim SJ, et al: Clinical evaluation of 40% urea and 12% ammonium lactate in the treatment of xerosis.Am J Clin Dermatol 3::217. ,2002. .
Roberts MS, Walker M: “Water—the Most Natural Penetration Enhancer,” in Pharmaceutical Skin Penetration Enhancement, ed by KA Walters, J Hadgraft p 1, Marcel Dekker, New York,1993. .
Habif TR: Clinical Dermatology: A Color Guide to Diagnosis and Treatment, 5th Ed, Mosby, Philadelphia,2009. .
Idsen B: Dry skin: moisturizing and emolliency.Cosmet Toilet 93::45. ,1978. .
Bauman L: Cosmetic Dermatology: Principles and Practice, McGraw-Hill, New York,2002. .
Smith EW, Surber C, Tassopoulos T, et al: “Topical Dermatological Vehicles: A Holistic Approach,” in Topical Absorption of Dermatological Products, ed by RL Bronaugh, HI Maibach, p 458, Marcel Dekker, New York,2002. .
Loden M, Andersson AC, Lindberg M: Improvement in skin barrier function in patients with atopic dermatitis after treatment with a moisturizing cream (Canoderm).Br J Dermatol 140::264. ,1999. .
Loden M: Role of topical emollients and moisturizers in the treatment of dry skin barrier disorders.Am J Clin Dermatol 4::771. ,2003. .
Rogers RS III, Callen J, Wehr R, et al: Comparative efficacy of 12% aluminum lactate lotion and 5% lactic acid lotion in the treatment of moderate to severe xerosis.J Am Acad Dermatol 21::714. ,1989. .
Wolverton SE: Comprehensive Dermatologic Drug Therapy, 3rd Ed, Saunders Elsevier, Philadelphia,2007. .
Jennings MB, Logan L, Alfieri D, et al: A comparative study of lactic acid 10% and ammonium lactate 12% lotion in the treatment of foot xerosis.JAPMA 92::143. ,2002. .
Jennings MB, Alfieri D, Ward K, et al: Comparison of salicylic acid and urea versus ammonium lactate for the treatment of foot xerosis: a randomized, double-blind, clinical study.JAPMA 88::332. ,1998. .
Uy JJ, Joyce AM, Nelson JP, et al: Ammonium lactate 12% lotion versus a liposome-based moisturizing lotion for plantar xerosis: a double-blind comparison study.JAPMA 89::502. ,1999. .
Carroll CL, Feldman SR, Camacho FT, et al: Adherence to topical therapy decreases during the course of an 8-week psoriasis clinical trial: commonly used methods of measuring adherence to topical therapy overestimate actual use.J Am Acad Dermatol 51::212. ,2004. .
Krejci-Manwaring J, Tusa MG, Carroll C, et al: Stealth monitoring of adherence to topical medication: adherence is very poor in children with atopic dermatitis.J Am Acad Dermatol 56::211. ,2007. .
Tusa MG, Ladd M, Kaur M, et al: Adapting electronic adherence monitors to standard packages of topical medications.J Am Acad Dermatol 55::886. ,2006. .
Murphy J, Coster G: Issues in subject compliance.Drugs 54::797. ,1997. .
Richards HL, Fortune DG, O’Sullivan TM, et al: Subjects with psoriasis and their compliance with medication.J Am Acad Dermatol 41::581. ,1999. .
Brown KK, Rehmus WE, Kimball AB: Determining the relative importance of subject motivations for non-adherence to topical corticosteroid therapy in psoriasis.J Am Acad Dermatol 55::607. ,1999. .
Charman CR, Morris AD, Williams HC: Topical corticosteroid phobia in subjects with atopic eczema.Br J Dermatol 142::931. ,2000. .
Rapp SR, Exum ML, Reboussin DM, et al: The physical, psychological and social impact of psoriasis.J Health Psychol 2::525. ,1997. .
Stebbins W, Alexis A, Levitt J: Cosmetic acceptability of six 40–50% urea preparations.Am J Clin Dermatol 9::319. ,2008. .
Background: We evaluated 35% urea in a water-lipid–based foam delivery system containing lactic acid in participants with mild-to-moderate xerosis of the foot.
Methods: This 4-week open-label study enrolled 12 participants with xerosis of the foot; six participants were diabetic and six were nondiabetic. Study medication was applied to the affected area twice daily. All adverse events were recorded. Disease severity was measured at baseline and at the end of treatment by Investigator’s Global Assessment, and investigator’s and participant’s signs and symptoms scores. At 4 weeks, compliance and participant satisfaction were determined from participant diaries and a 16-item survey instrument, respectively.
Results: Ten participants completed the study. No adverse reactions were noted with application of the foam. All of the participants who completed the study experienced an improvement in xerosis. The median Investigator’s Global Assessment score decreased significantly from baseline to the end of treatment (P = .005). The investigator and participants observed significant improvement (P < .05) in redness, scaling, and cracking from baseline to the end of treatment. Compliance with the regimen was good, and participants expressed satisfaction with the product.
Conclusions: Thirty-five percent urea in a water-lipid–based foam delivery system containing lactic acid can be an appropriate treatment option for mild-to-moderate xerosis of the foot. (J Am Podiatr Med Assoc 101(2): 153–158, 2011)