Background: Ablative fractional carbon dioxide laser (AFCO2) resurfacing causes transient skin barrier disruption characterized by decreased skin hydration and increased transepidermal water loss (TEWL). Snail Soothing and Repairing (SSR) cream, containing several glycoproteins with potential antimicrobial and antioxidant effects, may benefit skin hydration promotion after the laser treatment. Objective: To evaluate the efficacy and safety of SSR cream in skin hydration promotion after AFCO2 resurfacing. Method: The study was a double-blinded, split-face, placebo-controlled trial in participants aged 18–50 years with atrophic acne scars on both cheeks. After AFCO2 resurfacing, participants applied the product or placebo on either cheek twice daily for 14 days. Corneometry, TEWL, colorimetry, and clinical assessments (edema, erythema, crusting, pruritus, and tightness score) were evaluated at baseline, day 7, and day 14 after AFCO2 resurfacing. Results: From 22 participants in the study, the SSR cream-treated sides showed significantly higher corneometry levels than placebo-treated sides at day 14 (p = 0.033), while TEWL and colorimetry levels were not different at any study visits. Pruritus and tightness scores of the SSR side were lower, but not significant, than the placebo. Other clinical assessments (edema, erythema, and crusting) showed similar results. No significant adverse events took place. Conclusion: The SSR cream significantly improved skin hydration, highlighting skin barrier restoration after AFCO2 resurfacing, with a good safety profile.

1.
Proksch
E
,
Brandner
JM
,
Jensen
JM
.
The skin: an indispensable barrier
.
Exp Dermatol
.
2008
;
17
(
12
):
1063
72
. .
2.
Elias
PM
,
Wood
LC
,
Feingold
KR
.
Epidermal pathogenesis of inflammatory dermatoses
.
Am J Contact Dermatitis
.
1999
;
10
(
3
):
119
26
. .
3.
Wang
X
,
Ye
L
,
Lai
Q
,
Wen
S
,
Long
Z
,
Qiu
X
,
Altered epidermal permeability barrier function in the uninvolved skin supports a role of epidermal dysfunction in the pathogenesis of occupational hand eczema
.
Skin Pharmacol Physiol
.
2020
;
33
(
2
):
94
101
. .
4.
Smith
W
.
Stratum corneum barrier integrity controls skin homeostasis
.
Int J Cosmet Sci
.
1999
;
21
(
2
):
99
106
. .
5.
Ri
JS
,
Choe
SH
,
Schleusener
J
,
Lademann
J
,
Choe
CS
,
Darvin
ME
.
In vivo tracking of DNA for precise determination of the stratum corneum thickness and superficial microbiome using confocal Raman microscopy
.
Skin Pharmacol Physiol
.
2020
;
33
(
1
):
30
7
. .
6.
Proksch
E
,
Holleran
WM
,
Menon
GK
,
Elias
PM
,
Feingold
KR
.
Barrier function regulates epidermal lipid and DNA synthesis
.
Br J Dermatol
.
1993
;
128
(
5
):
473
82
. .
7.
Feingold
KR
,
Schmuth
M
,
Elias
PM
.
The regulation of permeability barrier homeostasis
.
J Invest Dermatol
.
2007
;
127
(
7
):
1574
6
. .
8.
Chang
YC
,
Croix
J
,
Hernandez
S
,
Chapas
A
.
A comparative split-face trial of plant-based hypoallergenic ointment vs petroleum-based ointment following fractionated carbon dioxide laser resurfacing of the face
.
J Drugs Dermatol
.
2018
;
17
(
11
):
1178
82
.
9.
Xu
Y
,
Deng
Y
.
Ablative fractional CO2 laser for facial atrophic acne scars
.
Facial Plast Surg
.
2018
;
34
(
02
):
205
19
. .
10.
Huang
L
.
A new modality for fractional CO2 laser resurfacing for acne scars in Asians
.
Lasers Med Sci
.
2013
;
28
(
2
):
627
32
. .
11.
Hwang
YJ
,
Lee
YN
,
Lee
YW
,
Choe
YB
,
Ahn
KJ
.
Treatment of acne scars and wrinkles in Asian patients using carbon-dioxide fractional laser resurfacing: its effects on skin biophysical profiles
.
Ann Dermatol
.
2013
;
25
(
4
):
445
53
. .
12.
Proksch
E
,
Soeberdt
M
,
Neumann
C
,
Kilic
A
,
Reich
H
,
Abels
C
.
Influence of buffers of different pH and composition on the murine skin barrier, epidermal proliferation, differentiation, and inflammation
.
Skin Pharmacol Physiol
.
2019
;
32
(
6
):
328
36
. .
13.
Rekik
DM
,
Ben Khedir
S
,
Daoud
A
,
Ksouda Moalla
K
,
Rebai
T
,
Sahnoun
Z
.
Wound healing effect of Lawsonia inermis
.
Skin Pharmacol Physiol
.
2019
;
32
(
6
):
295
306
. .
14.
Campolo
M
,
Lanza
M
,
Filippone
A
,
Paterniti
I
,
Casili
G
,
Scuderi
SA
,
Evaluation of a product containing xyloglucan and pea protein on skin barrier permeability
.
Skin Pharmacol Physiol
.
2020
;
33
(
4
):
231
6
. .
15.
Ellijimi
C
,
Ben Hammouda
M
,
Othman
H
,
Moslah
W
,
Jebali
J
,
Mabrouk
HB
,
Helix aspersa maxima mucus exhibits antimelanogenic and antitumoral effects against melanoma cells
.
Biomed Pharmacother
.
2018
;
101
:
871
80
. .
16.
Badiu
DL
,
Balu
AM
,
Barbes
L
,
Luque
R
,
Nita
R
,
Radu
M
,
Physico-chemical characterisation of lipids from Mytilus galloprovincialis (L.) and Rapana venosa and their healing properties on skin burns
.
Lipids
.
2008
;
43
(
9
):
829
. .
17.
Tsoutsos
D
,
Kakagia
D
,
Tamparopoulos
K
.
The efficacy of Helix aspersa Müller extract in the healing of partial thickness burns: a novel treatment for open burn management protocols
.
J Dermatol Treat
.
2009
;
20
(
4
):
219
22
.
18.
Tribó
M
,
Parrado-Romero
C
,
Rais
B
,
Reyes
E
,
Vitale-Villarejo
MA
,
Gonzalez
S
.
Clinical and histological efficacy of a secretion of the mollusk Cryptomphalus aspersa in the treatment of cutaneous photoaging
.
Cosmetic Dermatology
.
2009
;
22
:
247
52
.
19.
Fabi
SG
,
Cohen
JL
,
Peterson
JD
,
Kiripolsky
MG
,
Goldman
MP
.
The effects of filtrate of the secretion of the Cryptomphalus aspersa on photoaged skin
.
J Drugs Dermatol
.
2013
;
12
(
4
):
453
7
.
20.
Ulagesan
S
,
Kim
H
.
Antibacterial and antifungal activities of proteins extracted from seven different snails
.
Applied Sciences
.
2018
;
8
(
8
):
1362
. .
21.
Dolashka
P
.
Antimicrobial activity of peptides from the hemolymph of Helix lucorum snails, Pavlina Dolashka, Aleksander Dolashki, Wolfgang Voelter, Jozef Van Beeumen and Stefan Stevanovic
.
Int J Curr Microbiol Appl Sci
.
2015
;
4
:
1061
71
.
22.
Zheng
L
,
Lin
L
,
Su
G
,
Zhao
Q
,
Zhao
M
.
Pitfalls of using 1,1-diphenyl-2-picrylhydrazyl (DPPH) assay to assess the radical scavenging activity of peptides: its susceptibility to interference and low reactivity towards peptides
.
Food Res Int
.
2015
;
76
(
Pt 3
):
359
65
. .
23.
Sirivibulkovit
K
,
Nouanthavong
S
,
Sameenoi
Y
.
Paper-based DPPH assay for antioxidant activity analysis
.
Anal Sci
.
2018
;
34
(
7
):
795
800
. .
24.
Roy
S
,
Khanna
S
,
Nallu
K
,
Hunt
TK
,
Sen
CK
.
Dermal wound healing is subject to redox control
.
Mol Ther
.
2006
;
13
(
1
):
211
20
. .
25.
Sen
CK
.
The general case for redox control of wound repair
.
Wound Repair Regen
.
2003
;
11
(
6
):
431
8
. .
26.
Soneja
A
,
Drews
M
,
Malinski
T
.
Role of nitric oxide, nitroxidative and oxidative stress in wound healing
.
Pharmacol Rep
.
2005
;
57 Suppl
(
Suppl l
):
108
19
.
27.
Kimwattananukul
K
,
Noppakun
N
,
Asawanonda
P
,
Kumtornrut
C
.
Topical 0.5% timolol maleate significantly enhances skin-barrier restoration after fractional carbon dioxide laser treatment for acne scars
.
Lasers Surg Med
.
2020
.
28.
Trapella
C
,
Rizzo
R
,
Gallo
S
,
Alogna
A
,
Bortolotti
D
,
Casciano
F
,
HelixComplex snail mucus exhibits pro-survival, proliferative and pro-migration effects on mammalian fibroblasts
.
Sci Rep
.
2018
;
8
(
1
):
17665
. .
29.
Bortolotti
D
,
Trapella
C
,
Bernardi
T
,
Rizzo
R
.
Letter to the editor: antimicrobial properties of mucus from the brown garden snail Helix aspersa
.
Br J Biomed Sci
.
2016
;
73
(
1
):
49
50
. .
30.
Caberlotto
E
,
Cornillon
C
,
Njikeu
S
,
Monot
M
,
Vicic
M
,
Flament
F
.
Synchronized in vivo measurements of skin hydration and trans-epidermal water loss. Exploring their mutual influences
.
Int J Cosmet Sci
.
2019
;
41
(
5
):
437
42
. .
31.
Stettler
H
,
Kurka
P
,
Lunau
N
,
Manger
C
,
Böhling
A
,
Bielfeldt
S
,
A new topical panthenol-containing emollient: results from two randomized controlled studies assessing its skin moisturization and barrier restoration potential, and the effect on skin microflora
.
J Dermatolog Treat
.
2017
;
28
(
2
):
173
80
. .
32.
Pieńkowska
JR
,
Kosicka
E
,
Wojtkowska
M
,
Kmita
H
,
Lesicki
A
.
Molecular identification of first putative aquaporins in snails
.
J Membr Biol
.
2014
;
247
(
3
):
239
52
. .
33.
Bollag
WB
,
Aitkens
L
,
White
J
,
Hyndman
KA
.
Aquaporin-3 in the epidermis: more than skin deep
.
Am J Physiol Cell Physiol
.
2020
;
318
(
6
):
C1144
c53
. .
34.
Hara
M
,
Ma
T
,
Verkman
AS
.
Selectively reduced glycerol in skin of aquaporin-3-deficient mice may account for impaired skin hydration, elasticity, and barrier recovery
.
J Biol Chem
.
2002
;
277
(
48
):
46616
21
. .
35.
Hara-Chikuma
M
,
Takahashi
K
,
Chikuma
S
,
Verkman
AS
,
Miyachi
Y
.
The expression of differentiation markers in aquaporin-3 deficient epidermis
.
Arch Dermatol Res
.
2009
;
301
(
3
):
245
52
. .
36.
Hara-Chikuma
M
,
Verkman
AS
.
Aquaporin-3 facilitates epidermal cell migration and proliferation during wound healing
.
J Mol Med
.
2008
;
86
(
2
):
221
31
. .
37.
Hara-Chikuma
M
,
Verkman
AS
.
Prevention of skin tumorigenesis and impairment of epidermal cell proliferation by targeted aquaporin-3 gene disruption
.
Mol Cell Biol
.
2008
;
28
(
1
):
326
32
. .
38.
Denny
M
.
The role of gastropod pedal mucus in locomotion
.
Nature
.
1980
;
285
(
5761
):
160
1
. .
39.
Denny
M
.
Locomotion: the cost of gastropod crawling
.
Science
.
1980
;
208
(
4449
):
1288
90
. .
40.
Lim
VZ
,
Yong
AA
,
Tan
WPM
,
Zhao
X
,
Vitale
M
,
Goh
CL
.
Efficacy and safety of a new cosmeceutical regimen based on the combination of snail secretion filtrate and snail egg extract to improve signs of skin aging
.
J Clin Aesthet Dermatol
.
2020
;
13
(
3
):
31
6
.
41.
Yosipovitch
G
,
Xiong
GL
,
Haus
E
,
Sackett-Lundeen
L
,
Ashkenazi
I
,
Maibach
HI
.
Time-dependent variations of the skin barrier function in humans: transepidermal water loss, stratum corneum hydration, skin surface pH, and skin temperature
.
J Invest Dermatol
.
1998
;
110
(
1
):
20
3
. .
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.