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Treatment of Dry Skin Syndrome pp 149–178Cite as

Desquamation: It Is Almost All About Proteases

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Abstract

This chapter reviews the structure, function, and formation of the stratum corneum, how it is perturbed in a variety of conditions. In particular it discusses the role of proteases such as the kallikreins, plasmin, and urokinase and their inhibitors that play a role in desquamation of healthy and pathological skin. Faulty desquamation is the accumulation of corneocytes on the surface of the stratum corneum that leads ultimately to the cosmetic condition commonly termed as “dry skin.” This can be flaky skin as is normally seen on the body or rough skin observed on the face. Changes in the proteolytic balance of the skin can also result in inflammation, which leads to the typical clinical signs of redness, scaling, and itching. Reduced protease activity is known in soap-induced dry skin, but increased serine protease activity occurs in most, if not all, inflammatory dermatoses, ranging from genetic disorders, such as Netherton syndrome, psoriasis, and atopic dermatitis, to subclinical barrier abnormalities induced, e.g., surfactants, or by environmental influences. Serine proteases might represent key markers for underlying and sometimes nonobservable skin abnormalities. The biology of skin moisturization, of which hydration is only one benefit, is highly complex. The future of all new moisturizers lies in the fully understanding of the control and impairment of desquamation. Better understanding of the multistep proteolytic events and of the regulatory mechanisms involved in desquamation should enable the design of new treatments for the skin disorders associated with disturbance in the stratum corneum turnover. This will be the ultimate approach to corneocare.

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Authors and Affiliations

  1. DSM Nutritional Products Ltd., Bldg. 203-4/86, 2676, Basel, CH-4002, Switzerland

    Rainer Voegeli

  2. AVR Consulting Ltd., 26 Shavington Way, Kingsmead, Northwich Cheshire, CW9 8FH, UK

    Anthony V. Rawlings

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  1. Rainer Voegeli
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Correspondence to Rainer Voegeli .

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  1. Eviderm Institute, Bergshamra Allé 9, Solna, 17077, Sweden

    Marie Lodén

  2. School of Medicine, Department Dermatology, University of California, San Francisco, Divisadero 1701, San Francisco, 94143-0989, California, USA

    Howard I. Maibach

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Voegeli, R., Rawlings, A.V. (2012). Desquamation: It Is Almost All About Proteases. In: Lodén, M., Maibach, H. (eds) Treatment of Dry Skin Syndrome. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-27606-4_11

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