My dog’s skin is really dry, scaly, and itchy! What is the “Skin Barrier” & Why is it important in my dog’s skin disease?
What is the Skin Barrier?
Stratum Corneum (Skin) Barrier Overview: The skin is composed of several layers with the most surface being the stratum corneum. It is the outer portion of the epidermis and is composed of approximately 20 overlapping layers. This outer layer 1) controls hydration by restricting water movement into and out of the skin, 2) is the primary defense against environmental hazards such as allergens, pollutants, and irritants by continuous desquamation. Desquamation is the process of renewal –the cells in the lower levels of the epidermis multiply and migrate to the upper Stratum corneum level and then removal, where dead surface skin scales fall off into the environment, 3) maintains homeostasis with commensal organisms (bacterial and yeast organisms) via the production of antimicrobial peptides, and 4) absorbs UV light to protect sensitive underlying tissue. Alterations in the epidermal barrier can lead to devastating clinical disorders. Some of these disorders include ichthyosis (“fish scale disease”) and allergy! The epidermal barrier is vitally important in dog skin diseases.
LAYERS OF THE SKIN: epidermis, dermis and hypodermis (fat layer)
INDIVIDUAL LAYERS OF THE EPIDERMIS (that forms the stratum corneum layer- skin barrier)
Process of Cornification/ Keratinization (REGENERATION OF THE SKIN): The process of renewing the epidermis is a series of complex organized steps (controlled or regulated cell death). This process is most evident to all of us as we watch our suntans fade! Your skin and your dog’s skin regenerates itself every 22-28 days! These steps are vital to the understanding of various clinical disorders. An alteration in any of the individual steps can lead to barrier dysfunction and abnormalities in permeability. Hyperkeratosis (excessive scaling) is a reactive and adaptive response to repair the injured/ altered stratum corneum barrier. Lipid (oils) synthesis is up-regulated and the epidermis becomes hyperplastic (thickened) in order to provide more lipid to the stratum corneum to help improve the barrier function.
The final result of cornification (skin regeneration) produces a tough hydrophobic (repels water) layer of the skin. The process of cell migration through the layers of the epidermis (epidermal renewal) takes approximately 22-28 days. There is an extensive list of factors that can influence/ regulate the process.
ALLERGY PATIENTS AND AN ALTERED SKIN BARRIER:
Allergy patients exhibit an altered epidermal lipid barrier. This is the barrier that is responsible for protection against allergens as well as microbial organisms such as bacteria and yeast. It is unknown at this time if the disorder in the barrier is hereditary (due to abnormal stratum corneum proteins (fillagrin) or if it is a result of the inflammation associated with allergy. There is demonstrable increased transepidermal water loss (TEWL) as well as an increased incidence of bacterial infections (pyoderma/ folliculitis) in dogs with allergy.
OTHER DISEASES WITH ABNORMAL BARRIERS:
Golden Retriever Ichthyosis is one of the more common forms of ichthyosis (scaling disease) in veterinary medicine. Patients exhibit a large white-to-gray adherent scale that is prominent on the trunk. Clinical signs are usually evident by 1 year of age. This disease is a result of an autosomal recessive mutation of the gene PNPLA-1. This gene plays a role in lipid metabolism and organization. A European company, Antagene (www.antagene.com), offers a genetic test to assess carrier status in breeding dogs.
American Bulldog Ichthyosis is a result of a mutation in the gene NIPAL-4. This gene is responsible for expression of the protein icthyin, which plays a role in lipid metabolism in the epidermis. Drs. Elizabeth Mauldin and Margret Casal at the University of Pennsylvania School of Veterinary Medicine (Medical Genetics section) have characterized this disorder and developed a genetic test to assess carrier status in this breed. This ichthyosiform (scaling) disorder is more severe than that seen in the Golden Retriever. Clinical signs appear very early, often at weaning. Puppies have a scruffy disheveled coat with brown adherent scale of the glaborous skin and large white scale of the rest of the body. Malassezia (yeast) overgrowth is common and may contribute to pruritus (itching). These cases may be mistaken for atopic dermatitis (allergy).
Jack Russell terrier Ichthyosis is a mutation of transglutaminase 1 (TGM1) which mediates the cross-linking of peptides (involucrin, loricrin) to form the cornified envelope (portion of the skin barrier). This disorder is more severe than either the Golden Retreiver or Bulldog ichthyosiform dermatoses.
Wheaton terriers, Norfolk terriers, Cavalier King Charles Spaniels : hereditary scaling skin with rough coat and abnormal nail growth
Sebaceous Adenitis (long-coated breeds)- Poodle, Havanese, Akita, Samoyed, German Shepherds, etc. This disease is characterized by an inflammatory destruction of sebaceous glands that are attached to the hair follicles. These glands are necessary for the production of skin lipids (oils) necessary for a normal skin barrier. This destruction leads to hyperkeratosis (scaling. The hair is “matted” to the surface of the skin because of heavy scale formation. They have a dry and brittle coat. Scaling is often noted lining the epithelium of the vertical external ear canal.
Idiopathic (Pyo)Granulomatous Periadnexal Dermatitis was originally titled “short-coated” sebaceous adenitis. This form is common in the Vizsla and Dachshund. It is characterized by inflammation along the entire hair follicle and sometimes into the panniculus or fat layer just beneath the skin. Alopecia (hair loss) is diffuse with less scale than seen with Sebaceous Adenitis.
Color Dilution Alopecia affects fawn and blue colored patients. Some of these puppies are sold at a premium only to lose their coat by 1-2 years of age. “Silver Labs” are a prime example. These patients have a progressive light scale associated with partial alopecia (hair loss). Differentiation from idiopathic periadnexal pyogranulomatous dermatitis is via histopathology (biopsy).
THERAPEUTICS TO HELP DISEASES WITH ABNORMAL SKIN BARRIERS
Cyclosporine tends to have variable results in canine patients yet there is some limited data to support clinical trials. Cyclosporine has been shown to inhibit keratinocyte(skin cell) hyperproliferation in psoriatic human patients (JAAD 1995; 33:637-45). Transepidermal water loss was not beneficially affected by the use of cyclosporine in the canine patient (Marsella et al; Vet Dermatol 23, 2012). Some of the beneficial effects noted may be due to the anti-inflammatory properties of the drug (JAAD, 2010; 63:925-46). When appropriate, the author tends to trial cyclosporine for at least 2-3 months to allow for several cycles of epidermal turnover (skin regeneration) before evaluating clinical efficacy.
Essential Fatty Acids may be helpful in replacing abnormal lipid levels in the skin. Several very good commercial veterinary products are available. ConsumerLab.com may be useful in helping a client determine the appropriateness of a product if they choose to use an unfamiliar form. Some veterinary diets such as Hill’s JD and Iams Skin and Coat Response FP may also be beneficial in that they supply an increased level of EFA’s.
Topical Therapy remains the treatment of choice for all diseases characterized with altered skin barriers. The focus is currently on keratolytic agents to remove excess scale, moisturizers and emollients to restore the skin barrier and prevent water loss, and topical antimicrobials to prevent overgrowth. Topical barrier “repair” products can mimic the composition of epidermal lipids (free fatty acids, ceramides, cholesterol, phytosphingosines, etc). Phytosphingosines are pro-ceramides that play a key role in the natural defense mechanisms of the skin. Ceramides comprise 40-50% of epidermal lipids and function in the cohesion of the stratum corneum, control local flora, and balance hydration. Ceramides also have an anti-inflammatory effect by inhibiting protein-kinase-C, via anti-IL-1 activity and decreasing PGE2. These products are available as spot-on products, mousse, gels, sprays, lotions, rinses, and shampoos. While many of the “spot-on” products focus on lipid replacement, individual specific ingredients in some of the shampoos may offer a different avenue for “repair”. Salicylic acid is keratolytic (helps with desquamation by decreasing skin pH, which subsequently increases water absorption by the keratin in the stratum corneum. Canine Skin Solutions Recovery shampoo and spray were developed with this scientific data in mind. They were formulated specifically to treat these disorders by promoting healthy skin and healing damage skin. Although luxurious and spa-like, they are medically relevant and effective.
Welcome to healthyskin4dogs.com
Unleash Your Dog’s Healthy Skin.™
Canine Skin Solutions was founded by two veterinary dermatologists to create a better everyday life for dogs suffering with skin disease. These dogs are often itchy and have red, rashy, flaky or dry, greasy skin.
The Two-Step Recovery System (Shampoo & Spray) does what it says… clears infection and odor from the skin and helps to prevent future breakouts. The Recovery system also delivers the exceptional benefits of a premium skincare line- soothing itchy, sensitive skin and nourishing dry, damaged skin. The products are so elegant you will think your dog has been to a spa! We invite you to discover the skincare products that love your dog as much as you do.
Why it works
Dr. Karen Helton Rhodes and Dr. Terri Bonenberger uniquely understood the frustration of pet parents who brought all types of skincare products to their dog’s dermatology appointment. The doctors used their medical training and clinical expertise to develop an exceptional skincare line that actually works and is easy to use, whether you have a Chihuahua or a Great Dane.
How can our system work when our customers tell us so many other products failed? This is our secret: the Recovery Shampoo & Spray work because of their unique, clinically effective formulations and the overall regimen approach.
How to use
We know dogs’ skin. Recurrent itch, rash and inflamed skin typically occurs due to skin allergies (eczema/atopic dermatitis, flea allergy, food allergy). Skin allergies in dogs create a “perfect storm” of microscopic events- bacterial & yeast overgrowth, excess oil production, dead skin cells and inflammation. All these factors cause the odor and itch you notice with your dog. Recovery Shampoo & Spray is a system formulated to heal and clear infection, it also helps to restore skin to a healthy-looking appearance.
STEP 1: CLEANSE WITH RECOVERY SHAMPOO
When active skin problems are present, bathe 2-3 times weekly until the skin condition resolves, then weekly to maintain skin health.
STEP 2: SOOTHE & REPAIR WITH RECOVERY SPRAY
Apply leave-on spray after bathing and once daily in between baths until the skin condition resolves; then several times weekly to maintain skin health. The leave-on spray does not require rinsing and may be applied to wet or dry skin.
It’s All About the Ingredients
Like any perfect recipe, high quality, effective ingredients, combined in exactly the right proportions, are critical to a product’s success. These are the key ingredients that make Recovery Shampoo & Spray so effective at clearing infection and helping to prevent new breakouts.
It is widely known that dilute concentrations of Sodium Hypochlorite can be used to prevent and treat skin infections in people and pets but yet still be gentle enough for daily use. You’ll find it in both steps 1 and 2. Salicylic acid (step 1) is excellent at removing debris from the skin’s surface that contributes to infection, inflammation and odor. Rosemary-mint (step 1) and Eucalyptus (step 2) are soothing, calming and will give your dog that spa experience. Ceramides, Vitamin E, Fatty Acids (step 1) and Allantoin (step 2) nourish and repair damaged skin. Used in the right sequence and in our proprietary formulations, these tried and true ingredients both treat and control your dog’s skin problems.
THERAPEUTIC COMMENTS: Hyperkeratotic (scaling) disorders in the canine patient are extremely frustrating for the pet owner. Management of the condition is life-long and focuses on control versus cure. Topical therapy remains the treatment of choice for all forms of scaling diseases.
UNLEASH YOUR DOG’S HEALTHY SKIN