332 Jennings

Journal of the American Podiatric Medical Association In normal skin, the stratum corneum serves as a protective barrier against excessive evaporative water loss and environmental insults. The extensibility of the stratum corneum depends on its water content and environmental temperature.1 The stratum corneum must contain more than 10% water to remain soft and pliable; when the water content drops below 10%, it becomes rough, with possible scaling and cracking. Xerosis is defined as dehydration of skin characterized by redness, dry scaling, and fine crackling that may resemble the crackling of porcelain. These changes are seen most frequently on the extremities, especially the legs and feet.2 The treatment of xerosis has three aspects: replacing water content and maintaining hydration, alleviating the symptomatology, and controlling keratinization to reduce scaling.3 Relief and prevention of dryness of the skin are centered around maintaining the proper hydration of the epidermis, particularly the stratum corneum. Therapy has been limited to topical applications of hydrating emollients designed to soften the stratum corneum and alleviate the scaliness.4 One of the primary objectives of using an emollient is to maintain enough water in the stratum corneum to reduce the possibility of cracking and flaking.1 Emollients such as lanolin and glycerin are hydrophilic, act primarily on the skin’s surface, and form an occlusive barrier that decreases evaporation.1, 2 Another approach to treating xerosis is the use of skin protectants containing hygroscopic subComparison of Salicylic Acid and Urea versus Ammonium Lactate for the Treatment of Foot Xerosis A Randomized, Double-Blind, Clinical Study