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An Evidence-Based Approach to Skin Cleansing: Restoring and Maintaining the Skin Barrier in Diverse Patient Populations

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Jointly provided by: 

In affiliation with:

Supported by an educational grant from:
Johnson & Johnson Consumer Product Company
Division of Johnson & Johnson Consumer Companies, Inc.



Introduction and Presentation 1
Joseph F. Fowler, Jr, MD, Program Chair
Clinical Professor of Dermatology
Contact and Occupational Dermatology
University of Louisville
Louisville, KY

Presentation 1:
Demographics and the Skin Barrier:
Differences That Matter

Lawrence F. Eichenfield, MD
Chief, Pediatric and Adolescent Dermatology
Clinical Professor of Pediatrics and Medicine (Dermatology)
Children's Hospital San Diego
University of California
San Diego School of Medicine

Presentation 2:
A Clinician's Approach to Skin Barrier Science

Peter M. Elias, MD
Professor Emeritus
Department of Dermatology
University of California, San Francisco
School of Medicine Dermatology Service,
Veterans Affairs Medical Center
San Francisco

Presentation 3:
Cleanser Chemistry for Clinicians

Joseph F. Fowler, Jr, MD, Program Chair
University of Louisville
Contact and Occupational Dermatology
Clinical Professor of Dermatology
Louisville, KY

Presentation 4:
Practical Approaches to Skin Barrier Recovery and Maintenance:
Principles of Cleansing for Children and Adults

Renee P. McLeod PhD, APRN-BC, CPNP
Dean, School of Nursing and Health Professions
Brandman University
Irvine, CA

Presentation 5:
Panel Discussion Skin Cleansers

Joseph F. Fowler, Jr, MD, Moderator
Lawrence F. Eichenfield, MD
Peter M. Elias, MD
Renee P. McLeod, PhD, APRN-BC, CPNP, FAANP


Instructions for CME/CNE

Physicians:  To get instant CME credits online, go to Upon successful completion of the online test and evaluation form, you will be directed to a Web page that will allow you to receive your certificate of credit via e-mail. Please add to your e-mail "safe" list. If you have any questions or difficulties, please contact the University of Louisville School of Medicine Continuing Medical Education (CME & PD) office at


Nurses: To get instant CNE credits online, go to There are no fees for participating and receiving credit for this activity. Participants must 1) read the learning objectives and faculty disclosures; 2) study the educational activity; and 3) complete the posttest and the evaluation form. Once completed, click on Submit Posttest at the bottom of the page. If you successfully complete the posttest (score of 70% or higher), your certificate will be made available immediately. If you have any questions or difficulties, please contact the Creative Educational Concepts, Inc., office at; 859-260-1717.


Joint Sponsorship
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the University of Louisville School of Medicine and Global Academy for Medical Education LLC. The University of Louisville School of Medicine is accredited by the ACCME to provide continuing education for physicians.


ACCME Designation Statement

The University of Louisville Continuing Medical Education designates this for a maximum of 2.0 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


ANCC Designation Statement

This activity has been planned and implemented by Creative Educational Concepts, Inc. (CEC), and Global Academy for Medical Education LLC, for the advancement of patient care. CEC is accredited by the American Nurses Credentialing Center (ANCC), the Accreditation Council for Pharmacy Education (ACPE), and the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing education for the health care team. This activity is designated for 2.0 contact hours.


Learners are advised that accredited status does not imply endorsement by the provider or ANCC of any commercial products displayed in conjunction with an activity. 


Target Audience
This educational activity is intended for dermatologists, pediatricians, family physicians, nurses, nurse practitioners, physician assistants, and other health care practitioners who treat diseases of the skin in children and adults.


Program Description

Advances in understanding the physiology and multiple roles of the skin barrier have made it both possible and advisable for clinicians to become more educated about how skin care—and the various ingredients in skin cleansing agents—can maintain the normal integrity and function of the skin barrier and help to heal injured skin by promoting and supporting barrier function.


In addition, patients with dermatitides and other underlying skin conditions, as well as those with sensitive skin, a history of allergic contact dermatitis, or injuries (such as ultraviolet or other radiation

damage) have special skin cleansing needs. Finally, skin cleansing in elderly and medically compromised patients must be accomplished with great care to maintain the skin barrier.


Clinicians must also remain up-to-date with regard to evidence about skin cleansing ingredients that can degrade the integrity of the skin barrier, and cleanser components and skin care practices that can help restore and maintain barrier function. The presentations in this webcast address these issues and provide clinicians with information to assist them in making evidence-based, individualized recommendations for cleansing techniques and agents.


Learning Objectives
By reading and studying this supplement, participants should be prepared to:

  • Adapt patient care practices to reflect the current understanding about the stratum corneum structure and the role of skin cleanser and moisturizer ingredients.
  • Discuss the factors that adversely affect skin barrier structure and function, including medical conditions (for example, atopic dermatitis and allergic contact dermatitis) and environmental challenges (such as exposure to allergens and the use of harsh detergents for skin cleansing).
  • Determine from skin cleanser product labels which ones contain ingredients that help maintain the normal integrity and function of the skin barrier and help heal injured skin by promoting and supporting barrier function.
  • Incorporate into clinical practice evidence-based recommendations for skin-cleansing regimens and cleansing agents suitable to specific dermatologic conditions in pediatric and adult patients.
  • Evaluate the results of studies now in progress examining the safety, efficacy, and mechanisms of action of botanical ingredients in skin care products.
  • Demonstrate improved ability to instruct patients and parents or caregivers on cleansing techniques and agents that will help maintain or restore the skin barrier and avoid complications such as skin infections, irritation, and inflammation.


The authors would like to thank Global Academy for Medical Education for assistance with the preparation of this webcast.


As a sponsor accredited by the ACCME, the University of Louisville School of Medicine must ensure balance, independence, objectivity, and scientific rigor in all its sponsored educational activities. All faculty participating in this CME activity were asked to disclose the following:

  1. Names of proprietary entities producing health care goods or services—with the exemption of nonprofit or government organizations and non–health-related companies—with which they or their spouse/partner have, or have had, a relevant financial relationship within the past 12 months. For this purpose, we consider the relevant financial relationships of a spouse/partner of which they are aware to be their financial relationships.
  2. Describe what they or their spouse/partner received (eg, salary, honorarium).
  3. Describe their role.
  4. No relevant financial relationships.


CME & PD Advisory Board Members:

Lisa J. Pfitzer, MD; Soon Bahrami, MD; Douglas Coldwell, MD, PhD; W. Daniel Cogan, Ed.D., FAODME; Justin L. Costa, MD; James Creg; Daniel Da Justa, MD; Adair Heyl, PhD; Christopher Jones, MD;Lucy Juett, MS; Gerald Larson, MD; Rana Latif, MD; Kimberly Moore; Karen Napolilli; Scott Plantz, MD;Kerri Remmel, MD, PhD; Michael D. Stillman, MD; Uldis Streips, PhD; Kathy M. Vincent, MD; Lori Wagner, MD; Angela Wetherton, MD; and Stephen Wheeler, MD have no relevant financial relationships with any commercial interests.


CME REVIEWER: Courtney R. Schadt, M.D., Professor, Division of Dermatology University of Louisville, School of Medicine has no relevant financial relationships with any commercial interests.


Peter M. Elias, MD, has no relevant financial relationships with any commercial interests.

Lawrence E. Eichenfield, MD has been an investigator and/or consultant for Galderma Laboratories, Stiefel a GSK company, and Valeant Pharmaceuticals International.

Joseph F. Fowler, Jr., MD, has been a consultant and/or speaker and/or investigator for 3M, Abbott Laboratories, Allerderm, Allergan, Amgen Astellas Pharma US, Inc, Centocor, Dermik, Dow Pharmaceutical Sciences, Inc., Eli Lily and Company, Galderma Laboratories, L.P., GlaxoSmithKline, Johnson & Johnson Consumer Products Company, Medicis Pharmaceutical Corporation, Merck Pharmaceuticals, Merz Aesthetics, Novartis Pharmaceutical Corporation, OnSet, Promius, Pfizer, Quinnova, Ranbaxy, SmartPractice, Taisho, Taro, Valeant Pharmaceuticals International.

Renee P. McLeod, PhD, APRN, CPNP, FAANP, has been a speaker and/or consultant for Johnson & Johnson Consumer Personal Products Worldwide.

Joanne Still, BA has no relevant financial relationships with any commercial interests.

Sylvia H. Reitman, MBA has no relevant financial relationships with any commercial interests.

Shirley V. Jones, MBA has no relevant financial relationships with any commercial interests.


University of Louisville CME & PD Privacy Policy: All information provided by course participants is confidential and will not be shared with any other parties for any reason without permission.


Original Release Date: June 2013
Most Recent Review Date: June 2013
Expiration Date: June 30, 2015
Estimated Time to Complete Activity: 2.0 hours

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