Genesis of emollients. Past, present, future

The range of skin diseases in which it is necessary to moisturize the skin is wide and includes atopic dermatitis, ichthyosis, psoriasis, eczema, xerosis and even acne. In turn, the morbidity with these dermatoses is increasing, and their severity has been worsening in recent years. The search for alternative and additional treatment methods that minimize the need for corticosteroids and other topically applied drug products is one of the main challenges of dermatology. The new strategy for treatment of chronic skin diseases accompanied by dryness is called «emollients plus». Emollients plus — a new class of cognitive moisturizing agents, capable of providing a comprehensive approach to the treatment of frequent dermatosis accompanied by defects of the epidermal barrier precisely by restoring the barrier function of the skin and reducing the intensity of subjective manifestations. Unlike conventional emollients, which simply moisturize the skin, emollients plus contain active ingredients that have anti-inflammatory, anti-pruritic, antibacterial, antioxidant, modelling microbiome and epidermal barrier indicators properties, and this is not an exhaustive list. The article presents historical aspects of the evolution of skin softening products from vaseline and lanolin to modern classification including hydratants, occlusive agents, emollients, enhancers and «emollients plus». The mechanisms of action of topically applied agents of different classes and correct selection of emollient depending on the clinical situation are also considered.