Stratum corneum hydration in healthy adult humans according to the skin area, age and sex: a systematic review and meta‐analysis

Stratum corneum (SC) hydration is one of the most important skin biophysical parameters, which is affected by age, sex and anatomic site. We conducted a systematic review and meta-analysis to provide detailed information on baseline values of SC hydration in healthy human adults, according to the skin area, age and sex. The databases Medline, Embase, Web of Science and Scopus were searched for primary reports, with in vivo corneometry measurements, which were conducted on disease-free skin of human subjects, aged 18+ years in English. Risk of bias was evaluated using the critical appraisal tools for JBI Systematic Reviews, and only low-risk studies were selected. The comparison was performed in each skin area between males and females and also between young- and middle-age subjects. Among 323 Retrieved titles, full texts of 259 articles were read, and 240 studies were excluded due to unclear or insufficient reporting of SC hydration, as well as high or medium risk of bias. 19 studies (including 113 records) providing data about SC hydration in 12 skin areas were included in the final data synthesis. Pooled sample sizes ranged from n = 32 for lips to a maximum of n = 3202 for cheeks. The lowest hydration of 12.5 [95% CI 11.05-13.94] was reported for the back, and the highest hydration of 64.34) [95 CI% 62.07-64.59] for the periorbital area. Facial skin showed higher water content compared with other areas. There were also site-dependent differences in the hydration level of the facial skin. Comparisons between two age groups, and male and female participants, did not show any statistically significant differences. The main limitation was we included studies using only one measurement device. The quality of reporting SC hydration in humans should be increased in future studies.