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Licensed Unlicensed Requires Authentication Published by De Gruyter June 25, 2021

Role of Centella asiatica and ceramide in skin barrier improvement: a double blind clinical trial of Indonesian batik workers

Sylvia Anggraeni , Menul Ayu Umborowati , Damayanti Damayanti , Anang Endaryanto and Cita Rosita Sigit Prakoeswa EMAIL logo



Batik dyes contain irritant chemicals that increase the risk of skin barrier disruption. This study aims to determine the effect of Centella asiatica and ceramide in transepidermal water loss (TEWL), hydration of the stratum corneum and skin acidity (pH).


This was a double blind clinical trial of 30 Indonesian batik workers who suffered from skin dryness, but had no clinical manifestation of contact dermatitis. Subjects were given cream containing C. asiatica or ceramide that formulated and randomly labeled by manufacturer (PT Paragon Technology and Innovation). Both subjects and researchers were blinded to the type of the cream. Cream was applied to the hands and arms twice a day. Biological function of the skin (TEWL, stratum corneum hydration level, and skin acidity) was examined by Cutometer dual MP-580. Baseline was recorded in the first examination, followed by second and third examinations at two and four weeks after treatment.


After four weeks treatment, there were significant improvement of C. asiatica application in evaluation of corneometer palmar (p=0.007; CI 95%), corneometer dorsum (p=0.001; CI 95%), and skin acidity dorsum (p=0.017; CI 95%). Ceramide application also gave significant improvement of corneometer palmar (0.038; CI 95%), skin acidity palmar (p=0.001; CI 95%), TEWL dorsum (p=0.023; CI 95%), corneometer dorsum (p=0.002; CI 95%) and skin acidity dorsum (p=0.011; CI 95%). There were no significant differences of C. asiatica effectiveness compared to ceramide in skin barrier improvement.


C. asiatica and ceramide can improve skin barrier hydration in order to prevent the risk of contact dermatitis in batik workers.

Corresponding author: Cita Rosita Sigit Prakoeswa, Department of Dermatology and Venereology, Faculty of Medicine Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, Phone: +62811328199, E-mail: ; and Sylvia Anggraeni, Doctoral Program of Medical Science, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia; and Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, E-mail:

Funding source: PT. Paragon


We gratefully thank PT Paragon Technology and Innovation, Dr. Soetomo General Academic Hospital, Batik Zulpah Tanjungbumi, and other parties that supported this research.

  1. Research funding: PT Paragon Technology and Innovation

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: This study was approved by ethical committee of Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. (1678/KEPK/XI/2019).


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Received: 2020-12-15
Accepted: 2021-02-12
Published Online: 2021-06-25

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