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]. Cosmet. Sci.J 55, 189-205 (March/April 2004) Clinical effects of cosmetic vehicles on skin JOACHIM W. FLUHR and LUIGI RIGANO, Department of Dermatology and Allergology, Friedrich Schiller University, Jena, Germany U. W.F.), and ISPE Research Institute, Milan, Italy (L.R.). Accepted for publication January 26, 2004. INTRODUCTION Cosmetic vehicles play a central role in topical treatments in dermatology, with their protective, integrative, and problem-solving effects being of increasing interest. Differ­ ent therapeutic and physiologic functions of cosmetic vehicles are well recognized, and a review of such has recently been published (1). Research has shown that the compo­ sition of cosmetic vehicles is of great importance for the specific treatment of some skin diseases. However, the role of vehicles in drug delivery systems for different skin diseases has not yet been studied in detail. In this review a number of features of cosmetic vehicles will be presented, including vehicle composition, classification, role in thera­ peutics, and potential mechanisms of vehicle function, including their role(s) in epider­ mal barrier function and specific diseases. The use of the appropriate vehicle composition for the treatment of specific skin disorders has a significant impact on both the clinical outcome of treatment and, more-importantly, on the relapse-free period. Beneficial effects of an oil-in-water (o/w) moisturizing cream on the permeability barrier function in irritant and allergic contact dermatitis have been shown repeatedly (2). The chosen vehicle should no longer be regarded simply as a drug carrier, vehicle, or delivery system, but rather as an essential component of successful topical treatment. For example, a ceramide-dominant barrier repair lipid mixture in atopic dermatitis showed increased barrier repair and stratum corneum hydration (3). Furthermore, it has been shown that the use of fatty acid-rich emollients prevents the development of atopic eczema ( 4). Thus, it may be of importance to adapt type and composition of cosmetic vehicles either as adjuvant treatment or as the delivery system, according to the disease status. BASIC COSMETIC VEHICLE CLASSIFICATION Vehicles for dermatological and cosmetic uses can be divided into different classes according to their composition (Figure 1). However, the classification of commercially Address all correspondence to Joachim W. Fluhr. 189