## 4 Components of Emollients and Their Effect on the Changes That Occur in Atopic Dermatitis  
Most embilient products are based on humectants such as urea, glycerol or sorbitol. These ingredients promote hydration of the stratum corneum, reducing inflammation caused by AD [1; 7; 23; 53]. Inherent in their composition is an occlusive substance, whose main function is to retain water, and prevent it from evaporating from the skin surface [1; 23; 53]. Occlusive ingredients in emollients, such as Vaseline, can improve skin barrier function and inhibit the production of pro-inflammatory cytokines [12; 53]. Petrolatum, paraffin or mineral oils provide protection against adverse external factors and reduce TEWL [7]. Many emollients contain vegetable oils such as olive oil, coconut oil or avocado oil [53]. The authors of [7] state that components of emollients also include substances that seal the skin barrier, such as ceramides, cholesterol and fatty acids. Emollients by composition can be divided into two main groups: neutral emollients (containing only occlusive substances) and active emollients, which are divided by their profile of action--moisturizing and soothing [54]. Currently, an additional group of emollients is distinguished--emollient \"plus\"--which is included in the figure below [12; 54] (Figure 3). Figure 3: Division of emollients based on [54]. \begin{table}
\begin{tabular}{p{113.8 pt} p{113.8 pt} p{113.8 pt}} \hline \hline
**AZS Feature** & **Children** & **Adults** \\ \hline Distribution of changes & Face, torso, upper and lower limb extensor area [40; 51] & All body areas up to 30–40 years of age predominance of lesions in the folds and skin folds [19] \\  & Diaper dermatitis is common in infants [19]. & Skin folds [19] \\ \hline Morphology of the lesions & Inflammation [40; 51; 52] & Lichenoid, dry lesions [40; 51; 52] \\ \hline TH2/TH1 severity & High levels of TH2 in blood and skin, low TH1 [40; 51] & TH2 lymphocytes predominate in the early stages of the disease, while TH1/TH17 increases with age [40; 51]. \\ \hline Epithelium and lipid barrier & Decreased function, pronounced barrier defect [40; 51] & Retained function, less pronounced defect [40; 51] \\ \hline Therapeutic strategy & Therapies that are used in psoriasis can be effective [40; 51]. & Therapy targeting the skin barrier in earlier stages [40; 51] \\ \hline \hline \end{tabular}
\end{table} 
Table 3: Endotypic and phenotypic and therapeutic differences in atopic dermatitis in children and adults based on [19; 40; 51; 52]. Until recently, embolients did not contain additional active ingredients. Currently, \"plus\" emollients are used, whose composition is enriched with active ingredients [12]. The most commonly used active substances are as follows: flavonoids--saponins, riboflavin with extracts from young out shoots and bacterial lysates from species such as Aquaphilus dolomiae or Viteoscilla filiformis [12; 20; 24]. There are also other substances that have beneficial effects on skin lesions in AD; for example, chamomile added to emollients has an anti-inflammatory effect due to the presence of apigenin, an ingredient that relieves symptoms of atopic dermatitis [53]. Emollients have anti-inflammatory properties if substances such as glycyrrhizinic acid, allantoin or D-panthenol are present in their formulation [19]. On the other hand, emollients with added camphor or menthol have antipruritic properties [19]. The authors of the papers [55; 56] assure that the use of emollients with additives such as colloidal oats, avenuethramide or ceramides strengthens the skin barrier and is well tolerated in different age groups. Other researchers [20] emphasize that emollients \"plus\" restore normal microbial diversity in patients with mild to moderate AD. In their view, this is important because low microbial diversity and excessive colonization with _Staphylococcus aureus_ leads to exacerbations and aggravation of atopic dermatitis.