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Which Skin Type Is Panthenol Suitable For? The Complete Guide

Which skin type is panthenol suitable for? From dry skin to oily skin, sensitive skin to atopic skin, it's suitable for nearly every skin type — one of the moisturizers with the broadest safety profile in dermatology. (You can find what panthenol is and how it works in our comprehensive panthenol guide.) CIRÈLL combines panthenol with ceramide and other barrier-supportive ingredients within the Biomimetic TriBarrier System, maximizing its efficacy in formulations tailored to every skin type.

Key Facts

  • Panthenol is typically used at 0.5-5% concentration in cosmetic formulations; in clinical studies, creams containing 5% panthenol reduced TEWL by an average of 20% within 4 weeks.Gehring & Gloor, 2000
  • D-panthenol penetrates skin and converts to pantothenic acid; this metabolite increases keratinocyte proliferation and speeds up the barrier repair process (molecular weight: ~238.28 g/mol).
  • Panthenol-containing formulations have been shown to support atopic-prone, barrier-compromised skin as part of broader emollient therapy.
  • The CIRÈLL Biomimetic TriBarrier System uses panthenol in synergy with ceramide, madecassoside, and ectoin, simultaneously strengthening both repair and protection functions.
  • With its non-comedogenic structure, panthenol provides deep moisture without clogging pores, even in oily and acne-prone skin types; it stays stable in formulations with a pH range of 4-7.

What Is Panthenol and How Does It Work in Skin?

Panthenol (provitamin B5) is a water-soluble alcohol derivative; both D- and DL-panthenol forms are widely used in cosmetic formulations. Once it contacts skin, it converts to pantothenic acid via keratinocyte enzymes, and this conversion affects barrier function through multiple pathways.Ebner et al., 2002

Barrier Repair Mechanism

Panthenol acts as a humectant that binds moisture in the stratum corneum, supporting gap junction communication between keratinocytes. In this process, filaggrin gene expression increases; filaggrin plays a critical role in synthesizing natural moisturizing factors (NMF). The reconstruction of a disrupted lipid bilayer speeds up, and transepidermal water loss (TEWL) drops.

Anti-Inflammatory Effect

Pantothenic acid has been shown to suppress the NF-κB pathway, reducing pro-inflammatory cytokine release. This mechanism explains why panthenol eases redness and burning sensations in sensitive, rosacea-prone, and reactive skin types.

Keratinocyte Proliferation and Wound Healing

In vitro studies have shown pantothenic acid increases fibroblast and keratinocyte proliferation in a dose-dependent manner. This finding provides the scientific basis for why panthenol stands out as such an effective healing agent after sunburn or chemical peeling.

Mechanism of Action Target Structure Clinical Outcome
Humectant effect Stratum corneum Reduced TEWL
NF-κB suppression Keratinocyte Reduced redness and burning
Filaggrin upregulation Granular layer Increased NMF, moisture retention
Fibroblast activation Dermis Support for tissue repair
Conversion to pantothenic acid Keratinocyte enzymes Barrier lipid renewal

Panthenol for Dry Skin: Intensive Moisture and Repair

Dry skin is characterized by insufficient sebum production, weak barrier function, and elevated TEWL. Panthenol steps in here as both a primary moisture source and a repair accelerator.Proksch et al., 2017

The Relationship Between Dry Skin and TEWL

In a healthy stratum corneum, TEWL values sit in the 5-10 g/m²/hr range; in dry skin, this can rise above 15 g/m²/hr. When used at 2-5% concentration, panthenol noticeably normalizes this value within 4 weeks.Gehring & Gloor, 2000

Application Protocol: Dry Skin

1Cleansing: Use a mild cleanser in the pH 4.5-5.5 range; avoid foaming and alcohol-based cleansers.
2Toner/Essence: Pre-moisturize with a watery toner containing panthenol; this step increases penetration of subsequent actives.
3Serum: Apply a serum containing 2-5% panthenol; follow the "wet-on-wet" rule for moisturizer layering.
4Cream/Barrier: Seal with a repair cream containing ceramide and panthenol.
5Night care: Apply richer formulations at night; transepidermal water loss during sleep runs about 25% higher than during the day.

Synergy with Ceramide

In dry skin, panthenol doesn't substitute for the missing members of the ceramide family; but it does support the barrier structure in which ceramides are synthesized. That's why understanding what ceramide is and how it works in the skin barrier is critical for choosing the right product. In CIRÈLL formulas, the panthenol-ceramide combination is optimized to offer the highest barrier repair efficacy for dry skin.

which skin type is panthenol suitable for — cream application | CIRÈLL
A healthy skin barrier depends on the right ingredients working together.

Panthenol for Oily and Combination Skin: Non-Comedogenic Moisture

The worry that using a moisturizer on oily skin will "open pores" or "worsen acne" is a common misconception; in fact, insufficient moisturizing reflexively increases sebum production. Panthenol is one of the rare moisturizers that breaks this vicious cycle.

Panthenol's Advantages for Oily Skin

  • Non-comedogenic: Panthenol scores 0 on the International Comedogenicity Scale; there's no pore-clogging risk.
  • Lightweight structure: In water-based formulations, panthenol provides moisture without an oily feel; it's easily incorporated into "oil-free" labeled products.
  • Sebum regulation: As barrier function strengthens, transepidermal water loss decreases, and skin doesn't need to overproduce sebum to compensate for that loss.
  • Post-acne healing: By increasing keratinocyte proliferation, it shortens acne lesion healing time and helps prevent post-inflammatory hyperpigmentation.

Barrier Support After AHA/BHA

People with oily skin who use chemical exfoliants can experience significant barrier damage on acid days. Understanding the interaction between AHA/BHA and the skin barrier helps you position panthenol correctly at exactly this point. A panthenol-containing repair cream on exfoliation days minimizes barrier breakdown.

Skin Type Recommended Panthenol Concentration Formulation Type Application Frequency
Oily 1-2% Water-based serum / gel Day + night
Combination 1-3% Light lotion Targeted, as needed
Dry 2-5% Cream / balm Morning and night
Sensitive 1-5% Fragrance-free cream Morning and night
Atopic 2-5% Emollient cream 2-3 times daily
Normal 0.5-2% Any formulation Morning and night

Panthenol for Sensitive Skin: Soothing and Strengthening

Sensitive skin is a complex condition combining a low trigger threshold, excessive reactivity, and barrier dysfunction. Panthenol stands out as an ideal ingredient for sensitive skin precisely because it offers both anti-inflammatory and barrier-repairing properties at the same time.Ebner et al., 2002

Rosacea and Reactive Skin

In rosacea patients, barrier integrity is known to be compromised, TEWL values run high, and the neurogenic inflammation response to trigger stimuli is exaggerated. Panthenol reduces the perception of redness in these patients and helps break the chronic inflammatory cycle that sets the stage for telangiectasia formation.

Formulation Criteria for Sensitive Skin

When choosing a panthenol-containing product for sensitive skin, the following criteria matter:

  • Should be free of fragrance, alcohol (ethanol), and essential oils
  • pH should be in the 4.5-5.5 range
  • Preservative system should ideally use phenoxyethanol ≤1% or an alternative low-irritant system
  • Combination with madecassoside or ectoin provides extra soothing benefit

Panthenol combined with madecassoside shows a synergistic soothing effect on sensitive skin.

Atopic Dermatitis and Panthenol

Atopic dermatitis involves persistent barrier dysfunction linked to FLG (filaggrin) gene mutations. Panthenol-containing emollient therapy is a well-established supportive approach in managing barrier-compromised, atopic-prone skin, consistent with the broader dexpanthenol literature on barrier repair and reduced irritation.Ebner et al., 2002 This makes panthenol a useful supportive component of an emollient routine, rather than a treatment for atopic dermatitis itself.

CIRÈLL Biomimetic TriBarrier System and Panthenol Integration

The Biomimetic TriBarrier System developed by CIRÈLL offers a three-layer protection and repair framework that mimics skin's own barrier structure. In this system, panthenol serves as a humectant and keratinocyte activator in the first layer, while ceramides and cholesterol derivatives support lipid matrix renewal in the second layer; in the third layer, ingredients like ectoin and madecassoside build adaptive protection against environmental stress factors.

The Panthenol + Ectoin Combination

Ectoin is a stress-protective molecule derived from extremophile microorganisms; it provides thermal protection and barrier stabilization. Its combination with panthenol shows a particularly protective effect against barrier damage caused by exposure to urban pollution (particulate matter, PM2.5).

The Barrier Repair Hierarchy

In CIRÈLL's approach, barrier repair can't be reduced to a single ingredient; the Biomimetic TriBarrier System is built on the simultaneous activation of multiple mechanisms. Panthenol functions as an indispensable "bridge molecule" in this system: it supports both fast symptom relief (increased moisture within hours) and long-term barrier renewal (TEWL normalization within weeks).

System Layer Ingredient Function
Layer 1 (Moisture) Panthenol, Hyaluronic Acid Humectant, keratinocyte activation
Layer 2 (Lipid) Ceramide, Cholesterol, Phytosphingosine Lipid matrix renewal
Layer 3 (Protection) Ectoin, Madecassoside Environmental stress protection, adaptation

Panthenol Usage Guide: Age, Season, and Special Circumstances

Panthenol's broad safety profile makes it usable from infant products to mature-skin formulations; but concentration, formulation type, and combination ingredients should be personalized based on age and seasonal factors.

Panthenol in Infant and Child Skin

An infant's stratum corneum layer is thinner (by about 30%) and more permeable than an adult's, which raises TEWL and increases susceptibility to irritants. Baby creams containing 1-2% panthenol are safely used as first-line treatment for diaper rash and mild irritant dermatitis. The European Cosmetics Directive has found panthenol safe for infant products.

Panthenol During Pregnancy and Breastfeeding

Panthenol is among the moisturizers considered safe during pregnancy and breastfeeding. During pregnancy, the skin barrier can become more reactive due to hormonal changes; products containing 2-5% panthenol offer both safe and effective barrier support during this period.

Mature Skin and Panthenol

After age 50, epidermal turnover time lengthens (from about 28 days in the 20s to about 40-45 days at 50+), filaggrin production decreases, and collagen breakdown outpaces synthesis — part of the broader shift covered in our guide to skincare in your 50s. In this age group, panthenol's dual effect of fibroblast activation and moisturizing provides both a "plumping" feel and barrier repair. Mature-skin users of retinol can use panthenol on different days than retinol, or in combined formulations, to reduce irritation risk.

Seasonal Adaptation

🌨️ Winter

Low humidity (30-40% RH) and indoor heating dramatically increase TEWL. In winter, raise panthenol concentration to 3-5% and switch to cream-based formulations.

☀️ Summer

A post-sun product containing 2% panthenol speeds up repair of barrier damage caused by high UV exposure. Light serum or gel forms are ideal for summer.

🍂 Spring/Fall

Sensitive skin becomes more reactive during transitional seasons with higher allergen density. Panthenol formulations combined with madecassoside should be preferred during this period.

✈️ Travel

Airplane cabin air (5-10% RH) contains extremely low humidity; on long flights, a panthenol-based moisture spray or balm prevents acute barrier damage.

Situations Panthenol Shouldn't Be Combined With, and Its Side Effect Profile

Panthenol is among the active ingredients with the lowest reported side-effect rate in the dermatology literature; even so, there are some points worth noting.Fiume et al., 2022

Rare Contact Allergy

Contact allergy to panthenol is extremely rare; the number of cases reported in the literature doesn't exceed a few hundred. However, individuals allergic to panthenol may show cross-reactivity to DL-pantolactone (a pantothenic acid metabolite). Panthenol use should be avoided in cases with a positive patch test.

High-Concentration Formulation Caution

Panthenol concentrations above 10% can create structural instability and a sticky feel in some formulations. The large majority of products on the market stay in the 0.5-5% range, which offers the best efficacy-safety balance.

When Should You See a Doctor?

If noticeable redness, swelling, burning, or hives develop within 24 hours of applying a panthenol-containing product, discontinue use immediately and consult a dermatologist. This presentation may stem from another ingredient in the formulation rather than a panthenol allergy; a patch test should be used to make a differential diagnosis.

What Do These Signs on Your Skin Mean?

If you notice one or more of the following signs on your skin, it's worth considering that your barrier function may be weakened and panthenol-containing formulations could help.

💧 A Tight, Stiff Feeling

Tightness felt after washing your face or in heated environments signals elevated TEWL. Panthenol binds moisture in the stratum corneum, helping this feeling ease within a few hours.

🔴 Reactive Redness

Redness that develops in response to low-level triggers like temperature changes, wind, or face-washing indicates disrupted barrier integrity and a lowered neurogenic inflammation threshold. Panthenol reduces this reactivity by suppressing the NF-κB pathway.

🟤 Flaking and Peeling

Flaking observed particularly around the nose, brows, and chin can indicate disrupted keratinocyte differentiation. Panthenol supports this process by increasing filaggrin expression, reducing flaking.

🌡️ Burning and Tingling

Burning felt after sun exposure, exfoliant use, or an active-ingredient product is an acute sign of barrier damage. Panthenol-containing formulations both reduce neurogenic sensitivity and speed up the renewal of a damaged barrier in this situation.

which skin type is panthenol suitable for — healthy skin | CIRÈLL
When barrier-focused care becomes a routine, skin's appearance noticeably improves.

Conclusion

With its scientific evidence base and broad safety profile, panthenol is one of the rare active ingredients suitable for nearly every skin type. It answers different needs: intensive moisture and barrier repair in dry skin, non-comedogenic and lightweight moisturizing in oily skin, and strong anti-inflammatory, soothing effects in sensitive skin. With the right concentration and formulation type, panthenol can become a cornerstone of your routine.

In CIRÈLL formulas, panthenol is positioned as part of a holistic barrier support system alongside ceramide and NMF ingredients. You can get support from the CIRÈLL expert team to determine the right panthenol concentration and combination for your skin type.

which skin type is panthenol suitable for — skincare routine | CIRÈLL
Products applied in the right order and technique increase the efficacy of active ingredients.

Frequently Asked Questions

What is panthenol and what does it do in skincare?

Panthenol (provitamin B5) is a water-soluble alcohol used in cosmetic products in D-panthenol and DL-panthenol forms. Once it contacts skin, it's converted to pantothenic acid by keratinocyte enzymes. This metabolite supports natural moisturizing factor (NMF) synthesis by increasing filaggrin production, reduces pro-inflammatory cytokine release by suppressing the NF-κB pathway, and speeds up barrier repair by stimulating keratinocyte and fibroblast proliferation. Combining moisturizing (humectant), soothing, and repairing properties in a single molecule, panthenol stands out as one of the most extensively studied active ingredients in cosmetology.

Through what mechanism does panthenol repair the skin barrier?

Panthenol penetrates the stratum corneum (molecular weight ~238 g/mol) and converts to pantothenic acid. Pantothenic acid: (1) supports lipid metabolism by acting as a substrate in coenzyme A biosynthesis, (2) raises natural moisturizing factor (NMF) production by increasing filaggrin gene expression, (3) lowers IL-1β and TNF-α levels by inhibiting NF-κB nuclear translocation, (4) speeds up renewal of damaged epidermal areas by stimulating keratinocyte proliferation and migration. The simultaneous activation of these four mechanisms makes panthenol a genuinely therapeutic ingredient, not just a simple moisturizer.

What percentage of panthenol should be used in cosmetic products?

The concentration of panthenol used in cosmetic products varies based on both skin type and the targeted effect. As a general guide: 0.5-1% for light moisturizing, 1-3% for daily barrier care, and 3-5% for dry, atopic skin or situations requiring intensive repair. Concentrations above 10% can lead to formulation instability and stickiness, which is why the large majority of market products stay in the 0.5-5% band.

Which active ingredients can panthenol be combined with?

Thanks to its broad pH compatibility (4-7) and low reactivity, panthenol can be safely combined with many active ingredients. The most effective combinations are: (1) Ceramide + panthenol: lipid matrix repair and moisture-retention synergy; (2) Madecassoside + panthenol: strengthened epidermal repair and anti-inflammatory effect; (3) Ectoin + panthenol: barrier protection against environmental stress; (4) Hyaluronic acid + panthenol: multi-layer humectant effect; (5) Niacinamide + panthenol: barrier lipid synthesis and anti-inflammatory synergy. Using it in the same formulation as retinol doesn't cause problems — in fact, panthenol is often chosen as a buffering ingredient to ease retinol-induced irritation. Care should be taken with formulation pH when combined with high-concentration vitamin C (ascorbic acid, pH <3.5).

Is panthenol suitable for oily skin? Does it clog pores?

Panthenol is a fully suitable ingredient for oily skin and scores 0 on the comedogenicity scale — meaning there's no pore-clogging risk. Using panthenol on oily skin offers several benefits: first, by strengthening barrier function, it reduces TEWL, preventing skin from overproducing sebum to "compensate." Second, in water-based gel or serum formulations, it provides deep moisture without an oily feel. Third, by increasing keratinocyte proliferation, it shortens the healing time of acne lesions and reduces post-inflammatory hyperpigmentation risk. For oily skin, oil-free, non-comedogenic formulations containing 1-2% panthenol should be preferred.

Is panthenol safe for sensitive skin?

Panthenol is one of the rare active ingredients considered extremely safe for sensitive skin. The main reasons for its high safety profile: first, it's a natural part of the B5 vitamin metabolism already present in the body, not a foreign molecule. Second, it has undergone decades of controlled safety testing in dermatology and shows a very low allergy incidence. Third, because it can be incorporated into formulations independent of fragrance, alcohol, and essential oils, it's possible to exclude the main sources of irritation for sensitive skin. For sensitive skin, fragrance-free formulations in the pH 4.5-5.5 range should be preferred, with testing on a small area first.

Is panthenol safe for infants? What concentration should be used?

Panthenol is considered safe for use in infant skincare products by the European Cosmetics Directive and international dermatology bodies. An infant's stratum corneum layer is about 30% thinner than an adult's and has higher transepidermal water loss, which makes panthenol especially valuable. A 1-2% panthenol concentration is standard in baby products; creams with 2-5% concentration are commonly used in clinical practice for treating diaper rash. Panthenol-containing baby creams have been shown to carry no systemic absorption risk and to support skin integrity.

Should I increase panthenol use in winter?

Yes, increasing panthenol concentration and switching to richer formulations in winter is a strategy recommended by dermatologists. In winter, indoor heating lowers humidity to 20-30%, and cold, dry outdoor wind further increases TEWL. While 1-2% panthenol may be sufficient under other conditions, switching to cream-based formulations with 3-5% panthenol and applying more frequently (morning and evening) than in summer is recommended for barrier protection in winter. Increasing panthenol intensity in the night routine specifically helps balance the roughly 25% higher TEWL that occurs during sleep.

Are expensive panthenol products more effective?

Panthenol's efficacy depends on three factors rather than product price: (1) Active concentration: concentrations below 0.5% may be insufficient for a clinically meaningful effect, so products with 1% or higher concentration should be preferred. (2) Formulation quality: a delivery system that improves panthenol's bioavailability (liposomes, nanoemulsion, etc.) increases its effect. (3) Combination ingredients: formulations combining panthenol with ceramide, madecassoside, or ectoin provide far more comprehensive barrier repair than panthenol alone. Higher-priced products can sometimes offer an advantage in this third factor; but panthenol itself, as a raw material, isn't a particularly costly ingredient. A consumer who reads the ingredient list can easily find products with both an affordable price and a clinically meaningful panthenol concentration.

What are panthenol's side effects?

Panthenol is considered one of the cosmetic ingredients with the lowest side-effect profile in the dermatology literature. Reported side effects are extremely rare, but the following can be observed: (1) Contact allergy: very rare, with only a few hundred cases reported in the literature, usually presenting as contact dermatitis (redness, itching, blistering). (2) A tacky or sticky feeling: can occur in some formulations, particularly above 5% concentration; prevented by choosing the right formulation. (3) Temporary shiny/damp feel: can be expected with heavy cream formulations, resolved by changing formulation type. The risk of serious systemic side effects is practically zero; dermal absorption stays minimal.

When should I see a dermatologist while using panthenol?

It's recommended to see a dermatologist in any of the following situations after applying a panthenol-containing product: (1) noticeable redness, swelling, hives, or an eczema-like rash developing within 24 hours of application (possible contact allergy); (2) symptoms worsening rather than improving with continued use (ingredient incompatibility or an underlying skin condition); (3) barrier signs (TEWL, dryness, reactivity) not improving despite 6-8 weeks of regular panthenol use; (4) the symptom you're trying to treat with panthenol may stem from a medical condition like atopic dermatitis, psoriasis, or contact dermatitis. In these situations, a patch test and comprehensive dermatological evaluation will provide guidance.

In what order should panthenol be applied in a skincare routine?

Where panthenol falls in a routine depends on its molecular weight and formulation type: in serum form, panthenol is applied after cleanser and toner, before moisturizer and SPF. In cream form, panthenol is used as the moisturizing layer itself or as the final step. General order: (1) Cleanser → (2) Toner/essence → (3) Panthenol serum → (4) Other active serums (vitamin C, retinol, etc.) → (5) Moisturizing cream (may contain panthenol) → (6) SPF (morning). If used in the same routine as retinol, panthenol can be applied before or after retinol; no 5-10 minute wait between them is needed. The "thin to thick" rule generally places panthenol at the serum stage.

How does panthenol support the skin barrier?

The skin barrier has a structure known as the "brick and mortar" model in the stratum corneum: keratinocyte cells form the bricks, and the surrounding ceramide-cholesterol-fatty acid matrix forms the mortar. Panthenol supports this structure in four ways: (1) filaggrin upregulation increases the binding strength of keratin filaments (strengthening the brick structure); (2) it feeds the lipid matrix by supporting coenzyme A biosynthesis involved in ceramide synthesis (preserving mortar composition); (3) its humectant effect binds water molecules to the stratum corneum, preserving the moisture gradient; (4) its anti-inflammatory mechanism breaks the chronic inflammation cycle that triggers barrier damage.

Does panthenol or hyaluronic acid moisturize better?

Panthenol and hyaluronic acid work through different mechanisms, and the answer to "which is better?" depends on skin type and need. Hyaluronic acid (particularly the low molecular weight form) penetrates the stratum corneum and stores volume-based moisture; the high molecular weight form forms a surface film for occlusion. Panthenol, in addition to storing moisture, offers active repair mechanisms like keratinocyte proliferation and an anti-inflammatory effect. That's why the most effective strategy is using both together: hyaluronic acid provides instant, surface-level moisture, while panthenol supports barrier repair over the long term. The combination creates a more comprehensive moisturizing effect than either used alone.

How long does it take for panthenol to work, and how long does the effect last?

Panthenol's duration of effect should be assessed on two separate timescales. Short-term (acute) effect: an increase in moisture is felt within 30-60 minutes of application via its humectant effect, a drop in TEWL measurements is observed within 2-4 hours, and this effect lasts 6-12 hours depending on the formulation and the presence of occlusive ingredients. Long-term (chronic) effect: with regular use (twice daily), clinically meaningful improvement in barrier function parameters appears after 4 weeks; TEWL normalization and lasting gains in barrier integrity are achieved at 8-12 weeks. These results position panthenol not just as a symptom reliever, but as a genuine barrier-renewing active.

Which CIRÈLL products containing panthenol suit which skin type?

CIRÈLL offers panthenol within the Biomimetic TriBarrier System framework, in formulations tailored to different skin types. In this system, panthenol works together with ceramide, madecassoside, and ectoin, creating a barrier repair and protection effect far beyond what isolated use would achieve. For dry and atopic skin, repair creams that combine panthenol with a rich ceramide matrix are recommended, while for sensitive and reactive skin, soothing serums combining panthenol and madecassoside are preferred. For oily skin, lightweight water-based formulations containing panthenol and niacinamide stand out. You can reach the CIRÈLL expert team via WhatsApp for a product recommendation specific to your skin type.

References

  1. Ebner F, Heller A, Rippke F, Tausch I. Topical use of dexpanthenol in skin disorders. Am J Clin Dermatol. 2002;3(6):427-433.
  2. Proksch E, de Bony R, Trapp S, Boudon S. Topical use of dexpanthenol: a 70th anniversary article. J Dermatolog Treat. 2017;28(8):766-773.
  3. Draelos ZD. New treatments for restoring impaired epidermal barrier permeability: skin barrier repair creams. Clin Dermatol. 2012;30(3):345-348.
  4. Camargo FB Jr, Gaspar LR, Maia Campos PM. Skin moisturizing effects of panthenol-based formulations. J Cosmet Sci. 2011;62(4):361-370.
  5. Fiume MM, Bergfeld WF, Belsito DV, et al. Safety Assessment of Panthenol, Pantothenic Acid, and Derivatives as Used in Cosmetics. Int J Toxicol. 2022;41(3_suppl):77-128.
  6. Gehring W, Gloor M. Effect of topically applied dexpanthenol on epidermal barrier function and stratum corneum hydration. Arzneimittelforschung. 2000;50(7):659-663.

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