Dr. Baumann Recommends Barrier Repair Moisturizers Here’s Why.
Each of us is born with a natural “skin barrier” that locks in moisture, keeping our complexions hydrated and supple. But various environmental exposures can damage this barrier, breaking down the coating around the cells that maintain the integrity of the skin. As a result, the skin doesn’t hold water in and skin becomes dry and flaky. To make matters worse, lack of protection by the skin barrier also means that substances like irritants, allergens and bacteria can find their way in, leading to itching, infection and inflammation and further breakdown of the protective barrier.
Is it possible to repair a damaged skin barrier?
Absolutely! The three main components of a well-functioning skin barrier are cholesterol, fatty acids and ceramides. These are all types of fat (lipid) molecules that must be present in a specific ratio to keep your skin moist and healthy. There are various fatty acids that repair the skin barrier. My favorites are stearic acid (found in shea butter) and palmitic acid, which are common fatty acids found in skincare products. But not all fatty acids repair the skin barrier. In fact, oleic acid, the fatty acid found in olive oil, can cause tiny holes in the skin barrier. For this reason, olive oil is not a good skin hydrator for those with an impaired skin barrier.
Anything that disrupts these beneficial fats can damage the skin barrier. Besides cold weather and lack of humidity, common culprits are foaming cleansers, bubble baths, bar soaps and prolonged water submersion, all of which strip lipids from the skin. If you use any of these, you should stop immediately. Replace your bubble bath with bath oil, and try a creamy cleanser facial cleanser like VMV Hypoallergenic Moisture Rich Creammmy Cleansing Milk that was developed by a dermatologist who specializes in skin allergies.
You can also repair your skin barrier from the inside out by taking borage seed, fish oil or evening primrose oil supplements, or by adding salmon and other sources of fatty acids to your diet. I find that vegans are more likely to have a disrupted skin barrier and dry skin. I tell my vegan patients to add flax seeds to their diet, and I’ve seen dry skin improve from this alone.
What about moisturizers?
The best moisturizers help the skin to repair its own skin barrier and restore the balance of beneficial fats. These “barrier repair moisturizers” treat the causes of dry skin as well as the symptoms. It is important to use skincare products that have fatty acids (such as stearic or palmitic acid), cholesterol and ceramides to repair the skin barrier. My favorite technology to repair the skin barrier is MLE technology that is found in the brand Zerafite, which is sold by dermatologists. I personally use Zerafite Barrier Repair Face Cream and Zerafite ULtra Rich Body Cream. I have tested barrier repair moisturizers from around the world and this one made in South Korea is superior than the others I have tested and has good research to back it up.
In addition, there are other ingredients in moisturizers that treat the symptoms but not the cause of dry skin. These are divided into two main categories: occlusives and humectants. Occlusives are oily substances that coat the surface and prevent water from evaporating from the skin’s surface. Plastic wrap, which protects food by sealing in moisture, works in exactly the same way. Once this ingredient is washed off, the skin returns to the state of increased water evaporation that leads to dehydration. For this reason, these occlusive ingredients are a temporary solution. They have an emollient effect on the skin which makes it feel and appear smoother while it’s on the skin’s surface, but this effect is also temporary. Examples of occlusives include any oils, petrolatum and silicones.
Humectants are agents that avidly bind water and hydrate skin by actually drawing water into themselves and onto the surface of the skin. This extra moisture causes the skin to plump up a bit, temporarily giving the appearance of smoother skin with fewer wrinkles. Examples of humectants include glycerin, hyaluronic acid, heparan sulfate, urea and propylene glycol. You have to be careful, though, because in dry weather, the action of humectants is reversed. They will actually suck the moisture out the other way. For this reason, they work better when combined with occlusives. To learn more about moisturizing ingredients and humectants and occlusives, see Chapters 19- 31 in my book Cosmeceuticals and Cosmetic Ingredients (McGraw Hill).
This chart is a handy guide to humectants and occlusives. As you can see, some ingredients can belong in both categories.
|Glycerin: Clinically shown to restore normal moisture levels to skin and prevent the return of dryness faster than other formulations, even those containing petrolatum.|
|Propylene glycol: An odorless liquid that functions as both a humectant and an occlusive.|
|Urea: Used in hand creams since the 1940s, urea also helps soothe itchy skin.||Petrolatum: Many dermatologists consider this to be the best moisturizer, despite its greasy, oily texture.|
|Alpha hydroxy acids (AHAs): Organic acids derived from apples, grapes and citrus fruits. Because AHAs have a skin-thinning effect, they should be used in conjunction with sunscreen.||Mineral oil: Used cosmetically for over two thousand years. Though industrial grade oils have been linked to cancer, cosmetic grade mineral oil is safe.|
|Beta hydroxy acids (BHAs): Derived from willow bark. Like AHAs, BHAs have exfoliating properties.||Sunflower oil: Has also been shown to promote healing of the skin barrier.|
|Shea butter: Extracted from the fruit of shea tree. Common in organic products. Is an emollient as well, which means it has a smoothing effect on the skin’s surface.||Evening primrose oil: Rich in the linoleic acid needed for the skin to make ceramides. Found in oral supplements as well. However, too much Omega-6 fatty acids in the diet has been linked to inflammation.|
|Lactic acid: An AHA that smooths rough skin and reduces signs of photodamage. It also increases the production of skin-protecting ceramides.|
|Olive oil: Rich in antioxidants and fatty acids; the Ancients used this oil for bathing.|
|Jojoba oil: This essential oil has antibacterial and anti-inflammatory properties.|
|Hyaluronic acid: A sugar that can bind over 1,000 times its weight in water, hyaluronic acid is used as an injectable filler for wrinkles. Despite marketing claims, it cannot enter the dermis when applied topically.||Lanolin: Contains cholesterol, an important skin lipid; however, some users report allergic reactions.|
Why should I choose a barrier repair moisturizer?
Although humectants and occlusives give instant results, they do not solve the underlying problem, which is impairment of the skin barrier. Humectants and occlusives treat the symptoms of dry skin but not the cause. Those who are susceptible to dry skin must add a barrier repair moisturizer to their regimen twice a day. Barrier repair moisturizers protect against many insults, including transepidermal water loss (TEWL) which is evaporation of water off the skin’s surface.
When should the barrier repair moisturizer be applied?
Barrier repair moisturizers should be the last step before sunscreen in the am and the last step before (or after) retinol in the pm. This helps seal in the ingredients placed prior to it in the regimen. Using the retinol after the barrier repair moisturizer makes less retinol penetrate into the skin and helps you adapt to retinol when you are first starting to use it. Once you get used to the retinol, you can apply it before the barrier repair moisturizer.
Which barrier repair moisturizer is the best?
The most important ingredient to look for in a moisturizer in my opinion is MLE technology, also called Myristoyl/palmitoyl oxostearamide/arachamide MEA, which combines a ceramide, fatty acid and cholesterol in the proper three-dimensional structure for the tightest and strongest barrier protection. MLE (multi lamellar emulsion) technology is found in the skincare brand called Zerafite. Other moisturizers that have barrier repair technology containing fatty acids, ceramides and cholesterol in the proper ratio are EpiCeram and Skinceuticals Triple Lipid Restore 2:4:2.
What ingredients to look for on a moisturizer product label?
It is hard to read product labels to choose a barrier repair moisturizer because the ingredient list does not say “fatty acids,” although it may say cholesterol and ceramide. Also, the label will not tell you the ratio of these lipids, which is very important. If you put the wrong ratio of lipids on the skin, it actually impairs the skin barrier. For this reason, it’s best to stick to brands recommended by your dermatologist who understands the underlying science of these complex moisturizers.
For those of you who really want to understand this, look for products that have these fatty acid ingredients that contain high levels of stearic acid such as shea butter, argan oil, macadamia seed oil, safflower oil, and sunflower oil. The label should also say “cholesterol” and either “ceramide” or “Myristoyl/palmitoyl oxostearamide/arachamide MEA”. The product should have at least one of these fatty acid containing ingredients towards the beginning of the ingredient list, with cholesterol and ceramide or Myristoyl/palmitoyl oxostearamide/arachamide MEA later in the list.
I know this is complicated. Please tune back in for more blogs on eczema and dry skin and moisturizers so that you will better be able to understand this important concept. You can also visit my youtube channel to see videos about dry skin. To find a barrier repair moisturizer, visit your dermatologist or SkinTypeSolutions.com.
Wishing you great skin!
Dr. Leslie Baumann, M.D. and her team at Baumann Cosmetic Dermatology believe in proof, not promises. World-recognized for both cosmetic and general dermatology, our treatment strategies rely exclusively on evidence-based, scientifically verified products and procedures that promote skin health and a natural appearance. We combine effective medical procedures with individualized instruction on proper skincare, nutrition, supplementation and lifestyle in order to maximize the health of the skin and body as a whole while minimizing the effects of aging. For more, visit Dr. Baumann’s blog for daily updates Monday through Friday, or inquire about an appointment through Derm.net.