The Skin Barrier : How it can be damaged and how to manage it
- How do you know if your skin barrier is damaged? For me common signs are the skin feeling dry and tight after washing and needing to moisturise immediately. Having difficulty tolerating topical creams, the skin often stinging and burning. Essentially when the skin barrier is damaged it allows moisture out and is more likely to let irritants, allergens in with an increased risk of infection. If you are having to reapply moisturiser multiple times during the day, this suggests your skin barrier is not doing its job. Even being aware of your skin, i.e. it feels slightly tight or uncomfortable during the day suggests the barrier function is suboptimal.
- What can damage your skin barrier? For me one of the most common culprits is cleansers on the face and irritant household products on the hands. If you use too strong a cleanser or soap that disrupts the naturally acidic pH of skin then this will start to disrupt the skin barrier, leading to inevitable moisture loss. When we immerse our hands in washing up water with detergent or make contact with strong cleaning chemical such as bleaches, we will quickly damage the skin barrier and over time this can lead to an irritant hand eczema at risk of contact allergy. We saw a lot of irritant hand eczema around Covid due to frequent hand washing and application of alcohol-based hand gels. Of course, depending on our genetics some of individuals are much more vulnerable to barrier damage. In these individuals just central heating use, a cold wind or dry cold winter day can quickly damage the skin.
- Is it possible to repair your skin barrier? Can it repair itself? Absolutely, I always point out to my patients that most so-called sensitive skin, is in fact sensitised skin. A robust skin barrier underpins skin health. I am also always surprised how many people walk around with a damaged skin barrier and just accept symptoms of dryness, burning and stinging, thinking that it is ‘just my skin’. The other surprise is how quickly it can recover. Even after a couple of weeks of my new suggested skincare regime I often hear ‘this is the best my skin has ever felt’. Once an individual stops the irritant skin care such as a facial soap or too many actives, recovery can be very quick. Also pre-empting barrier damaging autumn/ winter weather and using more hydrating serums and richer moisturisers and barrier creams to protect a sensitive skin barrier can help prevent seasonal skin issues.
If your skin barrier’s damaged, how can you strengthen it skincare-wise in your experience?
Firstly, for the face you must look for the gentlest cleanser you can find. In my view the gentlest and least likely to cause issues is the Toleriane Dermo cleanser from La Roche Posay. Other very gentle cleansers include CeraVe’s hydrating cleanser, Cetaphil gentle cleanser- I love the new formulation. Not forgetting men who can often irritate their skin with foaming shaving products and astringent aftershave. I think the Xerocalm cleanser by Avene is perfect for shaving and showering and leaves the skin soft and hydrated.
When choosing a moisturiser, look for those that help to replenish the damaged the skin barrier. It is important to consider the key oils/fats that are integral to the skin barrier. These are fatty acids, cholesterol and ceramides. Ideally a moisturiser will contain substitutes for one or all these protective components. There are some fantastic ceramide rich creams, CeraVe’s products are known for their ceramide rich content. Shea butter is also an excellent replacement for these naturally occurring oils, I love La Roche Posay’s Lipikar AP Balm. Avene’s Xerocalm Balm (I prefer the balm to the cream) is perfect for the most sensitive skin, super hydrating and again gives lasting hydration. Eucerin have many fantastic moisturisers with the key ingredient urea that draws moisture into the skin barrier, their hyaluronic acid range is also incredibly moisturising and perfect for helping to repair damaged skin. The Ordinary’s Skin barrier repair cream is also excellent.
If you skin is incredibly dry and irritated and prone to allergy, my absolute go to is the Dermallego range by La Roche Posay. This range is created for the most sensitive skin and is calming and hydrating. It contains a patented peptide Neurosensine that helps to settle the sensation of stinging and burning. Layering its hyaluronic acid Hyalu B5 under the Dermallergo soothing moisturiser is incredibly effective at helping to repair the skin barrier.
Finally, barrier creams are excellent at helping to soothe and protect damaged skin. I love Cicalfate from Avene and Cicaplast B5 from La Roche Posay,
For hands always apply moisturiser immediately after handwashing, I would recommend having an effective hand cream at your desk during the day and next to the bed at night. Lipkar Xerand for hands contains shea butter and allantoin. Allantoin is a naturally occurring ingredient that comes from chamomile amongst other plants. It has soothing, anti-inflammatory and antioxidant properties. Lipikar Xerand is easily absorbed and perfect for applying at night under cotton gloves to allow 8 hours of hydration for the repair of a damaged skin barrier. Humectants such as glycerin absorb easily into skin without a sticky residue and attract water into the top layer of skin. Look for humectants in moisturisers such as hyaluronic acid, urea and glycerin. I love Neutrogena’s Norwegian formula hand cream; it is rich in the humectant glycerin giving long lasting hydration.
If you make the appropriate steps, how long could you expect to see improvements?
As before I am always so surprised how quickly the skin can start to settle.
What are your top tips for supporting your skin barrier in general?
Consider stopping any irritant actives until skin settles. Then, always choose the gentlest cleanser that leaves skin feeling calm and hydrated after use. Make sure you cleanse after the shower to remove any irritant shampoo or shower gel. If skin is very sensitive, apply a moisturiser or barrier cream to protect the skin during the shower. Look for a good humectant serum to layer next, applying to damp skin to draw that moisture into the skin e.g. a glycerin or hyaluronic acid-based serum. Next trap that hydration with an effective moisturiser that contains fats and oils that mimic those found in the skin e.g. ceramides, cholesterol, shea butter etc. Be patient and consistent and you skin will quickly benefit.
PLEASE NOTE THESE ARE JUST SKIN CARE SUGGESTIONS. THERE ARE MANY OTHER EXCELLENT BRANDS OUT THERE. THEY ARE ALSO OUR RECOMENDATIONS AT THE TIME OF WRITING THIS ARTICLE, WE MAY ADVISE OTHER SKIN CARE WITH TIME.
