Whenever you hear me talk about the skin barrier in clinic, you will almost always hear me use the analogy of a house. This is so you can better understand what it means to you’re your barrier in-tacked. This was what I was taught at AACDS and I find it the most effective way of understanding the barrier without all the big words.
The epidermis has 5 different layers and is around the thickness of a sheet of paper, but the one we are talking about today (although all are very much involved) is the outer most layer of the skin called the “stratum corneum” this beautiful layer of keratinocytes (epidermal skin cell) is what I refer to as my shingles on a roof.
But let’s not get ahead of ourselves and forget our skins first line of defense either, our skins “microbiome” a unique coating that sits on the very top layer of our skin.
This thin coating is slightly acidic with a PH sitting at about 4-5.5 it is suspended within a mixture of ceramides, lipids, beneficial bacteria and water this incredible little ecosystem creates an environment that protects us from harmful bacteria and germs that we are exposed to every minute of the day.
So, as you could imagine, this invisible little veil on our skin is easily forgotten about and is quiet easily disrupted.
Things like over aggressive treatments, exfoliation preservatives in our skin care can even affect this ecosystem, as preservatives are made to keep bacteria out, now remember that our microbiome is made up of bacteria (our good bacteria). The ones that help us protect our skin from the bad bacteria. so yes, we need this little guy to function correctly, but more on this in another blog down the track.
A barrier that is in-tacked will have slightly overlapping shingles, that are tightly placed together ensuring no outside assaults can penetrate inside the home, nor does it let anything of value escape. Then we have the structure “the bricks and mortar” the structured bricks, the “corneocytes” and the “mortar” a perfect balance of ceramides, cholesterol and fatty acids. that hold everything together perfectly.
If our barrier is damaged the shingles are missing and not on tight, then we find our house is at the whim of the world. Our bricks are no longer sitting perfectly, and the mortar is not holding up. So, when this analogy comes to the skin, we find it no longer holds moisture effectively, it is irritated, red, angry it stings and flares up with anything you put on it. It can look dry, rough, dull, sore with flakiness or even pustules.
Our skin is our largest vital organ, it protects us from the outside world of pathogens, irritants, physical assaults, UV damage, infections, it regulates our temperature, we feel touch via our skin, it prevents excess water loss in the skin aka (TEWL) trans- epidermal water loss.
So, the above is my exact reason as to why, I feel the skins barrier is the most important thing to fix first when treating the skin. If the skin barrier is not preforming how it was intended, then we have no hope of treating any other conditions within the skin.
How to repair our barrier?
Choose a lipid loving skin care range that support the barrier, as this is essential! And it is back to basics to start. You need to stop excessively cleansing the skin.
Step away from the exfoliants, especially the granulated ones, you can tear up the skin so easily with excessive pressure and overuse. I personally am more of an enzyme fan, when it comes to exfoliation products, but even these are not great when your barrier isn’t happy. Hot showers are a no go, as they can disrupt the skin natural balance, causing itchiness, redness and irritation to the skin.
Exposure to extreme environmental conditions, certain medications (check with doctor for an alternate medication if it is a disruptor never just stop), Poor skin care, products that are too strong and not suitable for your skin type (get your dermal therapist to guide you here). And lay off the aggressive in salon treatments (less is more for your skin), stress, diet and illness all play a part in your skin’s health, so try to address these where you can too. A naturopath can help with gut health here, we have a fantastic one kiarra.
So now that you have a little idea as to what contribute, helps and is a big fat no! in the case of barrier repair. Now we must be patient, as much as we all wish we could treat skin conditions over night, this is not the case, unfortunately it takes time, it can take months to fix the barrier, but consistency and a magical dermal therapist can help you start of your journey to better skin health.
| Symptoms of a barrier disfunction | Products that can help repair the barrier |
| Itchy skin | Niacinamide |
| Severe dry skin | Hyaluronic acid |
| Rashes/irritation | Urea |
| Inflammation | Panthenol |
| Rosacea/eczema | Glycerin |
| Dermatitis/ Psoriasis | Phospholipids |
| Stinging/burning | Colloidal oatmeal |
| Dehydrated, dull skin | Non preservative filled products |
| Thin Epidermis | Centella asiatica |
| Wrinkles | Essential fatty acids |
| Flaking skin | Squalene |
| Breakouts | |
| Sensitive | |
| Rough texture |