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I’ve been getting questions lately from patients regarding confusion and science over skin barrier function so thought I’d address this here. Will do more of your questions next week.
Our skin barrier is complex and wonderful. Underestimating how much of our immune system is in our skin is common. The easiest way to think about this is to think about burns. A minor (first degree) burn shows some reddening, some peeling while it heals and then there is a “dry area” for about month as the epidermis repairs itself. Second degree burns show some blistering, oozing of serum through the skin, and heal often with a mark that takes a long time to heal. Third degree burns go all the way into the deeper layer (dermis), and take a longer time to heal; a permanent scar is often the result.
4 Commonly Asked Questions:
- What is the skin barrier? It is all three layers of the skin, but mostly the outer two; the dead layer (stratum corneum) and the epidermis. The epidermis really does look a little like a brick wall of cells when you look at it through a microscope.
- Why is it important? Protection from things outside of us like viruses, bacteria, sun, wind, etc. is key. If we want beautiful skin though, we want this layer to be thick enough, but not too thick. As we age, it’s the dead outer layer that tends to build up and be retained too long. To get that “glow” back, we need to keep it at the optimal level with some chemical or physical exfoliation. From a more meditative point of view, skin is interesting because if we believe we are all connected to one another in some way, it’s often our skin that creates a sense of “I’m in here” and “you’re out there.”
- How can we improve our barrier layer? The current trends right now are to over exfoliate. You don’t need a hydroxy acid, a retinoid or physical exfoliation all in the same day or week even. The one exception may be if you are very young, and have thicker, oily, acne prone skin. It requires judgment and perhaps some help from a dermatologist. You skin won’t “glow” if you don’t exfoliate at all (except maybe in your 20s), and it won’t glow if you strip off that outer barrier too much. Not sure where you are? First try 1-2 weeks of skin rest which is just a gentle cleanser, a light moisturizer (like the MadisonMD Natural Lipid Rich) and then your sunscreen. At the end of the week one or two, does your skin look better or worse? If it’s better, cut back on the above mentioned exfoliants (consider trying our Zero Irritation Retinol) by half and then see where you are in two weeks. If your skin looks worse after the skin rest, step up your exfoliants by 25% and then see where you are in two weeks.
Hope this helps,
Dr. Brandith
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