Skin Health 101: How to Repair a Compromised Skin Barrier

Skin Health 101: How to Repair a Compromised Skin Barrier

What is the skin barrier? 

The skin is the largest organ of the human body with many amazing functions. It protects against cold, heat, moisture, and sun, keeps bacteria and other unwanted things out and keeps water in. Skin even helps make important substances like vitamin D. The outermost layer, called the stratum corneum, is made of small, flat, dead cells held together with fats and cholesterols, called the lipid layer. Think of the skin like a brick wall: the cells are the bricks, and the fats hold the bricks together. Healthy skin has an intact barrier, and a normal “turnover” cycle where the dead cells regularly slough off and are replaced with healthy cells. When the skin barrier is damaged, that wall no longer serves as a healthy barrier for the body. Damaged skin can feel dry, itchy, and irritated, and severely damaged skin can lead to other health issues. Maintaining a well hydrated, intact skin barrier is key to keeping your complexion  glowing and healthy.

What can damage the skin barrier? 

Think of your skin as a brick wall, keeping you safe from the environment. Skin cells are the “bricks” and fats are the “mortar” holding it all together. A damaged skin barrier means the wall of cells and fats isn’t well sealed. This can lead to abnormal moisture regulation and even raise risk of infection or development of rashes when chemicals or bacteria are able to get past the “wall”. Usually, this happens when the fats or “mortar” are damaged. Many things can do this: overly-drying cleansers or soaps, exfoliating scrubs, or other irritating substances like fragrances. Even hot water can be drying, as can chemicals such as chlorine in a pool. Certain skincare ingredients and medications can also cause damage (even those that are supposed to help skin such as acne treatments - AHAs, BHAs, PHAs, and retinoids). Wind and cold can also dry out the top layer of skin. And unfortunately, as we age, the lipid layer loses some moisture as well. 

What are signs that I have a damaged skin barrier? 

An unhealthy skin barrier can cause itching and dryness, and the skin may look dull, or red. You might notice flaking, scaling, or texture changes. In some cases, infections and breakouts can show up. Skin with a damaged barrier also is more sensitive and may react poorly to skincare products and products. Doctors also think that a damaged skin barrier may even contribute to food and environmental allergies, as otherwise harmless proteins and pieces of allergens get past the first layer of skin and are erroneously recognized by the immune system as problematic. For these reasons maintaining a healthy skin barrier is important for general health, as well as keeping you looking your best.  

How do I fix my skin barrier? 

When it comes to fixing a damaged skin barrier, you’ll want a simple, gentle routine that helps build up the fats in the mortar of your skin’s “brick wall” while removing impurities. You’ll want a routine that keeps your skin well-hydrated. A gentle cleanser with hydrating ingredients like hyaluronic acid will remove impurities without drying your skin out. We also recommend using lukewarm water when washing your face, as hot water strips oil and can lead to dryness.

After cleansing, choosing a moisturizer that promotes healing and replenishes moisture and healthy fats in the skin is important. There are three types of moisturizing ingredients to consider: occlusives, humectants, and emollients. 

Occlusives are ingredients that seal water into the skin and act as a barrier, sitting on top of the skin itself. Some example ingredients are petroleum jelly and beeswax. These are useful for very dry, irritated skin, but can feel heavy for those with mildly dry skin, and some may find these can have some unwanted pore-clogging effects. 

Humectants are ingredients that attract and binds water on the skin; widely used humectants include hyaluronic acid, lactic acid, alpha hydroxy acids, and glycerin. Hyaluronic acid is a particularly valuable moisturizer used in many forms in skincare. It’s an essential component of the support structure of connective tissues including skin, eyes, and joints. Technically an acid, it can absorb up to 1,000 times its own weight, making it a powerhouse moisturizer that locks moisture into the skin to help it stay dewy. Glycerin is a similar ingredient that can help smooth the skin out while providing a hydrating effect. 

Finally, emolliating ingredients are moisturizers that help rebuild the lipid layer in the skin. Ceramides and collagen are two important ingredients designed to repair the lipid layer and skin barrier. Ceramides are actually made in the skin and make up a large part of the lipid layer and are an essential part of the skin barrier. Unfortunately, with time, your skin slowly loses ceramides. To help fight this decline and maintain skin that looks and feels healthy, look for serums or moisturizers with this essential ingredient. Squalane is another emollient that is actually a stabilized form of squalene, which is naturally made by our skin. As with ceramide, a damaged skin barrier may benefit from application of squalane to aid in the repair process.  

When choosing a moisturizer for a damaged skin barrier, look for a serum that incorporates humectants, emollients, and occlusives for maximum healing effects. Applying moisturizer immediately after cleansing to slightly damp skin can also help lock in even more moisture. 

How can I prevent further skin barrier damage? 

Using a gentle cleanser and good moisturizer as discussed above will help maintain a healthy barrier. If you’re struggling with dry, irritated skin, try reducing use of potentially irritating products like retinoids or acne medications from daily to every other day, especially if you are new to these ingredients or using new products. In general, most dermatologists recommend you avoid overuse of toners, especially those with alcohol, as these are designed to strip oils. Avoiding products with fragrance will also reduce irritation. Consistent sun protection is key to reducing long-term damage to the skin from ubiquitous ultraviolet rays. Using products with antioxidants like vitamin C may also help reduce the damage from environmental toxins, but the key is using a product that uses effective but non-irritating forms and levels of vitamin C. We go into more details about vitamin C in this post.

How can I exfoliate without damaging the skin barrier? 

Gentle exfoliation, which sweeps away old, dry, dead cells at the top of the skin to reveal new, healthy cells underneath, is a key part of any skincare routine. But don’t overdo it - harsh, abrasive cleansers or scrubs can damage the skin barrier, resulting in dryness and irritation. Instead, reach for products that use gentle but effective ingredients such as lactobionic acid and gluconolactone, while also working in combination with super hydrating ingredients like squalene and hyaluronic acid. You don’t have to use exfoliating serums daily; instead, rotate them into your routine 1-2 times a week for a renewing effect without irritation. 

Remember that skin barrier health plays a vital role in maintaining a healthy, glowing complexion. If your skin barrier needs some extra attention, try Emdash Vivid Protect Antioxidant Serum and Bright-CE Eye Serum. These are powerhouse serums that are packed with ceramides, vitamin E, and other skin barrier loving ingredients. Pair with a thick moisturizer to lock in actives and maximize skin barrier nourishment. 

Disclaimer: As with all of the information on this site, this post is meant to be for informational and educational purposes only, and is not medical advice. When in doubt, please ask your physician. 

Teresa Fu, M.D.

Dr. Teresa Fu is a board certified dermatologist and mother of two. She graduated from Stanford Medical School and practices in the San Francisco Bay Area.