Repairing the Skin Barrier

Approaching skin problems through treatments that improve the function of the skin's permeability barrier.

The How and Why of Sensitive Skin

November 1, 2018 By Peter M. Elias, M.D. 1 Comment

Babies have sensitive skin, but so do many adults — Detail of angels from a fresco in Verona Italy
Babies, angels and many adults have sensitive skin. Photo by Mary L. Williams

An alarming percentage (about 60%) of normal adults, mostly women, self-report that they regularly experience ‘sensitive skin’. Most perceive ‘sensitive skin’ as various amounts of stinging, burning, irritation, and itch with the use of skin care products. In a large population based study in China, we found no increase in the proportion of females among those patients whose reactions were severe enough to seek the help of a dermatologist, but we did find the reactions to be more marked in older age groups.

The types of skin care products that produce these reactions vary greatly – and sometimes even include products like moisturizers and cortisone containing creams that are intended to help – not harm – the skin. This raises two obvious questions. 1) What is it about some people’s skin that makes it so ‘sensitive’ to skin care products? And 2) what is it about skin care products that is so hard on skin? [Read more…] about The How and Why of Sensitive Skin

Moisturizers vs. Barrier Repair Lotions and Creams

July 9, 2018 By Mary L Williams, M.D. 4 Comments

moisturizers vs barrier repair lipids — Diagram showing different fate of moisturizer vs barrier repair lipids. From: Elias PM and Sugarman J. Ann. Allergy Asthma Immunol. In Press, 2018.

Moisturizers vs. Barrier Repair Products: Are They The Same?

Some products for dry skin call themselves ‘moisturizers’, while others are labeled ‘barrier repair’. Moisturizers vs. barrier repair lotions and creams: are they really the same thing? If you have ever stood in front of a pharmacy shelf looking for something that could fix your dry skin, chances are you might have been a bit confused. Perhaps you felt unsure which one of the dozens of lotions and creams on the shelf before you is the right one for your skin.

In essence, a good moisturizer will treat the symptom – ‘dry skin’ – while a good barrier repair product will treat the disease – a defective skin barrier which was producing ‘dry skin.

Although both moisturizers and barrier repair formulations can be considered appropriate for the treatment of dry skin, they do address somewhat different therapeutic goals. Moisturizers aim to rehydrate the outer layer of skin – the stratum corneum – while barrier repair agents attempt to restore the skin barrier. If they are successful in repairing the barrier, they will be correcting the defect that caused the skin to be dry in the first place.

Starting First With Moisturizers.

When The Skin Barrier Fails: Barrier Repair Therapy

February 25, 2013 By Peter M. Elias, M.D. 2 Comments

Know anyone with psoriasis or some type of eczema? Most of us do. These are common skin conditions: one child in five has atopic dermatitis; 2% of the population has psoriasis. That’s a lot of people! Treatment is an ongoing battle for many who are affected by one of these conditions. They must often – sometimes several times daily – apply various creams and ointments to their skin, because the mainstay of treatment for these common skin disorders is still some form of topical therapy. Then, consider the issue of dry skin. This is an extremely common affliction, especially during winter months and as our skin gets older.

As those of us who suffer from one of these conditions search for effective skin creams and lotions, we fuel a large cosmetic and pharmaceutical industry that provides us with many choices. But just as one would not put diesel fuel into the tank of a car manufactured to run on gasoline, so too, it is important to put the right stuff on the skin.

We now know that having one of these skin conditions means that there is a problem with the skin barrier. Treatment of the barrier failure is an important part of healing the dermatitis and preventing relapses. Indeed, many products now tout their ability to restore or repair the skin barrier.

The task consumers face of sorting through the number and variety of products that claim to restore the barrier can be overwhelming, and the din of their marketing can be deafening. Indeed, ‘barrier repair’ has become something of a buzz word in the industry, yet the science behind these claims is all too often lacking. To assist in the reader in interpreting what the various products have to offer, we offer the following classification of strategies to repair the skin barrier.

Repairing the Skin Barrier

Moisturizers vs. Barrier Repair Products: Are They The Same?

Starting First With Moisturizers.

1) Dressings