March 30, 2020 at 12:20PM
Chronically dry, inflammation-prone skin is a dead giveaway that you suffer from a compromised skin barrier. When your barrier is compromised, your skin isn’t able to do its two primary functions: inhibit trans-epidermal moisture loss (i.e., the evaporation of water through the skin) and protection from environmental pollutants, irritants, allergens, microbes, and more. Here, we outline the importance of the skin barrier function, plus ways to support it both internally and externally.
Why is keeping your skin barrier strong so important?
An overly permeable skin barrier is what holistic board-certified dermatologist Mamina Turegano, M.D., refers to as a “leaky” skin barrier—sort of like a leaky gut—and it can act as an underlying cause of inflammatory skin conditions ranging from acne and eczema to even allergic reactions like hives.
“It protects us from mechanical injury, low humidity, cold, heat, sun, wind, chemical exposure, bacteria, viruses, fungi, and other pathogens,” explains board-certified dermatologist Hadley King, M.D., stating that, “a healthy barrier is critical to normal skin function.”
Supporting your skin barrier isn’t just superficial either: It has repercussions for overall health, too. Board-certified dermatologist Leslie Baumann, M.D., points to the results of a 2019 study delineating the link between skin dysfunction and various health conditions caused by chronic inflammation. In the study, researchers connected the use of barrier repair moisturizers with reduced pro-inflammatory cytokines in the blood, highlighting the importance of the skin’s protective role in our overall health: Namely, that poor barrier function is linked to inflammation that can trigger internal health conditions.
1. Ceramides and phytoceramides
If you have a compromised skin barrier, most dermatologists will tell you to find products with ceramides and phytoceramides. King shares, “Ceramides are thought to be the most important component for maintaining barrier function” as it is one of the very building blocks of our skin cells. It helps to use the “brick and mortar” analogy to envision the role of ceramides in skin. Think of it like this: If collagen and elastin make up the structural part of the skin, and the skin cells are the bricks, ceramides are the cement between the bricks. If the mortar degrades with cracks and openings, then all sorts of things can make their way in and wreak havoc.
“Ceramides are fatty molecules that make up the natural skin barrier and help to retain moisture,” elaborates Marisa Garshick, M.D., FAAD. “Specifically, ceramides serve as the glue that helps keep the skin cells together.” It is the integrity of these cellular components that determine barrier function. Research shows that when applied topically, phytoceramides dramatically improved the rate of repair of a damaged stratum corneum (top skin layer).
Not only can you find these in creams and lotions, but you can also find them in supplements. By utilizing the inside-out approach, you’ll be better able to bring your barrier function back to optimal health. And when taken orally, research participants noted improved moisture retention and skin quality in just 15 days. In another double-blind, placebo-controlled trial, participants with clinically dry skin took a phytoceramide-rich wheat extract oil for three months and saw up to a 35% improvement in skin hydration. “Some foods that are rich in ceramides include eggs, dairy, wheat germ, soybeans, and brown rice,” notes Garshick.
2. Fatty acids
“You need to be consuming sufficient amounts of healthy fats, which can be obtained from the diet,” says King. Salmon is one of the most popular fatty fishes recommended by dermatologists; omega-3 fatty acids can also be supplemented in fish oil or fish oil capsule form. Turegano adds that nuts—particularly almonds and walnuts—are especially beneficial nuts to incorporate for the skin.
This lipid is naturally found in your skin’s sebum. Previously it was harvested from shark liver, making it a very controversial skin care ingredient (for good reason), but recent developments in the last several years have made so that squalane is better able to be derived from plants. And research shows some advantages for the skin as an emollient and antioxidant and for hydration.
Humectants are any ingredient that pulls in and holds water, like glycerin and hyaluronic acid. Humectants cannot heal the skin barrier on their own; however, they provide an essential task of keeping skin moisturized while you repair your skin barrier function. As King tells us, these ingredients hydrate the epidermis while you seal in and retain the water with an outer layer of lipids.
Topically, use humectants first, followed by an occlusive cream or oil—this will speed up the repair of any compromised skin barrier. You can also look for hyaluronic acid supplements, which have been shown to retain skin moisture at the cellular level.* Not only is HA responsible for keeping skin looking healthy and hydrated, but it is integral to our body’s healing process. When we’re hurt, our bodies actually produce more hyaluronic acid, the synthesis of which increases during tissue injury and wound healing.
5. Colloidal oatmeal
Turegano adds that colloidal oatmeal extract can both also form a protective seal on the skin. It’s a natural skin care classic for those with sensitive skin: Research has shown time and again that the extract can soothe inflamed skin through its anti-inflammatory properties. The many clinical properties of colloidal oatmeal derive from its chemical polymorphism. The high concentration is responsible for the protective and water-holding functions of oat and contributes to its antioxidative properties. Additional research shows colloidal oatmeal aided genes related to skin barrier and resulted in recovery of barrier damage in an in vitro model of atopic dermatitis.
A balanced microbiome is the skin’s best defense, as it functions something like an immune system for your skin. First up: Maintain a healthy gut flora with probiotics. The gut-skin connection has been extensively studied, and the research shows there’s a direct link between your gut and skin flora. So if you have poor gut health, you are more likely to have similar issues with your skin. Probiotics can help by managing the healthy bacteria internally.
“In patients with atopic dermatitis and other inflammatory conditions, external microbes are a huge source of flares, so I look for ingredients that can balance the skin flora,” Turegano says. “By having healthy bacteria on the skin, the bad pathogens are less likely to take over and cause inflammation.”
And as probiotic supplements have surged in popularity, so have probiotic skin care lines. “Products that support healthy and diverse skin microbiota are also beneficial to the skin barrier,” King shares, explaining you should look for both pre- and probiotic skin care products. These can be found in topicals, as well as fermented foods like yogurt, if you want to DIY a mask for yourself.
7. Manuka honey
Manuka honey is renowned for its repairing benefits. Clinical studies have shown it to be a very effective technique in healing wounds, burns, and other topical damage because it inhibits the growth of harmful bacteria. And given the abundance of antioxidants found in Manuka honey, it is highly anti-inflammatory and has been shown to work against dermatitis, acne, and eczema, all conditions that tend to arise from a damaged skin barrier.
The bottom line.
A strong skin barrier is not just about superficial measures: Keeping your skin healthy has internal benefits, too. And with the right topical products and supplements, you can help your skin repair and protect itself.