Repair Your Skin’s Barrier To Treat Redness and Flushing
A healthy skin barrier prevents water loss and allergens, irritants and chemicals from penetrating skin and causing many commonplace rosacea symptoms.
A disrupted skin barrier allows for problematic amounts of water to evaporate from skin, leading to dryness, and for irritants and allergens to penetrate the skin, provoking symptoms.
Dermatologists have found that rosacea patients who use barrier repair products (and not just moisturizers) for extended periods of time frequently regain a normal flush response.
Unlike moisturizers, which sit on the surface of the skin to prevent the evaporation of water, barrier repair products actively repair the skin, helping treat more fundamental causes of its tendency to be dry, irritated and reactive.
A healthy, functional skin barrier does more than prevent water loss, it also shields the skin from allergens and irritants.
Frequently patients experience irritation from numerous sources, such as the climate (particularly if dry and cold) and cosmetics.
Many ingredients in skin care products are not intended to be substantially absorbed into the skin. However if the skin’s barrier is impaired they can affect the skin in untoward ways by reaching deeper into it than intended, producing redness, irritation, stinging, itching and prickling sensations.
If your skin’s barrier is extremely unhealthy, even water can be irritating.
Rather than trying endless moisturizers for your skin’s irritation you should make an effort to repair the fundamental deficiencies it has developed.
Vital Components of the Skin Barrier
Skin is made up of proteins protected by a mixture of oils comprising approximately 50% ceramides, 25%cholesterol and 15% fatty acids.
Changes to any of these components, either in quantity or quality, can lead to faulty skin barrier function.
Skin irritation from many sources, including the process of flushing, exposure to daylight, the hormonal influence of stress and inferior facial cleansers, are known to alter the properties of the skin barrier.
Consequences for Blood Vessel Reactivity
Skin irritation is accompanied by an increase in blood flow, which in rosacea quickly becomes pathological and leads to persistent redness and visible capillaries.
By improving the skin barrier the likelihood of skin irritation is decreased and so follows less of the blood vessel reactivity which leads to harmful episodes of flushing.
Ingredients Which Harm/Degrade The Skin Barrier
Skin care products for acne and aging skin concerns are replete with ingredients which (either in small quantities or if misused) can abuse the skin’s barrier.
Prime examples are alcohol, benzoyl peroxide, essential oils and several exfoliating acids such as glycolic acid.
Alkaline products, particularly soaps but also many cleansers and some moisturizers, inhibit activities in the skin which produce natural ceramides.
Sulfates, such as sodium laureth sulphate, and other surfactants and detergents found in many cleansers, actively remove ceramides, cholesterol and fatty acids from the skin.
While this may be passable for someone with very oily skin, all skin types and conditions, and particularly patients with rosacea, can benefit greatly by avoiding these ingredients.
Ingredients Which Repair The Skin Barrier
Combinations of ceramides, fatty acids, cholesterol, natural occlusives (such as grape seed and squalene) and humectants (such as glycerin, sodium hyaluronate/hyaluronic acid) in products such as Epiceram are effective at restoring healthy skin barrier function.
Beta glucan and centella asiatica help accelerate the restoration of the skin’s barrier by the above ingredients.
Occurring naturally in the skin, beta glucan modulates healing, strengthens the skin’s protective abilities and accelerates skin renewal.
Centella asiatica (titrated extract) improves the skin’s tolerance while protecting against irritation.
Centella asiatica also stimulates collagen synthesis to help heal and re-densify weakened skin.
Testing Products for Irritancy In Rosacea Patients
The reaction of blood vessels in response to skin care products can be measured via laser doppler velocimetry(LDV) and photoplethysmography (PPG).
When synchronized with the pulse rate, these instruments measure changes in the skin’s vasculature.
They also help detect irritation which doesn’t produce immediate visible redness but which may be cumulatively harmful. This is known as sub-clinical inflammation.
Used in conjunction with other methods LDV and PPG help confirm the suitability of both the individual constituents and the final formulae of the Clinic’s products.
Summary of What To Do
First, avoid removing the essential components of the skin barrier by avoiding cleansers which are alkaline(those which have a pH above 7) or contain sulphates. For the most part this mandates avoiding soaps.
If possible, use a skin-supporting cleanser which contains ceramides to protect the skin during cleansing. TheRosacea Anti-Inflammatory Foaming Cleanser is an example of such a product.
Second, avoid exfoliating acids and drying treatments such as benzoyl peroxide, at least until your skin has recovered (this will take months and allow a year of barrier repair techniques to see a durable change in your skin’s reactivity and sensitivity).
Use effective, tested barrier repair products, such as Rosacea Treatment Fluid and Rosacea Treatment Creamwhich have demonstrated efficacy on rosacea patients.
Apply Rosacea Treatment Fluid or Cream more generously at night, taking time to massage gently until the point of complete absorption, for optimal and faster results.
A diet with a balanced intake of Omega 3 and 6 essential fatty acids also supports the development and maintenance of healthy skin barrier function.
New Methods for Restoring The Skin Barrier — Clinical Dermatology.
The Skin’s Vasculature — Biology of Skin.
Crawford GH, Pelle MT, James WD. Rosacea: I. Etiology, pathogenesis, and subtype classification. J Am Acad Dermatol 2004; 51: 327-41; quiz 42-4.
Pelle MT, Crawford GH, James WD. Rosacea: II. Therapy. J Am Acad Dermatol 2004; 51: 499-512; quiz 3-4.
Author: Peter Wilson.
Reviewed: Sunday, 22 September 2013.