When I first visited Aesthetica - a locally owned skin clinic in Byron Bay's industrial estate - I had a rash around my nose that I'd be mismanaging since I was 12-years-old. I had booked in for a skin needling session but thought I'd see, for the 100th time, if I could get to the bottom of the redness that had been lurking for over a decade. My therapist Jade plainly told me that my barrier function was likely impaired and the result was perioral dermatitis around my nose. What?
After explaining what an impaired barrier function meant and completing my treatment (which left me with baby skin) she sent me on my way with a sample of a Dermaviduals Cream Cleanser and the advice "use this for a week and see how your nose goes". It's been approximately 2 years and the rash has never returned. In fact, since learning about the importance of keeping the skins barrier function healthy with the help of Aesthetica, my skin and I have remained on good terms. The buzzwords will keep buzzing, but if there is one skincare tip to keep front-of-mind, it's how to take care of your barrier function, properly. Here, we speak with Gee Lee, marketing manager and in-clinic dermal therapist at Aesthetica to find out why.
Can you explain in short what barrier function is and why it’s so important?
It is the foundation for healthy functioning skin. Our skin has many metabolic functions to help keep us alive but in terms of explaining skin barrier function, this can be simplified into two jobs. To keep water in and unwanted stuff out! The skin’s barrier is what stands between us and the outside world.
Its primary role is to prevent excess water loss, keeping us well hydrated. Water is essential for many enzymatic processes within the skin, such as desquamation (exfoliation) and ensuring that skin cell turnover is regulated. The second vital role of barrier function is to provide a protective shield to prevent bacteria, toxins and allergens from entering the body.
Our outermost layer of skin, the stratum corneum, is made up of multiple stacks of flattened cells called corneocytes, each of which is encased in a thick water-repellent coating of fat (lipid), holding the cells together to form a cement-like glue. This is also referred to as the extracellular matrix i.e. everything that surrounds the cell.
To help visualise this imagine a brick wall, with the bricks being our cells (corneocytes) and the mortar, holding the bricks together, as the lipids. Brick walls are fairly strong structures, however, if you started removing the mortar, the wall becomes weak and breaks down.
This is what happens in our skin if the barrier function is compromised. The results can be devastating for skin health.
When the skin barrier is not in balance and is disrupted, it loses its ability to protect and defend itself and is therefore no longer safeguarded from environmental stressors and pollution. An impaired barrier also allows bacteria and allergens to enter the skin, resulting in autoimmune responses. Conditions such as acne, rosacea, eczema, dermatitis and psoriasis all have some form of impaired barrier function. Therefore repairing it should be essential to treating these conditions.
How can we maintain a healthy barrier function?
Although there are a number of factors that can affect skin health, some of the ways in which we can build a healthy skin barrier include; eliminating any ingredients from our skincare that are irritants such as emulsifiers, preservatives, parabens, fragrances, mineral oils, silicones, dyes and amines.
At Aesthetica, we follow a methodology called Corneotherapy, which in simple terms, is called Skin Cell Therapy. We focus on the integrity of skin cells and their function to ensure your skin is in a state of homeostasis at all times, meaning that the skin can function on its own in a healthy way. Corneotherapy is all about building up and maintaining the skin barrier so it is healthy, in equilibrium and functioning as it should.
We use prescribed skincare to achieve this called Dermaviduals. A dermatological skincare system which restores the barrier back to health.
How can your barrier become damaged or compromised?
The skin barrier serves an important role in protecting us from toxins, bacteria, infection, and other DNA-damaging elements. Today, however, a compromised barrier is more prevalent than ever before as a result of our environment. Overuse of skincare products with harsh ingredients, medications, autoimmune diseases, and even aggressive professional treatments. It’s a delicate balance to get right.
Some main culprits we see in clinic are, over-exfoliating, harsh chemicals (aka the nasty’s mentioned above) reckless use of AHAs/BHAs and Retinol’s and cleansers which leave the skin squeaky clean lowering our PH. Anything which lowers our PH contains fragrance or harsh chemicals has no business being on our skin. All of these will throw out the natural balance of the microbiome.
Are there ways to repair it? If so, how?
As our body’s largest organ, our skin needs to be protected and nourished. Just by following a basic skincare regime, it is possible to protect the skin from everyday wear and tear and assist in combating environmental stresses such as pollution, sun and wind, exposure, lack of sleep, poor diet choices and work or lifestyle pressures.
A balanced skin barrier also gives your skin an advantage in alleviating and managing skin conditions. Once your skin is strong enough to either self-manage or tolerates advanced skin correction products such as actives. You can also say goodbye to redness!
What are some common misconceptions about healthy barrier function?
The most common misconception we see in the clinic is trying to maintain a healthy barrier function whilst stripping the skin. Using excessive exfoliation techniques to achieve a more youthful or clearer appearance. This is actually counteractive to the cell turnover. We see a lot of overuse of AHAs/BHAs, peels and retinol’s in the clinic, where clients over strip their skin, causing a cascade of inflammation and barrier impairment.
You do not need to over-exfoliate, as the skin struggles to perform its natural desquamation (or exfoliation) process. Over-exfoliating with harsh scrubs and peels actually causes your stratum corneum to degrade and the more of it you take away unnecessarily, the less it can perform it’s own. which in turn causes further congestion within the skin. While some exfoliation is good, overdoing it will cause so much more harm than good – you’re basically taking away your skin’s chance to heal itself and deal with the congestion, naturally.
Another common misconception is all “natural” or “organic” Skincare is going to repair my barrier and restore the microbiome.
Organic/natural skincare falls under a very broad banner, many of the ingredients are misleading and in fact, loaded with chemicals hidden under the “natural” banner. There are no industry standards or regulations for these terms and no global standards. There is no real way to know what is actually in many of these products, many of them actually contain synthetic counterparts. Some essential oils contain fragrances and as natural as they may be, these throw out the balance of our barrier and actually attract the UV rays to our skin. which makes it impossible to maintain a healthy barrier function.
This is why you really need to be aware of the delivery system and technology that goes into a product and the exact ingredients it contains before it goes anywhere near your skin.
There is no one size fits all when it comes to our skin. Every skin is as unique as a fingerprint and should be treated individually and holistically. After all, we are autonomous creatures.
Is there a difference between a healthy microbiome and a healthy barrier function?
The two go hand in hand. You can’t have one without the other. In order to have a healthy skin barrier, you need to have a healthy microbiome.
The skin’s microbiome is a collection of living microbes (bacteria). Combined with the acid mantle and lipid barrier, the microbiome is a crucial component of our skin barrier. Think of our microbiome as the first line of defence against an army of invading bacteria! Right below the microbiome, the slightly acidic acid mantle (pH of around 5.0) helps inhibit the growth of external stressors like other bacteria, fungi, and pathogens in general.
A healthy microbiome is about maintaining an ideal environment for both good and bad bacteria to coexist and work together. It needs proper maintenance and nourishment to thrive.
So in turn, a healthy microbiome, a healthy skin barrier!