Repairing the skin barrier – A guide to the application of moisturizing medical skin care products in dermatology
1.What is the skin barrier?
The outermost layer of the skin is called the stratum corneum, which is composed of 20 layers of flat, interwoven keratinocytes. The keratinocytes are as tough as “bricks”, with lipids like “mortar” connecting the keratinocytes closely to each other, forming a “brick wall structure”. There is also a protective film (hydrolipidic film) composed of sweat and sebum on its surface, which together form the barrier of the skin. The skin barrier can lock the skin moisture and oil, and resist the invasion of various skin surface germs, which plays a very important protective role for human health.
2.Dermatological diseases and skin barrier
There are various skin diseases, and many of them tend to recur, but it is difficult to find the specific cause. The common skin redness, itchiness, dryness and other “skin allergy” performance, it is difficult to find the specific “allergens”. However, these skin diseases have a common cause – “damaged skin barrier”, that is, the skin surface loses its normal protective function and there is a loss of skin moisture, resulting in dry, flaky or itchy skin. At the same time, germs on the skin surface can easily enter the skin through the damaged skin barrier, which can further trigger skin inflammation. Therefore, damaged skin barrier is not only the manifestation of many skin diseases, but also may be an important reason why skin diseases are prone to recurrence.
3. Skin care products and the skin barrier
In the treatment of skin diseases, doctors not only use drugs, but also skin care products that can repair the skin barrier function, that is, to supplement the “water-lipid film” on the surface of the skin and the “mortar” between cells by moisturizing skin care products, so as to strengthen the “brick wall structure” on the surface of the skin. The “brick wall structure”.
Moisturizing skin care products to repair the skin barrier should have the following 3 basic ingredients.
① Moisture-absorbing agent ingredients, including glycerin and urea, which can absorb water from the environment and replenish the water lost by emanation from the stratum corneum.
②Sealing agent raw materials, such as petroleum jelly, avocado oil, etc., can form a thin hydrophobic oil film on the skin surface, which has the effect of reinforcing the skin barrier.
③Add the same or similar “bionic” raw materials as epidermis and dermis, which can repair the skin barrier, such as natural moisturizing factor, cymbopogon oil, ceramide, hyaluronic acid, etc.
4.What are medical skin care products?
The skin care products used by doctors to assist in the treatment of skin diseases can be referred to as “medical skin care products”, which, compared with ordinary skin care products, require the following three characteristics.
(1) higher safety: more than ordinary skin care products emphasize the formulation of streamlined, strict screening of raw materials, without or as little as possible to damage the skin or cause skin allergies, such as pigments, fragrances, preservatives, irritating surfactants, and as far as possible, the raw material products for clinical safety assessment.
(2) Clear efficacy: the main product ingredients of moisturizing and skin barrier repair function skin care products have clear mechanism of action and have been confirmed by scientific experimental research.
(3) Clinical validation in multiple hospitals: Clinical studies conducted by dermatology departments in multiple hospitals before marketing to verify the clinical efficacy and safety of skincare products.
From the above 3 features, it is clear that medical skin care products themselves do not have any toxic side effects on the skin and can be used for a long time as appropriate to reduce or mitigate recurrent skin diseases.
5.Which common skin diseases require the use of skin barrier repair – moisturizing medical skin care products?
The use of medical skin care products varies in the treatment of different skin diseases. Some skin diseases can be relieved by using moisturizing skin care products alone, while some skin diseases must be treated with moisturizing skin care products on the basis of medication.
(1) Eczema, atopic dermatitis
Eczema or atopic dermatitis is one of the most common chronic recurring skin diseases, which manifests itself as swelling, erosion and exudation in the acute phase and dryness and flaking in the chronic phase. Therefore moisturizing skin care products are the basis of treatment for the chronic phase of these disorders (skin care products should not be used during the acute vesicular and exudative phase).
For patients in the mild chronic stage, moisturizing skin care products alone may alleviate the condition. For patients with persistent or obvious skin lesions, moisturizing skin care products should be used in conjunction with drug therapy. After the lesions are controlled, consider discontinuing the medication and continuing to use moisturizing skin care products to reduce the recurrence of this type of dermatitis. For patients with atopic dermatitis, even normal-looking skin is dry, so moisturizing skin care products are also needed to reduce its flare-ups.
(2) Psoriasis
Psoriasis is a chronic disease that manifests itself as repeated large flakes at the lesions, and tends to worsen in the winter when the climate is dry. The basic treatment of psoriasis is moisturizing and skin care, while using corresponding topical drugs or ultraviolet light therapy, and if necessary, using systemic oral or injectable drugs. However, the oral medication of this disease, such as Avelox or phototherapy, can aggravate the dryness of the skin, therefore, it is more necessary to cooperate with moisturizing and skin care at this time.
(3) Erysipelas
Erythroderma is a serious skin disorder that manifests as redness, swelling and flaking of the skin all over the body. This type of dermatitis makes the patient extremely uncomfortable and may cause bacteria on the skin surface to enter the human bloodstream through the damaged skin barrier and cause secondary bacterial infections throughout the body. Therefore, moisturizing skin care is very important. When the lesions are dry and flaky, it is advisable to use oily petroleum jelly ointment or boric acid ointment externally, and when erysipelas are fine branched scales, it is advisable to use cream moisturizing skin care products with better comfort.
(4) dry skin pruritus
The disease occurs in autumn and winter, especially in middle-aged and elderly people with reduced sebaceous gland function, more likely to appear dry or itchy clinical symptoms. The use of moisturizing skin care products alone can usually significantly reduce the symptoms, but long-term use is required, along with oral antihistamine medication if necessary, and do not over-clean the skin.
(5) Congenital ichthyosis
Due to the abnormality of hereditary genes, patients with ichthyosis have different degrees of dry skin. Mild ichthyosis can be relieved by using moisturizing skin care products alone, while more severe patients can use topical Vaseline ointment or boric acid ointment with sealing effect during the day, and then use cream-based moisturizing skin care products with better comfort at night.
(6) Keratosis pilaris
The skin around the hair follicles is rough and dry due to genetic abnormalities in patients with peri-trichal keratosis. For mild cases of periorbital keratosis, moisturizing skin care products can be used alone to relieve the symptoms, and for those with obvious symptoms, topical medication or fruit acid peeling treatment can be used on top of moisturizing skin care.
(7) Exfoliative keratolytic disease
It is a chronic recurrent skin disease that occurs on the palms and soles of the feet, manifested by dry, flaky skin without obvious itching symptoms, but the cause of the disease is not clear. Long-term topical moisturizing skin care products is the main treatment for the disease, for the more serious cases can be short-term topical hormone cream.
(8) Facial seborrheic dermatitis
Facial seborrheic dermatitis is a chronic dermatitis that occurs in areas rich in sebaceous glands. Due to the obvious impairment of skin barrier function at the lesions, dry and flaky skin occurs, and is prone to recurrence. Mild patients are effective with moisturizing skin care products alone; for recalcitrant patients, short-term topical medications are used on top of moisturizing skin care. For seborrheic dermatitis with significant oiliness in the nasolabial folds or nasal bridge, oil-control skin care products can be used in conjunction.
(9) Rosacea
Rosacea is a chronic dermatitis that occurs mainly on the central part of the face, such as the cheeks, forehead, perioral area or nose, mainly manifested by paroxysmal flushing in the central part of the face, and the flushing is aggravated by sun exposure, emotional excitement or temperature rise, and can appear facial vascular hyperplasia and red papules and pustules, and a small number of patients may have redness or hypertrophy of the nose (so the disease can also be called “rosacea (so the disease can also be called “rosacea”).
Clinically, the majority of patients with rosacea on the cheeks and around the mouth have varying degrees of impaired skin barrier function and dryness and flaking, so it is important to moisturize the skin while taking oral medications. However, patients who develop it on the nose often have oily skin, so it is advisable to use oil-control skin care products.
(10) Hormone-dependent dermatitis
Hormone-dependent dermatitis is a chronic dermatitis in which the skin barrier is severely broken due to long-term topical use of hormone medication or topical use of hormone-containing skin care products, and moisturizing skin care is the key to treatment. However, after stopping the use of hormones for about 3 days, there will be a rebound of symptoms (i.e., unpleasant dryness, itching, burning and other symptoms will increase), so we must insist on using moisturizing skin care products. Generally, after 2 weeks of treatment, the symptoms begin to gradually improve, and then continue to use moisturizing skin care products for 4-8 weeks to make the symptoms continue to subside.
(11) Chronic actinic dermatitis
Chronic actinic dermatitis is a chronic dermatitis that occurs in exposed areas of the middle-aged and elderly, such as the back of the face and neck and hands, and is characterized by aggravation after sun exposure. This dermatitis is often accompanied by dryness, flaking symptoms, in oral and topical medication at the same time, need to use topical moisturizing skin care products.
(12) white pityriasis
Prevalent in children, the disease is self-limiting, should not be excessive drug treatment. Topical moisturizing skin care products are preferred, and if necessary, short-term topical medication.
(13) Exfoliative labyrinthitis and perioral dermatitis
Exfoliative labyrinthitis is one of the most common chronic inflammatory conditions, manifested by repeated flaking and thickening of the lip mucosa. Perioral dermatitis occurs on the upper lip, lower jaw, and nasolabial region, and also manifests as redness, dryness, and flaking. These two kinds of dermatitis alone with moisturizing skin care products may achieve good clinical results, for recalcitrant patients can be short-term topical drugs, after the lesions improve that is to stop using drugs, but need long-term use of moisturizing skin care products to reduce the recurrence of such dermatitis.
(14) Sensitive skin
Clinical manifestations such as tingling, burning, dryness and redness of the facial skin due to impaired skin barrier function, but not due to a specific skin disorder, this phenomenon is medically called “sensitive skin”, and the common causes are as follows.
a, a subhealthy state of facial skin: often due to dry climate, environmental pollution, poor skin care habits or patients with neurological disorders and induced.
b, medication for skin diseases: such as acne or psoriasis oral retinoid drugs, one of the side effects of such drugs is to cause temporary impairment of the skin barrier function, i.e. causing dryness and flaking of the skin or the mucous membrane of the mouth and lips.
c. Minimally invasive treatment of dermatological diseases: such as modern laser or fruit acid peeling treatment Although it has brought breakthroughs to dermatological diseases and skin beauty, this treatment has a temporary damage effect on the skin barrier function, and should be used mainly for sensitive skin, mainly using moisturizing skin care products.
(15) Other skin diseases with dry skin
However, any other skin diseases accompanied by dry skin such as neurodermatitis, pityriasis rosea, pigmented purpura dermatitis, skin amyloidosis, etc., can be treated with moisturizing skin care products to assist.
6.Using method and instructions
Face: you should consider using a mild and non-stimulating cleanser, and use moisturizer after cleansing, and then use medical moisturizing skin care products, and also use sun protection gear when going out, and apply mild and non-stimulating sunscreen, but in the acute phase of dermatitis, sunscreen needs to be used with caution.
Torso and extremities: Clean with water or mild non-irritating body wash only and then apply medical moisturizing skin care products. If you need to use topical medication, you can apply moisturizing skin care products to increase the hydration level of the skin first, and then apply medication after 30 minutes or so.
Types of moisturizing skin care products: commonly used as creams, can also be gels, water or masks, etc. How to choose the type in clinical practice should be based on the symptoms of the skin to make a decision.
Medical skin care products are not drugs and are generally not sold in pharmacies within hospitals (except for moisturizers with device approvals), but are purchased in pharmacies, supermarkets or shopping malls.