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”, and there are lipids like “mortar” between them to connect the keratinocytes closely with 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, the surface of the skin is easily damaged. 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 several hospitals: Clinical studies conducted by the dermatology departments of several hospitals before marketing to verify the clinical efficacy and safety of skin care products.
As can be seen from the above 3 features, 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.What common skin diseases require the use of skin barrier repair-moisturizing medical skin care products?
Medical skin care products are used in different ways 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, in the acute phase manifested as swelling, vesicles, exudation, in the chronic phase manifested as dryness, flaking. Therefore moisturizing skin care products are the basis of treatment for the chronic phase of these disorders (skin care products are not recommended during the acute vesicular and exudative phase).
For patients in the mild chronic phase, moisturizing skin care products alone may alleviate the condition, but for patients who are persistent or with significant skin lesions, moisturizing skin care should be used in conjunction with drug therapy. After the lesions are controlled, you can consider stopping the medication and continue 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 they also need to use moisturizing skin care products to reduce their flare-ups.
(2) Psoriasis
Psoriasis is a chronic disease that manifests itself as repeated large flakes at the lesions, often easily aggravated in the dry winter climate. 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 the disease, such as Avion 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) Erythroderma
Erythroderma is a serious skin disorder that manifests as redness, swelling and flaking of the skin all over the body. This kind of dermatitis makes the patient extremely uncomfortable and may cause bacteria on the surface of the skin 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 for external application, and when erythrodermatitis manifests itself as fine bran-like scales, it is advisable to use moisturizing skin care products of cream type with better comfort.
(4) dry skin pruritus
The disease occurs in the autumn and winter seasons, 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 antihistamines 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
Patients with perifollicular keratosis have a genetic abnormality that makes the skin around the hair follicles rough and dry. Mild cases of periorbital keratosis can be relieved with moisturizing skin care products alone, while those with obvious symptoms can be treated with topical medications or fruit acid peels on top of moisturizing skin care.
(7) Exfoliative keratolytic disease
It is a chronic recurring skin disease that occurs on the palms of the hands and soles of the feet, manifested by dry, flaky skin and no obvious itching symptoms, but the cause of the disease is not clear. Long-term topical moisturizing skin care products are the main treatment for the disease, and for those with more severe conditions, short-term topical hormone creams can be used.
(8) Facial seborrheic dermatitis
Facial seborrheic dermatitis is a chronic dermatitis that occurs in areas rich in sebaceous glands. The skin is dry and flaky due to the obvious impairment of skin barrier function at the lesions, and it 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 can be combined with the use of oil-control skin care products.
(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, and is mainly characterized by paroxysmal flushing in the central part of the face, which is aggravated by sun exposure, emotional excitement or temperature rise. “).
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 whose skin occurs on the nose often show oily skin, so it is appropriate 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. manifested as unpleasant dryness, itching, burning and other symptoms aggravated), and it is necessary to 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 face and neck, the back of the 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, the need for external 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 short-term topical medication is needed when necessary.
(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, jaw, and nasolabial region and also manifests as redness, dryness, and flaking. These two types of dermatitis may have good clinical efficacy with moisturizing skin care products alone. For recalcitrant patients, topical drugs can be used for a short period of time, and the drugs will be discontinued when the lesions improve, but long-term moisturizing skin care products are needed 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, are medically known as “sensitive skin”, with the following common causes.
a. A sub-healthy state of facial skin: often induced by dry climate, environmental pollution, poor skin care habits or patients with neurological disorders.
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 skin diseases: such as modern laser or fruit acid peeling treatment although it has brought breakthroughs in dermatology and skin cosmetology, but this treatment has a temporary damage effect on the skin barrier function, to cope with sensitive skin, mainly by 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 purpuric 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.