Skin Barrier and Causes of A Damaged Skin Barrier

When the skin barrier is broken and disrupted, the skin's health is compromised. This blog will explain the science and anatomy of the skin barrier,  Damaged moisture barrier symptoms can be identified using a quiz that dermatologists use to identify the Baumann Skin Type.

The definition of skin barrier is a protective layer of lipids that surround skin cells in the epidermis.

The function of the skin barrier is to keep water in the skin and prevent entry of germs, allergens and irritating substances into the skin.

Other names for the skin barrier are:

• the moisture barrier
• lipid barrier
• skin protective barrier
• skin water barrier
• multilamellar layer
• lipid bilayer

An intact skin barrier prevents water from evaporating off of the skin’s surface.

A compromised skin barrier causes holes in the skin barrier.

A broken moisturize barrier allows:

• water to leave the skin’s surface
• allergens to enter the skin
• microbes like bacteria to enter the skin
• better penetration of skincare products
• increased retinoid side effects
• Toxic chemicals to get into the skin

A damaged skin barrier may be genetic or it may be caused by something your skin is exposed to.

The skin barrier is damaged by:

• Chlorine in water such as swimming pools
• Cholesterol lowering drugs like statins
• Friction
• Hard water with calcium and magnesium
• Harsh detergents or surfactants
• Lack of fat or cholesterol in diet
• Exfoliants
• Poor diet (not enough fat)
• Water (type and exposure time matter)
• Cholesterol lowering drugs

I often see patients who have an injured skin barrier due to their habits.  In their case, it is not a genetic issue, but something they are doing wrong.  These habits can injure your skin barrier by stripping needed lipids from your skin:

• Overexfoliation
• Too frequent baths
• Bath and showers that are too hot
• Prolonged immersion in chlorinated water
• Cleansers that have too many detergents (vigorously foaming cleaners)
• Soaps
• Using baking soda on the skin
• Beginning a retinoid

A damaged skin barrier makes your skin susceptible to dehydration, rashes, infection, and inflammation.

A broken moisture barrier has tiny holes in between skin cells that allow damaging substances into the skin.

Compromised skin that has a disrupted skin barrier is more susceptible to:

• Allergy
• Chemical burn
• Dehydration
• Infection
• Inflammation
• Irritation
• Stinging

You can tell if your skin barrier is damaged if your skin is:

• Dull
• Dry
• Itchy
• Rough
• Uncomfortable 20 minutes after washing when no moisturizer is applied
• Feels tight and stiff without moisturizer
• Happiest when you use a heavy moisturizer
• Soothed when oils are applied

There are devices that can measure if the skin barrier is compromised such as a TEWAmeter® and a Corneometer®.

Dermatologists use our skin type quiz to detect a damaged skin barrier.

Detergents and soaps in foaming cleansers destroy the skin barrier by removing lipids from the skin.

Examples of lipids in the skin are cholesterol, ceramides and fatty acids.

Detergents weaken the skin barrier by removing these lipids. They surround the lipids and strip them away from the upper layers of the skin.

Friction and minerals in water can also break the skin's moisture barrier by stripping it of lipids.

Water has a big effects on the skin barrier.

These attributes of water can compromise the skin barrier:

• Exposure time
• Calcium
• Chlorine
• Magnesium
• Salt (sodium chloride)
• Temperature

Learn more about the best type of water to wash your face and body with here.

A damaged moisture barrier leads to dehydration, inflammation and impaired desquamation.

Damaged skin barrier symptoms are:

• Ashy skin
• Bumpy skin
• Dry dehydrated skin
• Dull skin
• Eczema.
• Inflammation
• Itching
• Poor skin texture
• Reactive Skin
• Rough skin
• Stinging
• Uneven skin texture

Signs of a compromised skin barrier are:

• Frequent rashes
• Itching
• Poor light reflection
• Rough texture

• Sensitive skin

  
  

The skin barrier is in the upper layer of the epidermis called the stratum corneum.

The skin barrier is in the outermost layer of the epidermis, called the stratum corneum.

It is a bilayer membrane that surrounds the skin cells, called keratinocytes.

There are multiple layers of the lipid bilayers in between each keratinocyte of the stratum corneum.

The skin barrier is a bilayer of lipids that surround the skin cells in the upper part of the epidermis.

These multilamellar membranes bathe keratinocyte skin cells in protective lipids.

The lipids (fats) that make up the skin barrier are:

• ceramides
• fatty acids
• cholesterol

These lipids line up in bilayer membranes so that their hydrophobic tails (yellow in the illustration) form a center section that repels water. The way the lipid line up determines how strong the barrier is. The strongest barriers show a maltese cross pattern under the microscope.

When lipids are packed together in the tightest way, this prevents the passage of water across the multilamellar membranes.

The lipids that form the bilayer membranes are like puzzle pieces.

They must be the correct size and shape to fit together and eliminate any spaces between them.

You must have a 1:1:1 ratio of lipids.

The skin barrier is made of of 3 main lipids:

• Ceramides
• Fatty acids
• Cholesterol

There are many different kinds of fatty acids, and the type of fatty acid affects barrier strength and function.

Barrier repair moisturizers should:

• Contain the correct 1:1:1 ratio of lipids to repair the skin barrier
• Show a maltese cross pattern when viewed under a cross polarized microscope.
• Have soothing oils
• Have a combination of humectants and occlusive ingredients

Learn more about the lipids in the skin barrier with my interview with a skin barrier scientist on You Tube.

Moisturizers that have the three lipids (ceramides, fatty acids and cholesterol), or that contain barrier repair technologies, will repair the skin barrier.

Click here to learn more about how to repair the skin barrier and find the best barrier repair moisturizers.

The skin barrier components are mostly made by the skin. The lipids in the skin barrier come from:

• Diet- fats and oils in the diet
• Enzymes in the epidermis¹⁵
• Granules in the granular layer of the epidermis
• Sebum
• Moisturizers and other skin care products that contain lipids and oils

The wrong skin care products are the most common cause of a broken skin barrier.

These factors also damage skin barrier integrity:

• Cholesterol-lowering medications like statins¹⁶
• Poor diet leads to fewer nutrients
• Vegan diets low in cholesterol and fat
• Gut microbiome and use of probiotics¹⁷
• Presence of inflammation from disease
• Genetic defects such as a defect in filaggrin gene¹⁸

If you have a damaged skin barrier, avoid these ingredients:

• Alcohol- denatured
• Essential Oils
• Exfoliants
• AHAs (alpha hydroxyacids)
• Acne medications such as benzoyl peroxide
• Retinoids
• Foaming cleansers
• Preservatives
• Fragrances

Retinoids and hydroxyacids initially damage the skin barrier, but once you use them regularly they strengthen the skin barrier. I take this into account when I design your custom skin care routine based on your skin care routine quiz.

Can retinol destroy the skin barrier?

Retinol is a type of retinoid.

When beginning a retinoid, if you develop retinoid dermatitis, your skin barrier can be temporarily damaged.

As you become acclimated to the retinoid, the skin barrier will be repaired. In fact, long term use of retinoids strengthens the skin barrier.

You can avoid retinol damaging your skin barrier by:

• Use a low strength retinoid
• Chose a retinol cream for beginners
• Use the retinol properly
• Use the proper barrier safe cleanser for your Baumann Skin Type
• Match a barrier repair moisturizer to your Baumann Skin Type

Why is the Skin Barrier Important?

Defects of the skin barrier can lead to diseases such as eczema, dermatitis, asthma, and allergies.¹⁹

When skin barrier defects cause inflammation, the risk of inflammatory diseases such as diabetes and heart disease increases.

Using barrier repair moisturizers has been shown to decrease systemic inflammation ²⁰ which should improve general health.

To take a questionnaire to see if your skin barrier is compromised - click here.

The best way to know if you need a barrier repair moisturizer is to take the quiz.  I will tell if you need one of these moisturizers and show you which brands are best for your skin type.

Learn about barrier repair moisturizers at this link or see our favorites here:

Dr. Leslie Baumann MD, FAAD

Dermatologist, Author, Researcher

LeslieBaumannMD.com

Bestselling Author of:

• The Skin Type Solution (Bantam Dell (2006)

• Baumann's Cosmetic Dermatology (McGraw Hill 2002, 2009, 2022)

• Cosmeceuticals and Cosmetic ingredients (McGraw Hill 2015)

References and Research studies about the skin barrier:

1. Baumann L. Ch. 12, 19 and 43 in 3rd edition of Baumann's Cosmetic Dermatology (McGraw Hill 2022)
2. Baumann L. Ch 19, 20 and 21 in Baumann, L. Cosmeceuticals and Cosmetic Ingredients (McGraw Hill 2015)
3. De Paepe, K., Roseeuw, D., & Rogiers, V. (2002). Repair of acetone?and sodium lauryl sulphate?damaged human skin barrier function using topically applied emulsions containing barrier lipids. Journal of the European Academy of Dermatology and Venereology, 16(6), 587-594.
4. Fluhr, J. W., Gloor, M., Lehmann, L., Lazzerini, S., Distante, F., & Berardesca, E. (1999). Glycerol accelerates recovery of barrier function in vivo. ACTA DERMATOVENEREOLOGICA-STOCKHOLM-, 79, 418-421.
5. Umino, Y., Ipponjima, S., & Denda, M. (2019). Modulation of lipid fluidity likely contributes to the fructose/xylitol-induced acceleration of epidermal permeability barrier recovery. Archives of dermatological research, 311(4), 317-324.
6. Katsuta, Y., Iida, T., Inomata, S., & Denda, M. (2005). Unsaturated fatty acids induce calcium influx into keratinocytes and cause abnormal differentiation of epidermis. Journal of investigative dermatology, 124(5), 1008-1013.
7. Denda, M., & Nakatani, M. (2010). Acceleration of permeability barrier recovery by exposure of skin to 10–30 kHz sound. British Journal of Dermatology, 162(3), 503-507.
8. Tsutsumi, M., & Denda, M. (2007). Paradoxical effects of β?estradiol on epidermal permeability barrier homeostasis. British Journal of Dermatology, 157(4), 776-779.
9. Proksch, E., Nissen, H. P., Bremgartner, M., & Urquhart, C. (2005). Bathing in a magnesium?rich Dead Sea salt solution improves skin barrier function, enhances skin hydration, and reduces inflammation in atopic dry skin. International journal of dermatology, 44(2), 151-157.
10. Denda, M., Katagiri, C., Hirao, T., Maruyama, N., & Takahashi, M. (1999). Some magnesium salts and a mixture of magnesium and calcium salts accelerate skin barrier recovery. Archives of dermatological research, 291(10), 560-563.
11. Garg, A., Chren, M. M., Sands, L. P., Matsui, M. S., Marenus, K. D., Feingold, K. R., & Elias, P. M. (2001). Psychological stress perturbs epidermal permeability barrier homeostasis: implications for the pathogenesis of stress-associated skin disorders. Archives of dermatology, 137(1), 53-59.
12. Denda, M., Tsuchiya, T., Shoji, K., & Tanida, M. (2000). Odorant inhalation affects skin barrier homeostasis in mice and humans. British Journal of Dermatology, 142(5), 1007-1010.
13. Denda, M., & Fuziwara, S. (2008). Visible radiation affects epidermal permeability barrier recovery: selective effects of red and blue light. Journal of Investigative Dermatology, 128(5), 1335-1335.
14. Abe, Y., Konno, H., Yoshida, S., Yamauchi, T., Yamasaki, K., Denda, M., & Nishizawa, M. (2019). Red light-promoted skin barrier recovery: Spatiotemporal evaluation by transepidermal potential. Plos one, 14(7), e0219198.
15. Denda, M., Sokabe, T., Fukumi-Tominaga, T., & Tominaga, M. (2007). Effects of skin surface temperature on epidermal permeability barrier homeostasis. Journal of Investigative Dermatology, 127(3), 654-659.
16. Altemus, M., Rao, B., Dhabhar, F. S., Ding, W., & Granstein, R. D. (2001). Stress-induced changes in skin barrier function in healthy women. Journal of Investigative Dermatology, 117(2), 309-317.
17. Pappas, A. (2009). Epidermal surface lipids. Dermato-endocrinology, 1(2), 72-76.
18. Parke, M. A., Perez-Sanchez, A., Zamil, D. H., & Katta, R. (2021). Diet and skin barrier: the role of dietary interventions on skin barrier function. Dermatology practical & conceptual, 11(1).
19. Salem, I., Ramser, A., Isham, N., & Ghannoum, M. A. (2018). The gut microbiome as a major regulator of the gut-skin axis. Frontiers in microbiology, 9, 1459.
20. McGrath, J. A., & Uitto, J. (2008). The filaggrin story: novel insights into skin-barrier function and disease. Trends in molecular medicine, 14(1), 20-27.
21. Sahle, F. F., Gebre-Mariam, T., Dobner, B., Wohlrab, J., & Neubert, R. H. (2015). Skin diseases associated with the depletion of stratum corneum lipids and stratum corneum lipid substitution therapy. Skin pharmacology and physiology, 28(1), 42-55.
22. Ye, L., Mauro, T. M., Dang, E., Wang, G., Hu, L. Z., Yu, C., ... & Man, M. Q. (2019). Topical applications of an emollient reduce circulating pro?inflammatory cytokine levels in chronically aged humans: a pilot clinical study. Journal of the European Academy of Dermatology and Venereology, 33(11), 2197-2201.