All About Moisturizers (When EVERYTHING Breaks You Out)

Having to sift through hundreds of moisturizers on the market can be difficult, so I’m here to help you along your journey in learning everything there is to know about moisturizers for clear skin. 

Beginning a new skincare routine is an incredibly daunting process, especially when you suffer from frequent acne breakouts as well as red, irritated skin that doesn’t seem to react well to anything you put on it. Whether you have oily, acne-prone skin, or dry, flaky skin, you need to include a high quality moisturizer in your routine. 

Why Moisturize?

The skin is very delicate. It is an interconnected network of cells, lipids, ceramides, cholesterol, and much more. These form a barrier to the outside world. There are a multitude of mechanisms the skin uses to protect itself from external stressors, environmental pollutants, harsh products, and abrasive items, such as razors, rough towels, and even your daily cotton pad use. The skin keeps itself functioning by trying to balance its water content and actively repair damage from external stimuli, such as UV rays. Our skin is in a constant state of change, as we change our environments throughout the day.

Now, imagine using harsh cleansers that disrupt the skin barrier, and having the sun’s rays damage the skin’s collagen. Environmental pollutants irritate the skin and cause erythema. Now, on top of all these factors that affect the skin, dismissing the use of a moisturizer will only amplify these negative effects. The skin becomes dry, flaky, in need of hydration and subsequently becomes weaker and susceptible to breakouts, skin diseases, and an overall dull look. 

The Skin Barrier and Moisturization

The stratum corneum is the outer layer of the skin. There must be a suitable amount of water content in the skin to promote desquamation or skin shedding of the dead outer layer skin cells. Without this water content, skin cells begin to build up and contribute to the look of extremely dry and flaky skin (1). In addition, the skin is made up of natural moisturizing factors (NMF) such as lactic acid, amino acids, and urea. They keep the skin smooth and healthy. In order to form the NMF, the skin needs enough water to do so (1). 

In order to maintain this water balance, cue a great moisturizer. Moisturizers can aid in maintaining the water content in the skin.  They can improve the function of the skin barrier and strengthen the skin’s ability to resist weakening in the face of stressors and irritants (1). In persons suffering from skin conditions such as atopic dermatitis (characterized by dry and itchy skin), a moisturizer is an imperative component to their treatment in order to rebuild the impaired skin barrier (1). The use of a good moisturizer can reduce the look of flakes by providing the skin with the hydration it needs. 

Types of Moisturizers

Not all moisturizers are made the same. It is important to look at the ingredients the moisturizer is formulated with in order to decide where in your routine it should go, or even if you want to incorporate that product in your routine or not. Let’s delve into the different kinds of moisturizers on the market.

Emollients

Emollients are substances such as oils and lipids that can be used to treat dry skin conditions as they play a role in maintaining skin smoothness (2). Our skin is made up of layers of lipids, like fatty acids, that contribute to the structural integrity of the stratum corneum. The use of emollient lipids can improve the strength of this layer. For example, emollients have even been shown to prevent infants from suffering from atopic dermatitis, which involves red, itchy, and sensitive skin (3). Compounds such as cholesterol and ceramides are emollients that have a positive effect on the skin, as they are easily absorbed and promote softer skin (4).

Cholesterol

As noted above, proper functioning of the skin’s barrier is essential to the health of your skin. Lipids, including cholesterol, help to make up the skin barrier in the stratum corneum (5). It is essential that this barrier remains intact to protect against external irritants and microbes entering the skin, potentially leading to local or systemic infections. Cholesterol is a waxy substance that plays an important role in the permeability barrier of the skin (5). When the skin is damaged (For example, from the use of harsh cleansers or abrasive items used on the skin), the stratum corneum quickly increases the synthesis of cholesterol to restore the integrity of the skin barrier (5).  

Ceramides

Ceramides play a large role in maintaining the water content of the skin by contributing to the permeability barrier of the stratum corneum (6). Many skin disorders are associated with low ceramide content in the skin. Therefore, proper maintenance of ceramide levels in the skin is imperative to healthy skin functioning. Upon barrier damage, the skin begins to increase the synthesis of ceramides in order to repair the permeability barrier (5). Even after one topical application of a ceramide-containing cream, skin hydration was significantly increased over a 24-hour period (7). 

Humectants

Next is humectants. Humectants are substances that bind to water. Remember, the water content in the skin is incredibly important in maintaining the strength of your skin barrier and keeping the skin healthy. A substance that attracts water and keeps it in the skin is ideal. Humectants include ingredients like glycerin and urea (1). Both of these help the skin barrier to repair itself when affected by environmental stressors. 

Glycerin

Glycerin can be found in almost all lotions, creams, and balms. This ingredient is a wonderful humectant that has been studied extensively and has a good safety profile. It plays a role in protecting the skin against irritants and functions in repairing the skin barrier (8). In addition, it has been shown to effectively increase skin hydration and can even accelerate the healing time of wounds. 

Urea

Urea is another example of an ingredient that supports the skin barrier and increases hydration in the skin (9). It is a safe ingredient that has been shown to be effective in treating atopic dermatitis (10). It is also a great ingredient to incorporate into your routine if you experience dry or flaky skin, as it functions as a keratolytic agent. Keratolytic agents are substances that help to slough off dead skin cells on the outer layer of the skin (10). This process, in turn, helps the skin bind to water.

It is important to note that although humectants are amazing for increasing skin hydration, they are only effective in two situations. For one, if the humidity in your environment is greater than 70%, humectants will draw water out of the air and into your skin. As you may already realize, the humidity in many locations is not greater than 70%. Therefore, humectants will often pull water out of the dermis and epidermis, i.e. draw water out of your skin. Due to this, it is SO important to use an occlusive after you apply a humectant onto the skin.

Occlusives

Occlusives are substances that prevent transepidermal water loss in the skin. It forms a barrier over the stratum corneum to keep hydration in the skin. Examples include certain plant oils like sea-buckthorn oil, and petroleum jelly. Click here to read all about occlusives in skincare. 

Choose Minimal Ingredient Products

I know how difficult it can be to choose a great moisturizer, especially when you suffer from sensitive, acne-prone, red, and/or irritated skin conditions. The first rule of thumb is to choose a minimal ingredient moisturizer. This simply means finding a product that does not have a long list of ingredients. As you become more familiar with your skin, you can expand the list of ingredients that your skin likes. Starting out with a minimal ingredient moisturizer simply reduces your chances of breaking out, because there are less ingredients, as well as a smaller combination of ingredients that could potentially irritate your skin.

Let’s take a prime example of a moisturizer that includes hydrating ingredients, and a minimal ingredient list. Sebamed Clear Face Gel. Here are the ingredients:

Aqua, Aloe barbadensis leaf juice, Propylene Glycol, Glycerin, Sorbitol, Panthenol, Sodium Hyaluronate, Allantoin, Sodium Carbomer, Citric Acid, Sodium Hydroxide, Phenoxyethanol.

With such a short list of ingredients, it is a good choice for a moisturizer. Aloe vera soothes the skin. It also contains glycerin, a great humectant as explained above. Panthenol is a wonderful ingredient for reducing redness, fading post-inflammatory erythema, and increasing skin hydration. Sodium hyaluronate, a derivative of hyaluronic acid, penetrates the skin and increases hydration as well. Make sure to pair this with a good occlusive to get all of the benefits of the humectants within this moisturizer. 

Here is a quick summary of all the pertinent information in this post:

References

(1) Harwood A, Nassereddin A, Krishnamurthy K. Moisturizers. [Updated 2021 Jun 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-.  

(2) Lodén, Marie. (2003). Role of Topical Emollients and Moisturizers in the Treatment of Dry Skin Barrier Disorders. American journal of clinical dermatology. 4. 771-88. 10.2165/00128071-200304110-00005.

(3) Glatz, M. (2018, February 28).  Emollient  use alters skin barrier and microbes in infants at risk for developing atopic dermatitis. PLOS One.

(4) Sethi A, Kaur T, Malhotra SK, Gambhir ML. Moisturizers: The Slippery Road. Indian J Dermatol. 2016 May-Jun;61(3):279-87. doi: 10.4103/0019-5154.182427. PMID: 27293248; PMCID: PMC4885180

(5) Feingold KR. The outer frontier: the importance of lipid metabolism in the skin. J Lipid Res. 2009 Apr;50 Suppl(Suppl):S417-22. doi: 10.1194/jlr.R800039-JLR200. Epub 2008 Oct 31. PMID: 18980941; PMCID: PMC2674689.

(6)  Coderch L, López O, de la Maza A, Parra JL. Ceramides and skin function. Am J Clin Dermatol. 2003;4(2):107-29. doi: 10.2165/00128071-200304020-00004. PMID: 12553851.

(7)  Spada F, Barnes TM, Greive KA. Skin hydration is significantly increased by a cream formulated to mimic the skin’s own natural moisturizing systems. Clin Cosmet Investig Dermatol. 2018 Oct 15;11:491-497. doi: 10.2147/CCID.S177697. PMID: 30410378; PMCID: PMC6197824.

(8) Fluhr JW, Darlenski R, Surber C. Glycerol and the skin: holistic approach to its origin and functions. Br J Dermatol. 2008 Jul;159(1):23-34. doi: 10.1111/j.1365-2133.2008.08643.x. Epub 2008 Jul 1. PMID: 18510666.

(9) Celleno L. Topical urea in skincare: A review. Dermatol Ther. 2018 Nov;31(6):e12690. doi: 10.1111/dth.12690. Epub 2018 Oct 30. PMID: 30378232.

(10) Pan M, Heinecke G, Bernardo S, Tsui C, Levitt J. Urea: a comprehensive review of the clinical literature. Dermatol Online J. 2013 Nov 15;19(11):20392. PMID: 24314769.

 

 

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