Skin Inc. – January 2020
Considering the skin contains around 64% water, why is the cosmetic industry so obsessed with hydration and what does it really mean? Unless you have atopic dermatitis, hyperthyroidism, ichthyosis or at the very least diabetes, dry skin is not the common symptom or even category everyone imagines.
Moisture and Aging
We all start out with dewy, bouncy, young skin, never feeling the urge to slap on a moisturizing cream. After the age of 23 or 25, dead cells no longer self-exfoliate as well as when we were children. Dead cells build up with what I like to call “the redundant cuticle.” These dead cells, which are still attached to the epidermis, are smaller than the living cells underneath. This imparts that tight, dry feeling and leaves the person with the perception of dry skin.
Most people will put a moisturizer on it, and the oils in the product break the dry, tight tension. We might think we are moisturized, but we are just greased.
In fact, the very word moisturizer is a misnomer invented in 1962 to sell and market beauty creams. If properly formulated, creams can be excellent delivery systems for lipid carrying nutrients, but water is not one of them. Creams can maintain hydration levels, but only if the skin is in hydration homeostasis already.
The Importance of the Matrix
The matrix of the skin is that jelly-like fluid, mostly hyaluronic acid, sugars, salts and chondroitin sulfates. Real hydration is when this matrix is thick and bouncy by virtue of intercellular water retention bound by essential fatty acids. As we age, this matrix of the skin gets thinner and thinner. The skin can become chicken-like and crepey.
Hydration must be addressed from both the outside and the inside, as we will discuss below. Approaching the skin from both sides maintains water homeostasis, which kind of “kick-starts” all systems we enjoyed in youth into acting normal again.
Inside. The only way to really address a thinner matrix is consumption of water and taking essential fatty acids orally. Sea buckthorn and evening primrose oil are my choice of essential fatty acids for many reasons.
Outside. The epidermis is another matter, but it must be maintained at the same time. First, we must remove the excess cuticle barrier and this can be done with different forms of enzyme exfoliants or different acids, depending on skin condition, age, sex and ethnicity.
Once this is done, the acid mantle must be reestablished daily by using the proper homecare products that imitate the acid mantle. This is nature’s natural moisturizer and is the replication of the two secretions we are born with: water from the sudoriferous gland and sebum from the sebaceous gland. Together, these secretions blend on the surface of the epidermis and form the biofilm—the acid mantle.
One of the things that confuse skin therapists is the peel craze, a popularity that will not go away. This has been around as long as I have been in this field, which is 50 years. The old-fashioned medical peel with phenol acid and croton oil was the top of the line in the 1950s. I made many serums for plastic surgeons back then. I am embarrassed to confess it now, but at least I tried to slow down what basically was burning the heck out of the epidermis. The resulting erythema and edema of this peel was viewed as a “great result” only to have the real picture pop up a year later. Skin looked fake and waxy with no pigmentation or worse.
The CO2 laser was not much better, instead just vaporizing the heck out of the epidermis.
Alpha hydroxy acids (AHAs) were gentler, but misunderstood at first. They were not “all-natural” fruit sugar acids that were harmless as popularly touted. They are hygroscopic acids that, when applied to dead, dry cells, would pull all available moisture into the cells which swelled up like an over-full balloon, eventually bursting and the fragments detaching from the underlying newer cell epidermis.
Since that time, I have seen bio-peels, green peels, blue peels, microdermabrasion, scrapping skin off with a scalpel and even bird poop peels, whose incredulity outranks fish-nibbling peels. The assumption is that with enough peeling, miracles will happen and voila, new skin!
Gentle peeling such as with AHAs can be effective without causing the trauma associated with aggressive peels, but again, we must realize that once we do this, we have robbed the water bank of the client. Following these procedures, the practitioner must put the hydration back immediately. The “peel” is just a door opener for our real work—removing the redundant cuticle and feeding the new baby cells with the nutrients that they require and recognize.
After gentle peeling, we must add beta glucan into the skin for the Langerhans cells to help with the healing from the peel. Essential fatty acids are also important after a peel, due to the water loss. Lastly, transdermal delivery creams that penetrate the skin are a great way of putting nutrients back into the skin.
We cannot force any ingredient into new revised skin that the cells do not recognize, regardless of how exotic or trendy that ingredient may be. What could happen is either rejection, which gets no result, or contraindications.
Also, keep in mind that a thorough removal system leaves a desert behind—no water, no trees and no bushes.
This is a perfect landscape for Staphylococcus aureus or any other bad bacteria to come in and rule the land— creating all types of dermatitis and other skin anomalies.
The Role of the Microbiome
Eczema, psoriasis or atopic dermatitis are all deficits
in water. To get down into the root of it, the skin’s microbiome must be established immediately. Fortunately, we have our own good and bad bacterial colonies at certain points around the face and body. The trick is to provide a field where a protective biofilm can be formed to maintain the good bacteria and keep the bad guys at bay along with a variety of viruses and parasites
Microbiome research is a growing trend that I am pleased to be in on. It is still the tip of a very large iceberg and a lot of money will be made off hard working therapists that do not bother to research the microbiome.
Establishing a healthy skin microbiome will help regulate the skin. All the problematic skin conditions due to lack of hydration (eczema, psoriasis) will be addressed once you have a healthy microbiome. We can think about as preparing a garden. If the soil is healthy and maintained, then the plant that grows from this healthy soil will be healthy and fruitful.
When the skin condition is serious enough to warrant special microbiome treatment—such as eczema, psoriasis or atopic dermatitis—the products used must have live spores of the good bacteria. This is not easy to do and very costly to do right. I know this from three years researching this viable phenomenon, looking at everything and trying many approaches.
A Skin Journey
Following the paths of logic in biochemistry and biology, usually one can come up with workable formulas and protocols. Remember the body is a complex, organic computer capable of many self-repair modalities if given the right protocol, ingredients and environment. Client compliance with ongoing home treatment is essential to any life-changing result. Your clients must accompany you on the journey to better skin health and regardless of their IQ or education, you as the professional, must educate them along the way.
Danné Montague-King is the founder of DMK Skin Care, which is based on his “remove, rebuild, protect, maintain” concept. He is a known educator, author and presenter.