How to treat compromised or sensitive skin

The Stratum Corneum (SC) is the very outer layer of your skin, this is your body's first defense against the environment, damage from the sun's UV rays, micro-organisms, toxins, and foreign substances.

A compromised skin no longer has the ability to protect and maintain itself, something has damaged the outer layer and the ability to protect, leaving it vulnerable to problems:

1) the skin can no longer hold onto moisture as well, causing dryness, flaking, itching, and redness

2) the skin can’t protect itself as well, making it more vulnerable to environmental toxins, harmful UV rays, bacteria, allergens, and harsh chemical ingredients in personal care products.

It is critical for the health of your skin that the layer is intact. In Part One - What Causes Sensitive skin? we looked at the many factors that affect the health of your skin when your 'barrier' is compromised transepidermal water loss can occur, and your skin can become more susceptible to irritants, allergens, and infections.

The Major Components of your Barrier Function 

PERMEABILITY BARRIER
Consists of the formation of stratum corneum lipids, some antimicrobial peptides, natural moisturizing factor, cornified envelope and the corneocyte-lipid envelope maintenance of water gradient, calcium gradient, acid mantle (acidic pH) and the response of primary pro-inflammatory cytokines to impairment of permeability barrier.

ANTIMICROBIAL BARRIER 
Maintenance of an acidic skin pH decreases skin colonization by pathogenic bacteria and yeastsAntibacterial activity of stratum corneum lipids (e.g., free fatty acids, sphingosine, others)Genetically encoded primary antimicrobial peptides (defensins, cathelicidins, dermcidins) synthesized in SC, present in sebum and in sweat (dermcidin-derived)Multiple agents with antimicrobial activity as an alternative function (some chemokines, some neuropeptides, others)

ANTIOXIDANT BARRIER 
The network of enzymatic and nonenzymatic antioxidant systems to counter oxidative stress antioxidants present in epidermis (stratum corneum, skin surface lipids) and dermisHydrophilic nonenzymatic antioxidants include ascorbic acid (vitamin C) and uric acidMajor lipid-soluble nonenzymatic antioxidant is alpha-tocopherol (vitamin E)Co-antioxidants (ascorbic acid, ubiquinol [coenzyme Q10]) allow tocopherol regenerationGradients in stratum corneum for ascorbic acid and tocopherol (lowest near-surface)Interceptive antioxidant enzymes (catalase, superoxide dismutases, glutathione peroxidases)Antioxidant repair enzymes (e.g., methionine sulfoxide reductase)High concentration of alpha-tocopherol in sebum accounts for high levels in facial sebaceous gland stratum corneum (sebum serves as a physiological delivery pathway)

IMMUNE RESPONSE BARRIER 
Dendritic cells involved in immune surveillance and antigen recognition (e.g., plasmacytoid dendritic cells, myeloid dendritic cells, Langerhans cells)Toll-like receptors involved in recognition of microbial pathogens and other agonistsAntimicrobial peptides and some of their enzymatic conversion products (e.g., LL-37)Innate and acquired immune response pathways and balance with T regulatory cell system

PHOTO-PROTECTION BARRIER Epidermal melanin barrier (degree of protection related to Fitzpatrick skin type) Stratum corneum protein barrier Antioxidants within stratum corneum (protection against photo-oxidative stress) Optical reflective properties of the stratum corneum (stratum corneum thickness more important than epidermal thickness for protection against ultraviolet/solar radiation)

Too much of a good thing

Applying multiple skin care products with different active ingredients can increase the risk of skin irritation - more is not always better, this mindset can lead to a greater chance of interactions between the multiple ingredients within the different products. Acids are a perfect point in case - alpha and beta hydroxy acids namely salicylic acid, glycolic acid, lactic acid, and mandelic acid along with retinoids can be very effective and gentle on the skin (with good formulation) however; if you are incorporating them into your routine in a way they are not intended to be used this can and will cause irritation, including burning, redness, and inflammation you now have a compromised skin barrier with way less function! 

How to treat compromised skin?

1. KEEP IT SIMPLE - Is your skincare routine overcomplicated? with an already compromised skin barrier, this is akin to throwing fuel on the fire! Keep it simple for effective, nurturing skincare. Avoid foaming cleansers, which literally wash away our Natural Moisturising Factor (NMF) along with products with astringents, like alcohol and witch hazel. 

Natural Moisturising Factor (NMF) consists of water-soluble compounds that occur only in the (SC) its role is to make sure that the outer layer of the skin remains hydrated despite the environmental factors it is exposed to.

2. EXFOLIATION - Exfoliation/scrubs/cleansing – if they’re not gentle enough, they can bring up a lot of inflammation for sensitive skin, remember your skin is already struggling, inflamed//irritated fighting off allergens the last thing it now needs is exfoliating resulting in stripping away already depleted lipids. A simple face washer (flannel) is sufficient to cleanse along with your chosen face oil/balm, the face washer will very gently exfoliate as you removed the face cleanser.

Use an oil cleanser or balm for your face and always choose a body wash, soap or cleanser that has a pH between 4.5–6.5 (similar to the normal pH of the skin) Remember too that shampoo is a foaming product i.e. it will contain a surfactant, and this will in a shower run down onto your face and body. 
Oil Facial Cleansers or balms - clean without stripping away the skins microbiome or the skins protective Acid Mantle Barrier.
Cleanse your face with tepid water - hot water will only strip the skin, showers and baths should not be overly hot in general. Try to not itch, too, as this will damage the skin’s surface further.

3. RETINOL - Retinoids can be too harsh for the sensitive types or if you have rosacea, acne, or psoriasis, so much can depend on how a product has been  While you are dealing with sensitive skin Rosehip Seed Oil is an excellent source of trans-retinoic acid (Vitamin A) that may not have the risk of potential irritation that retinoic acid might cause. Once you have calmed down your skin inflammation and improved your skin barrier function, you may be able to tolerate lower-strength retinol.

You can use a plant-based alternative to Retinol, Tanu - Cell Affinity Coactive Serum was developed exactly for this reason, my skin cannot tolerate Retinol, I do not like it and I don't think the long term use is beneficial to skin health - my blog my opinion! This Serum offers the same benefits as Retinol without skin sensitivity and or photo-sensitivity (backed with clinical trials). It is gentle enough to use both AM and PM and safe while pregnant and nursing.

4. ACIDS  - Active acids Hydroxy Acids are naturally occurring organic acids that promote exfoliation, therefore, accelerate the turnover of skin cells.

AHA (Alpha-Hydroxy Acid) and BHA (Beta-Hydroxy Acid) should be avoided as these remove the top layers of skin, we want to protect and build not strip away or remove.

Tanu has been formulated to incorporate Willow Bark Extract, this has long been used to soothe irritated skin. Containing salicin — from which salicylic acid is derived Willow Bark offers anti-inflammatory and antibacterial properties while clearing pores and alleviating acne and irritation. High in tannins, phenolic acids, flavonoids, and numerous minerals, synergistically helping to soothe the skin and aid in cell regeneration.

5. PROTECT THE ACID MANTLE - PH MATTERS - The Acid Mantle is an invisible viscous fluid known as hydro-lipid film, it maintains and protects the overall health of skin and hair and is slightly acidic — It comprises:

  • Sebum is secreted by our sebaceous glands and this oily substance is our skin's own moisturizer.
  • A salty watery mixture is secreted by our sweat glands 
  • Skins' microbiome secretions 

These together form the Acid Mantle and have a pH level ranging from 4–6. pH is a measurement of acidity. A neutral pH is 7, anything above that creates an ALKALINE environment, and anything below creates an ACID environment.

Use a Toner - that does not contain potentially irritating astringents like Witch Hazel and alcohol [ethyl or denatured alcohols, which are damaging to the skin. Choose a water-based toner or hydrosol that is both gentle, hydrating and will rebalance the pH of your skin after cleansing.

6. HYDRATE  - Hydrators are ingredients also known as humectants, some examples include glycerin or hyaluronic acid, that absorbs water from the atmosphere or your skin and hold it in place on your skin.

6. MOISTURISE - your skin with Emollients (oils and butters) these help increase the rate of barrier repair as they contain lipids similar to those found naturally in our skin. Jojoba Oil is an excellent example of an emollient.

Occlusives help to form a barrier over the top of the skin increasing moisture levels and help prevent epidermal water loss. Avocado Oil has excellent occlusive properties. Choosing a moisturizer with linoleic acid, an omega 6 fatty acid helps repair barrier function and is an effective moisturizing agent. Omega 6 is an essential fatty acid that we can’t manufacture ourselves, so we must obtain it through diet and/or topical application.

7. SPF PROTECTION - Sun exposure really increases inflammation in the skin, (remember sitting by a window you are still exposed to UV light). Wear sunscreens - zinc-based ones offer good anti-inflammatory properties, also look also for antioxidants to ensure protection from other environmental stressors. 

8. KNOW THE RIGHT INGREDIENTS - Get into the habit of reading all the labels of any product that goes onto your skin. As always with sensitive skin issues, reading the labels of your products is a must to make sure you’re getting the building blocks you need to build the skin's barrier.

Protecting against free radical damage can help maintain a strong skin barrier, so look for antioxidants in your products. Along with lipids you need good antioxidants and anti-inflammatories - vitamins A, C, D + E

Fatty Acids - Botanical seed oils contain bioactive lips called essential fatty acids (EFA) these play an important role in supporting skin barrier function along with additional skincare benefits of anti-inflammatory and anti-irritancy properties. 

The goal is to the replenishment of the stratum corneum intercellular lipid membrane, how do we do this? by using formulations that contain lipids - ceramides, ceramide precursors, fatty acids and niacinamide can all assist in skin barrier repair.

 9. YOU ARE WHAT YOU EAT AND  DRINK - The healthier you are generally, the better your skin will be. Simple carbohydrates, like refined sugar, white bread, and soda, cause your insulin levels to spike, which leads to inflammation throughout the body, it is wise to cut them from your diet. Omega-rich foods such as wild-caught cold-water fish, flaxseed, and walnuts contain essential fatty acids (EFA) that are required for the absorption of fat-soluble vitamins A, D, E, and K.

On a personal note, my recovery from Chronic Fatigue Syndrome (CFS) and adrenal fatigue all went back to my gut health or in my case the lack of a healthy gut. I removed all grains, dairy, and anything processed, over a few months my incredibly reactive skin normalized. Monthly female related monthly hormone imbalances since creating Tanu have gone! now I just deal with environmental challenges from the wind, sun, sea, heat ect. My skin is still sensitive or reactive and I am very aware of what goes onto my body (and into it).  

Drink Kombucha - this is a fermented tea that encourages the growth of beneficial bacteria in the gut and helps to keep the skin clear. Encouraging the removal of heavy metals and toxins from your body thus keeping the skin clear (avoiding breakouts). Kombucha is successfully been used for the treatment of eczema, acne, and psoriasis. 

10. DE-STRESS - When you are stressed skin tends to break out more, this is due to the increase in the stress hormone cortisol, which signals glads to produce more oil, oily skin is more prone to acne and other skin issues. Stress aggravates psoriasis, rosacea, and eczema and can cause hives and rashes. At this point in time, we are even more stressed and anxious and it is incredibly important to not let this get on top of you read my blog post Immunity Service detailing 4 Acts of Self of Care you can do daily to help with stress and your immune function.

CONCLUSION: Take a good hard look at what you are applying to your skin, along with the number of different products you have included in your daily routine. Repair and build up your skin's barrier with 'Barrier repair agents'. 

This is my simple but effective daily routine:

Morning 

  • Cleansing Balm to freshen-up using warm water and face washer (gentle exfoliation)
  • Hydration Serum - Gloopy
  • Tanu - Moisturise
  • Protect - SPF (if required)
Evening
  • Cleansing Balm to remove my minimal if any at all makeup and pollution using warm water and face washer (gentle exfoliation)
  • Face Mist/essence - To tone and add moisture and botanical benefits prep skin ready for...
  • Hydration + Moisture - I mix Gloopy with Tanu into a microemulsion
  • Treat - Sleep Mask to add and help retain skin hydration 
  • Treat - Dry Powdered Face Mask once per week to gently exfoliate and add antioxidants.

Be very aware of what you are eating and drinking - ask yourself is this helpful or harmful (to my health/skin) be patient changes take time and remember to be kind to yourself. It’s always a good idea to test a tiny amount of a product that you have not used before on the skin on the inside of your forearm before you spread it all over your face/body. Leave just a small amount of the product on your arm for eight hours. If there are no visible skin reactions on your arm, then it is likely to be safe for use on your face and or body. Do this every time you switch brands and products.

until next time..

be human, be kind, be you 



 

 

 

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