Understanding and Repairing a Damaged Skin Barrier: A Comprehensive Guide

When we think of skin, we often imagine a radiant, glowing complexion. However, a damaged skin barrier can quickly turn this dream into a nightmare, making your skin dull and hard to manage.

As a physician specializing in natural skincare, I've not only researched the intricacies of a healthy skin barrier but have also personally experienced the hardships of skin sensitivities. In this guide, you'll benefit from both my professional insights and personal journey to repair and maintain a healthy skin barrier.

Keep reading to learn about the skin barrier and its functions, how to know if you have skin barrier damage, and how to figure out the cause. We'll give you a step-by-step plan for skin barrier repair, plus strategies to keep it healthy.

What is the Skin Barrier

What exactly is the skin barrier? Imagine it as a wall - keeping the good things in and the bad things out.

The skin barrier is a watertight membrane that holds vital water inside, that's why it's also called the moisture barrier. It's a protective shield that keeps harmful elements like bacteria, allergens, and pollution out.

When you have a healthy barrier, your skin feels plump, soft, and supple. If these outer layers become damaged, the skin becomes dry and dull. It loses vital substances like ceramides and cholesterol. This causes water loss and the skin becomes susceptible to external damage.

It is not surprising that a damaged skin barrier makes it difficult to repair post-breakout and aging signs.

The Epidermis Under A Microscope

The skin has 3 major layers: epidermis, dermis, and subcutaneous. However, the epidermis itself actually has about 5 different layers of cells, each with different functions. 

The most important part of the epidermis to understand is the stratum corneum, which is the outermost layer and is made up of 10-30 thin layers of dead keratinocytes that are constantly shedding. The pH of the stratum corneum is slightly acidic (PH 4-5.5) which helps prevent bacterial growth, and that's why it's also often referred to as the acid mantle.

When a skin cell, called keratinocyte, enters the stratum corneum, it takes about 2 weeks to work it's way up from the bottom until it is is finally shed. That's what is called cell turnover. It takes approximately 6 weeks for the entire stratum corneum to have cycled through from formation to shedding.

Functions of a Healthy Moisture Barrier

The way the epidermis performs these functions is due to its structure. The external layer is primarily dead skin cells with a lipid matrix (oils) surrounding them. Think of your cells as bricks of a wall with the lipids acting like mortar.

For the skin barrier to work correctly, it is essential that the lipids in this matrix, such as ceramides and fatty acids, are balanced in a particular proportion.

This construction works well to maintain hydration and keep bacteria, pollutants, and allergens out when the skin barrier is intact.  When water is lost, so too is elasticity. The skin will look rough, dry, and flaky.  

Five Essential Skin Barrier Functions

The skin barrier function comes from the cumulative effect of multiple processes from skin cells.

1. Permeability: the specific ratio of lipids and natural moisturizing factors prevent water from leaving the skin.
2. Antimicrobial: pH and different proteins present within the sebum have antimicrobial activity. The pH of the skin is slightly acidic (between 4-6). This acid mantle creates a layer of protection against bacterial and fungal growth. The microbiome is also essential to maintain the balance between good and bad bacteria.
3. Antioxidant: natural antioxidants as well as enzymes and high concentrations of tocopherol in the sebum work to prevent or repair oxidative damage.
4. Immunity: immune cells produced in the epidermis as well as the antimicrobial effects described above.
5. Photoprotection: natural antioxidants, reflective properties, melanin.

How to Know if You Have Skin Barrier Damage?

It can be tricky to recognize sometimes and many people initially write off their skin as just being 'dry' or 'acne-prone'. In fact, this may be barrier damage and quite fixable. When your barrier is damaged, skin conditions, such as breakouts and allergies, become more severe.

Most Common Damaged Skin Barrier Signs and Symptoms

The signs and symptoms of a broken barrier often start out subtle and worsen over time.

• Dryness and dehydration
• Redness
• Increased sensitivity
• Burning or stinging 
• Itchy skin
• Flaking or peeling
• Dull appearance 
• Hyperpigmentation
• Skin infections
• Acne breakouts
• Incomplete or slow wound healing

Dullness or Dryness: Trans-epidermal water losses increases which leaves your skin dry, tight, scaly, and/or flaky. 

Redness and Inflammation:  Cracks in the skin barrier permit allergens and irritants to get through, which can cause an inflammatory reaction.

Sensitivity and Allergies:  Although sensitive skin is often genetic, external factors make it more sensitive. You can become sensitized to an ingredient that hasn't caused you problems in the past. This is because the ingredients proteins act as an allergen if it crosses your damaged barrier. 

Acne Flare-Ups: Bacteria that cause acne can penetrate more quickly to the skin. In addition, benzoyl peroxide and other traditional acne-fighting agents can dry out the skin, leading to further damage, resulting in an unfortunate cycle. Incorrectly, acne has been viewed as a sign of poor hygiene. This led to people over-washing their faces to get rid of the pimples. Damaged skin barrier and acne go hand-in-hand - repair the skin barrier and the acne improves too. 

What Are The Causes of a Damaged Barrier

There are both non-modifiable and modifiable causes of moisture barrier damage. Thankfully, so many of the underlying causes can be fixed or avoided!

Non-Modifiable Causes of a Compromised Skin Barrier: 

• Genetics can make you prone to eczema or atopic dermatitis which prevents the skin from functioning correctly and leaves it vulnerable.

• Aging is another factor you can't control. Your ability to produce oil decreases with age. It is more difficult to replenish the lipids necessary for the integrity of the skin barrier. 

External Causes of Barrier Damage That Can Be Modified and Avoided:

• Pollution and wind
• UV radiation
• Washing too frequently
• Washing with soaps that strip the natural lipids
• Cleaning with water that's too hot
• Over-exfoliation with acids that are too strong or too frequent
• Over-exfoliation with abrasives
• The new addition of retinol (retinol ruined my skin every time I tried it)
• Other cosmetic chemicals that are known irritants (ie. tea tree oil, ascorbic acid)
• Smoking
• Other health-related factors: sleep, nutrition, stress

How to Repair Skin Barrier Damage

The skin barrier won't repair itself unless you take some steps to help it. Thankfully, the steps are usually easy.

You may need some skin barrier repair products, but usually you can restore and heal your barrier with time, patience, and some simple changes to your routine. If you've caught things early, a simple moisturizing cream might be all you need for skin repair.

Should I Stop My Skincare Routine?

No!

You need to fully examine what you've been doing. The amount you need to change, and how long you need to change it, depends on how severe the damage is. You might need to cut out a considerable portion of your routine, at least temporarily.

Think of it more like starting a sensitive skincare routine for your healing phase.

Crucial Steps to Skin Barrier Repair

We go into a lot more detail in our free e-book and step-by-step guide, but here are some very important key principles to get you started repairing your skin and lipid barrier.

• Strip your routine down to the most gentle essentials and wait to see signs of recovery before adding anything new. If you're changing something, you need to give it time before deciding whether to change it again. For example, if you've newly started something like retinol or an alpha hydroxy acid, you may need to stop, heal, then restart at a lower concentration or frequency.

• Assess your skincare routine and determine if your skin requires a break. This is where your skin type plays a significant role: If you have oily or combination skin, it might be okay to cleanse twice a day. If you have dry skin, it might be a good idea to cleanse your skin only at night and use plain water the rest of the time.

• Make sure you choose the right cleanser. A cream cleanser is more gentle on the skin than a foam. When it comes to cleansing, the pH balance of the products you use is also important.

• If your barrier is damaged, temporarily stopping all exfoliation is important. Most people only need to exfoliate once or twice a week, so restart gradually after you’ve finished healing. Physical exfoliants can be more gentle if you opt for something like a konjac sponge or bamboo powder. Even though flaky skin is what you want to exfoliate away, flakiness is one of the symptoms of a damaged barrier so it might actually get worse and worse the more you try to exfoliate it.

• Check the strength and type of active ingredients in your products. Glycolic acid 8% is obviously stronger than 3%. Better yet, consider lactic acid as a gentler chemical exfoliant. Also consider the group called PHAs (polyhydroxy acid) because they still exfoliate, while being gentle and hydrating.

• Retinoids are a huge problem for some people. As a physician, I understand why it's an amazing ingredient, but retinol ruins my skin no matter what I try - so alternative routines are important for many of us.

• Always moisturize. Even if you have oily skin, moisturizers should be a regular part of your skin care routine. Be sure to hydrate and moisturize properly to get the most out of your products - especially in dry climates.

• Sunscreen is critical, as UV exposure can cause free radical activity on your skin, which is damaging. Sun exposure is one of the modifiable causes barrier damage, so never skip this product step.

How Long Does it Take For Damaged Skin to Heal?

How long it takes to heal a damaged moisture barrier depends on the severity of the damage and the approach you take.

In general, healing barrier damage ranges in the order of 2-6 weeks and most people can expect to see significant improvement in the 3-4 week range.

Can Your Skin Barrier be Permanently Damaged?

Most skin barrier damage can be repaired. It's not usually permanent damage.

The skin barrier can rarely be permanently damaged, though this is usually related to an underlying medical condition. Even in the case of a permanent condition, simple steps and products will provide improvements. Some people do need prescription therapies like hydrocortisone cream. Be sure to see your doctor or dermatologist if you are worried.

Key Ingredients Needed for Skin Barrier Repair

No need to feel overwhelmed, stick to the basics. You don't have to run out and buy an entirely new skin care routine.

Some of the best skin barrier repair ingredients are found in the simplest formulas. Of course you can buy a specific barrier repair moisturizer or ceramide barrier serum, but skin moisture can be restored easily with simple products - you don't need an elaborate treatment.

Humectants

These molecules offset trans-epidermal loss of water that may occur when your skin barrier becomes broken. Humectants are substances that bind water and maintain skin hydration.

Examples include glycerin, hyaluronic acid, beta glucan, and natural sugars like sorbitol or erythritol. 

Humectants are most effective when used in combination with emollients because humectants pull moisture into the skin and emollients seal it in.

Emollients

Emollients contain lipids that can coat the skin (sealing off to prevent water loss) and help repair the barrier itself (think: patching the mortar holding bricks together). 

Oils and butters make skin soft and smooth. They integrate with the epidermis' lipid matrix and fill in any gaps. This is one of the main reasons we love face oil so much. Face oils have a role for all skin types and can be an integral component of any barrier healing regimen. This article about the best oils for sensitive and irritated skin is a good place to start. 

Ceramides

Ceramides are an essential part of your skin barrier. Your own skin lipid layer contains up to 50% ceramides - lipids and fatty acids that make a healthy matrix. In cosmetics, they are generally skin-identical synthetically produced or derived from plants. A loss of your own natural ceramides (as you age) results in thinning of the skin, loss of elasticity, and sagging.

Using barrier repair products that contain ceramides will go a long way to improving the lipid matrix and restoring your healthy skin barrier functions.

Antioxidants

Antioxidants are the second-line defense against environmental aggressors such as UV exposure and pollution. In addition, they work to protectively shield your skin and repair it once damage is done. You can find antioxidants such as vitamins E, B3, and C in a wide range of skincare products.

Actives

Active botanical ingredients can be incredibly soothing and healing for a broken skin barrier.

The key is to start slow and stick with ingredients that are known to be anti-irritants. This doesn't guarantee they'll work for you, but the chances of them helping is much higher.

Two good active botanical actives to look for skin soothing effects are allantoin and bisabolol. Bisabolol is excellent because it's oil solubility and ability to penetrate the skin layers - it is an anti-inflammatory and anti-irritant and has many benefits for compromised skin. Better penetration is one of the benefits to using waterless products and oil-soluble active ingredients.

bareLUXE includes bisabolol as well as extracts of aloe, calendula, and chamomile in our nourishing and gentle skin barrier oil serum - an award-winning, dermatologist tested face oil for sensitive skin.

There are some additional treatments, such as growth factors, worth exploring. However, this increases the complexity and the costs - and usually the simple approach is all you need.

Common Mistakes to Avoid

Over-cleansing and over-exfoliating are the two most common culprits. You can tell if your skin feels tight or squeaky clean after rinsing. Irritation is often caused by over-doing it in the cleansing department.

Although chemical exfoliants are great at removing dead skin cells, they can also damage your barrier. Mechanical exfoliants like scrubs and other abrasives can cause tears on the skin. Signs of over-exfoliation include burning, redness, and peeling. Typically, over-exfoliated skin might start out looking super-smooth, but that gives way to dry patches or rashes.

If you're prone to allergies or sensitive skin, there is a whole list of ingredients that are likely on your 'bad list' for triggering reactions. 

The indoor environment around you also plays a role in the health of your skin. Indoor factors like air conditioning and heating and humidity all contribute. 

The outdoor environment is also involved. Sunlight, UV rays, and pollution can harm the integrity of the skin barrier. Free radicals are unstable molecules that will damage cells, lipids and DNA, as well as accelerate the aging process. And don’t forget the harsh winter cold and wind that some of us are faced with every year. 

What Should Healthy Skin Look Like? 

A healthy skin barrier is key to radiant skin and achieving a healthy glow.  Healthy, hydrated skin is smooth, plump, and radiant. When it comes to products, often less is more! Simplicity is at the heart of our products - explore our skin barrier repair oil serum now.

Have Realistic Expectations

Being kind to yourself means realizing what normal skin looks like.

Healthy and normal skin does not mean flawless or pore-free. It is essential to treat your skin with respect and not strip it of its natural pigment and pores. Glass skin is not possible.

There is nothing wrong with seeking to improve the appearance of your skin, but the quest can go too far and do more damage if your expectations are not set for a realistic result.

Treat Inflammation

If you have significant inflammation or acne, be sure to consult a dermatologist or your primary care physician. Conditions like rosacea, eczema, and acne all have medical therapies that are very effective. Once your underlying condition has been managed, you will often tolerate a wider variety of products. For sensitive skin, however, it is better to use less, especially fragrances. Chronic inflammation accelerates aging - inflammaging. 

Take Care of Yourself

Your skin is the largest organ of your body, but the truth is that it is an integral part of your entire body. Your overall health and skin health will be affected by what you eat and how well you sleep.

The lines between self-care, skincare and beauty care have blurred. Don’t underestimate the importance of a balanced diet, good hydration, high quality sleep, and stress reduction activities. 

Frequently Asked Questions

Why is the skin's pH level important?

The skin's pH level plays a crucial role in maintaining a healthy skin barrier. A balanced pH (typically around 5.5) ensures optimal functioning of enzymes and proteins vital for skin health and defense against pathogens.

Can diet impact the health of my skin barrier?

Absolutely. A balanced diet rich in omega-3 fatty acids, antioxidants, and vitamins can support skin health. Conversely, excessive alcohol, sugar, or processed foods might weaken the skin barrier.

Is there a difference between dry skin and a damaged skin barrier?

Yes. While both can feel tight or flaky, a damaged skin barrier often results in heightened sensitivity, redness, and itchiness. Dry skin might simply need hydration, while a damaged barrier requires targeted repair.

How often should I exfoliate my skin?

It depends on your skin type and the exfoliation method. Generally, 1-3 times a week is recommended for chemical exfoliants, while physical exfoliants might be less frequent. Over-exfoliation can harm the skin barrier.

Are there any lifestyle changes I can make to support my skin barrier?

Certainly! Drinking ample water, managing stress, getting regular sleep, and avoiding smoking can all positively impact your skin barrier's health.

Does the skin barrier change with age?

Yes. As we age, production of essential lipids and natural moisturizing factors can decrease, potentially weakening the barrier and leading to drier skin. The quality and quantity of our own natural substances like hyaluronic acid and collagen decreases.

How do different climates affect the skin barrier?

Extreme climates can challenge our skin. Cold, dry air can strip away moisture, while excessive humidity might lead to increased oil production. It's vital to adjust your skincare routine based on the climate.

How can I strengthen my barrier if it’s already healthy?

Your barrier doesn’t have to be damaged to use the key advice from this article. Preventing damage is the best thing overall. Have a consistent skincare routine targeting a gentle approach, add new actives or potential irritants very gradually, keep your lipids replenished, and sunscreen! Purchasing a face oil is a great start to barrier strengthening.

Final Thoughts

Your skin barrier is your best friend. It's the key to glowing radiance and soft, smooth skin. It protects you from the bad stuff in the world and holds onto valuable, essential water.

Unfortunately, our skin barrier is affected by our external environment and skincare routines. The new wave of skin-barrier-friendly skincare products is an opportunity for a skincare reset, with a new focus on curating an available, gentle, effective, and enjoyable routine. 

References:

1. Rosso JD, Zeichner J, Alexis A, Cohen D, Berson D. Understanding the Epidermal Barrier in Healthy and Compromised Skin: Clinically Relevant Information for the Dermatology Practitioner: Proceedings of an Expert Panel Roundtable Meeting. J Clin Aesthet Dermatol. 2016;9(4 Suppl 1):S2-S8. 
2. Elias PM. Skin barrier function. Curr Allergy Asthma Rep. 2008;8(4):299-305. 
3. Kanwar AJ. Skin barrier function. Indian J Med Res. 2018;147(1):117-118. 
4. Jensen JM, Proksch E. The skin's barrier. G Ital Dermatol Venereol. 2009 Dec;144(6):689-700.
5. Wu Y, Wangari-Olivero J, Zhen Y. ARTICLE: Compromised Skin Barrier and Sensitive Skin in Diverse Populations. J Drugs Dermatol. 2021 Apr 1;20(4):s17-s22.
6. Lin TK, Zhong L, Santiago JL. Anti-Inflammatory and Skin Barrier Repair Effects of Topical Application of Some Plant Oils. Int J Mol Sci. 2017 Dec 27;19(1):70. 
7. Lefèvre-Utile A, Braun C, Haftek M, Aubin F. Five Functional Aspects of the Epidermal Barrier. Int J Mol Sci. 2021 Oct 28;22(21):11676. 
8. Parke MA, Perez-Sanchez A, Zamil DH, Katta R. Diet and Skin Barrier: The Role of Dietary Interventions on Skin Barrier Function. Dermatol Pract Concept. 2021 Jan 29;11(1):e2021132. 
9. Lee AY. Molecular Mechanism of Epidermal Barrier Dysfunction as Primary Abnormalities. Int J Mol Sci. 2020 Feb 11;21(4):1194. 
10. Thiboutot D, Del Rosso JQ. Acne Vulgaris and the Epidermal Barrier: Is Acne Vulgaris Associated with Inherent Epidermal Abnormalities that Cause Impairment of Barrier Functions? Do Any Topical Acne Therapies Alter the Structural and/or Functional Integrity of the Epidermal Barrier? J Clin Aesthet Dermatol. 2013 Feb;6(2):18-24. 
11. Haftek M, Roy DC, Liao IC. ARTICLE: Evolution of Skin Barrier Science for Healthy and Compromised Skin. J Drugs Dermatol. 2021 Apr 1;20(4):s3-s9. 
12. Del Rosso JQ. Repair and maintenance of the epidermal barrier in patients diagnosed with atopic dermatitis: an evaluation of the components of a body wash-moisturizer skin care regimen directed at management of atopic skin. J Clin Aesthet Dermatol. 2011 Jun;4(6):45-55. 
13. Yang G, Seok JK, Kang HC, Cho YY, Lee HS, Lee JY. Skin Barrier Abnormalities and Immune Dysfunction in Atopic Dermatitis. Int J Mol Sci. 2020 Apr 20;21(8):2867. 
14. van Smeden J, Bouwstra JA. Stratum Corneum Lipids: Their Role for the Skin Barrier Function in Healthy Subjects and Atopic Dermatitis Patients. Curr Probl Dermatol. 2016;49:8-26.