How To Repair Your Skin Barrier! | Dr. Shereene Idriss

Summary

In this episode of Pillow Talk Derby Academy, dermatologist Dr. Shireen Idris discusses the importance of skin barrier health. She explains the skin's structure, likening it to a pizza, and emphasizes the role of the skin barrier in protecting against environmental aggressors. Dr. Idris highlights common causes of skin barrier damage, such as stress, weather changes, and over-exfoliation, and offers tips for repair, including simplifying skincare routines and using gentle, hydrating products. She concludes with practical advice for maintaining healthy skin, especially hands, amidst frequent washing.

Takeaways

• 🧬 The skin is the largest organ of the human body and is crucial for overall health.
• 🛡️ The skin barrier is essential for protecting the body from environmental aggressors like toxins and pathogens.
• 🍕 The skin is composed of three main layers: the epidermis (top layer), dermis (middle layer), and subcutaneous tissue (bottom layer).
• 🧱 The skin barrier consists of corneocytes (skin cells) held together by a lipid matrix made of cholesterol, fatty acids, and ceramides.
• 🚨 Signs of an impaired skin barrier include redness, flaking, irritability, itchiness, pain, and burning sensations.
• 🌡️ External factors like extreme weather, allergens, and irritants can damage the skin barrier, as can over-exfoliation and the use of harsh soaps.
• 💧 The skin's acid mantle, a slightly acidic pH, helps to fend off infections and maintain skin health.
• 🧴 To repair the skin barrier, simplify skincare routines, focusing on nourishing and hydrating the skin without over-exfoliating.
• 🛑 Avoid harsh products and ingredients, especially when the skin barrier is compromised, to prevent further irritation.
• 🌱 Consider using gentler exfoliants and occlusives to help restore the skin's lipid barrier and lock in hydration.
• 🌿 Lifestyle adjustments, such as using a humidifier in dry environments, can also support skin barrier health.

Q & A

What is the main topic discussed by Dr. Shireen Idris in the video?

The main topic discussed is skin barrier health, its importance, and how to maintain and repair it.

Why is the skin considered the largest and most important organ according to Dr. Idris?

The skin is considered the largest and most important organ because it serves as a protective barrier, and without it, the body would be vulnerable to dehydration and other health issues.

What are the three main components of the skin as simplified by Dr. Idris?

The three main components of the skin are the epidermis (the topmost layer), the dermis (the middle layer), and the subcutaneous tissue (the bottom layer).

What is the role of the stratum corneum in the skin?

The stratum corneum is the most upper part of the skin, consisting of corneocytes (skin cells) held together by a lipid matrix, which forms the skin barrier.

What are the main ingredients of the lipid matrix that holds the skin cells together?

The lipid matrix is made up of cholesterol, fatty acids, and ceramides, which act like the cement that holds the cells together.

What happens when the skin barrier is disrupted or impaired?

When the skin barrier is disrupted, the skin becomes more susceptible to aggressors such as environmental toxins, pollution, and pathogens, leading to inflammation, redness, irritation, and other negative symptoms.

What are some of the root causes of a damaged skin barrier according to the video?

Root causes of a damaged skin barrier include intrinsic factors like psychological distress and certain medical conditions, as well as extrinsic factors like extreme weather variations, allergens, irritants, over exfoliating, and the use of harsh soaps or topical steroids.

Why is the skin's acid mantle important for maintaining skin health?

The skin's acid mantle is important because it helps to kill bacteria, viruses, and fungi, warding off infections and maintaining a healthy skin environment.

What is the first step Dr. Idris recommends to repair a disrupted skin barrier?

The first step is to simplify the skincare routine by focusing on one pressing skin issue at a time and using products that are nourishing and calming.

What is the role of occlusives and humectants in repairing the skin barrier?

Occlusives like petrolatum and lanolin lock in hydration, while humectants like glycerin and urea attract and retain moisture, both of which are essential in repairing and maintaining the skin barrier.

How can lifestyle changes help improve skin barrier health?

Lifestyle changes such as investing in a humidifier for dry environments, using less moisturizer in humid environments, and protecting hands with gloves and glycerin-based creams can help improve skin barrier health.

Outlines

00:00

🛡️ Skin Barrier Health Basics

Dr. Shreen Idris starts the video by introducing the topic of skin barrier health, emphasizing its importance as the body's largest organ and a crucial protective layer. She explains the skin's structure, including the epidermis, dermis, and subcutaneous tissue, and delves into the components of the stratum corneum, which includes corneocytes and the lipid matrix that holds them together. The doctor highlights the role of ceramides, fatty acids, and cholesterol in maintaining skin integrity. She also discusses the consequences of a disrupted skin barrier, such as inflammation, irritation, and increased vulnerability to environmental aggressors.

05:03

🌪️ Causes of Skin Barrier Disruption

The second paragraph delves into the factors that can damage the skin barrier. Dr. Idris mentions intrinsic factors like psychological stress and certain medical conditions, but focuses on extrinsic causes such as extreme weather variations, allergens, irritants, and over-exfoliation. She criticizes the overuse of exfoliating acids and the use of alkaline soaps that disrupt the skin's natural pH balance. The doctor also warns against the overuse of topical steroids, which can weaken the skin barrier over time. She emphasizes the importance of the skin's acid mantle in fighting off infections and the need to maintain this pH balance for healthy skin.

10:03

🧴 Repairing and Protecting the Skin Barrier

In this segment, Dr. Idris offers advice on how to repair and protect the skin barrier. She suggests simplifying skincare routines and focusing on one pressing skin issue at a time. The doctor recommends using hydrating cleansers that are close to the skin's natural pH and avoiding harsh exfoliants when the skin is inflamed. She advises taking a break from exfoliating and, upon resuming, to opt for gentler acids. Dr. Idris also discusses the use of occlusives like petrolatum and lanoline to lock in hydration and the importance of using products without essential oils when the skin barrier is compromised.

15:06

💧 Enhancing Skin Barrier Health with Humectants and Lifestyle

The final paragraph discusses the use of humectants and occlusives to enhance skin barrier health. Dr. Idris recommends products like La Roche-Posay Cicaplast B5 and Aveeno's Nourishing Cleanser for sensitive skin. She also mentions the importance of using rich emollients and Triple Lipid Restore by Skinceuticals, which contains ceramides, cholesterol, and fatty acids. The doctor advises on the care of hands and feet, especially due to frequent hand washing, and suggests using glycerin-based hand creams and wearing latex-free gloves for better absorption. She wraps up with lifestyle tips, such as investing in a humidifier to maintain the right balance of moisture in the environment, which is essential for skin health.

Keywords

💡Skin Barrier

The skin barrier refers to the outermost layer of the skin, which acts as a protective shield against environmental factors and pathogens. In the video, Dr. Shireen emphasizes its importance as the body's first line of defense, preventing dehydration and maintaining overall skin health. The skin barrier is composed of the stratum corneum and lipid matrix, which includes corneocytes (skin cells), ceramides, cholesterol, and fatty acids.

💡Dermatologist

A dermatologist is a medical professional specializing in skin health, diseases, and conditions. Dr. Shireen, the speaker, is a dermatologist, and her professional perspective influences the content of the video, providing an authoritative voice on the topic of skin barrier health.

💡Stratum Corneum

The stratum corneum is the uppermost layer of the epidermis, often likened to the 'cheese of the pizza' in the script. It is composed of dead skin cells (corneocytes) bound together by a lipid matrix, which is crucial for maintaining the skin's barrier function.

💡Lipid Matrix

The lipid matrix is a complex mixture of lipids, including ceramides, cholesterol, and fatty acids, that forms a protective barrier within the stratum corneum. It acts as the 'glue' that holds the skin cells together, as mentioned in the script, playing a vital role in skin barrier health.

💡Ceramides

Ceramides are a type of lipid found in the skin's lipid matrix. They are essential for maintaining skin hydration and barrier function. The script mentions ceramides as part of the 'cement' that binds skin cells together, highlighting their importance in skin health.

💡Intrinsic Factors

Intrinsic factors are internal influences such as genetics, hormonal changes, and psychological stress that can affect the skin. In the video, Dr. Shireen discusses how stress can lead to increased cortisol levels, which in turn can impact the skin barrier.

💡Extrinsic Factors

Extrinsic factors are external influences on the skin, such as weather, allergens, and irritants. The script discusses how extreme weather variations, allergens, and irritants can disrupt the skin barrier, leading to inflammation and other skin issues.

💡Over Exfoliation

Over exfoliation refers to the excessive removal of the skin's outer layers, which can damage the skin barrier. The script warns against using exfoliating acids too frequently, as this can lead to a broken skin barrier and increased sensitivity.

💡Occlusives

Occlusives are substances that form a physical barrier on the skin, preventing water loss and locking in hydration. In the video, Dr. Shireen recommends using occlusives like petrolatum (Vaseline) to help repair the skin barrier, especially when it is compromised.

💡Humectants

Humectants are substances that attract and bind moisture to the skin, helping to maintain hydration. The script mentions glycerin as a humectant, which is beneficial for skin barrier health, especially when used in conjunction with occlusives.

💡Acid Mantle

The acid mantle refers to the skin's slightly acidic pH, which helps to protect against harmful microorganisms. The script explains that maintaining this acidity is crucial for a healthy skin barrier, as it enables the skin to ward off bacteria, viruses, and fungi.

💡Hydration

Hydration in the context of skin health refers to the process of retaining moisture within the skin to prevent dryness and maintain elasticity. The script discusses the importance of hydration for skin barrier health and suggests using nourishing cleansers and moisturizers to support it.

💡Simplification of Skincare Routine

Simplification of skincare routine is the practice of reducing the number of products and steps in one's skincare regimen to avoid overdoing it and potentially harming the skin barrier. Dr. Shireen advises simplifying the routine by focusing on the most pressing skin issue first and then addressing others, which is a key message in the video.

Highlights

Dr. Shireen Idris introduces the topic of skin barrier health and its importance as the body's protective layer.

The skin is the largest organ and crucial for overall health, emphasized by Dr. Idris as more important than other organs like the heart or brain.

Explanation of the skin's structure, comparing it to layers of a pizza with the epidermis, dermis, and subcutaneous tissue.

The stratum corneum is identified as the skin's outermost layer, crucial for maintaining the skin barrier.

Ceramides, fatty acids, and cholesterol are highlighted as key components of the lipid matrix that holds skin cells together.

Dr. Idris discusses the consequences of a disrupted skin barrier, including inflammation, irritation, and increased susceptibility to environmental aggressors.

Signs of an impaired skin barrier are listed, such as redness, flaking, and itchiness.

Intrinsic factors like psychological stress and genetic predisposition, as well as extrinsic factors like weather and allergens, are mentioned as causes of skin barrier damage.

The importance of the skin's acid mantle in maintaining its health and protecting against infections is explained.

Dr. Idris warns against over-exfoliation and the use of harsh soaps that can strip the skin of its natural acidity.

Advice on repairing the skin barrier includes simplifying skincare routines and focusing on nourishing the skin.

Recommendations for hydrating cleansers and the avoidance of irritating additives in foaming cleansers are given.

The role of occlusives like petrolatum and lanolin in locking in hydration and repairing the skin barrier is discussed.

Dr. Idris suggests using gentle exfoliating acids like PHAs and reducing their frequency to avoid over-exfoliation.

The use of emollients and humectants to replenish the skin's lipids and maintain moisture is recommended.

Hands and feet care is briefly mentioned, emphasizing the need for extra care due to frequent hand washing and environmental factors.

Lifestyle adjustments, such as using a humidifier, are suggested to support skin barrier health in different environmental conditions.

Dr. Idris concludes with a reminder that skin barrier health is essential and provides a final overview of the discussed topics.

Transcripts

good morning you little nerds i am dr

shireen idris and welcome to your

morning edition of pillow talk derby

academy

where every saturday morning we cover a

new topic from a to z so this week my

friends we are going to talk about skin

barrier health

so put on your chastity belts

because your skin is your barrier now

what do i mean by that

first of all

obviously i'm a dermatologist

so i may or may not be

slightly

a lot

subjective

and not as objective as you'd want me to

be but the truth of the matter is

not only is your skin your largest organ

and that is a fact

but i vote it is your most important

organ because without your skin being

intact you will completely deflate

get dehydrated and fizzle out

i.e you will not have a life i mean the

heart we can keep you on a machine

your brain

debatable whether some people actually

still use their brains but the truth of

the matter is without your skin you

cannot function now the kidneys may be a

little bit more important but that is to

be debated

not a debate for today

um so no but in all seriousness without

your skin being intact a whole slew of a

cascade of unfortunate events can take

place

and

if our skin is meant to protect our

insides then what exactly is protecting

our skin

and that is your skin

barrier

health

and that is the big topic it's been a

huge topic of 2021 where everybody is

all of a sudden skin barrier experts

talking about the skin barrier as if as

if it was the the newest thing since

sliced bread as if it just got recently

discovered

your skin barrier

let's talk about this

your skin itself is made up of various

layers there's three main components if

i had to simplify it there is your

epidermis

the

uppermost topmost upper crust layer of

your skin consider that the cheese of

your pizza

then we have the dermis which is your

marinara sauce and then we have the

subcutaneous tissue which is the dough

so

those are the three layers of pizza and

those are the three layers of your skin

now within the epidermis within the

cheesy layer the cheese is not created

equal all across your pie you have the

gooeyness which is the deeper part and

then you have the crispy

charred uppermost part which is

perfection and that is your stratum

corneum which is the most upper part of

your skin

now within the stratum corneum we have

corneocytes which are skin cells okay

and then we have the glue holding the

corneocytes together and that is what we

call the lipid matrix it is made up of

cholesterol yep we got cholesterol in

our skin

fatty acids and you've heard this one

before

se ramides think of ceramides fatty

acids and cholesterol like the cement

that is gluing the cells together

okay

and that my friends is the skin in a

nutshell now you have your phd

so

without your skin barrier or when it is

disrupted what should we expect

you have inflamed skin your skin is red

your skin is irritated like my toddler

by the way i'm in a mood right now

because i just went through 45 minutes

of screaming so i apologize if i am

slightly delusional

at the moment it is currently 9 30 p.m

while i'm recording this but aggressors

let's take a step

you know what i may or may not choose to

edit this video because i think this

might be pure entertainment but without

your skin barrier what happens

your skin is actually going to be more

open

and available

for aggressors to aggress and what do i

mean by that that means you might have

openings within your skin and aggressors

environmental toxins pollution

a super strong ingredient that you don't

necessarily want to have deeper

penetration for

and get your mind out of the gutter um

different pathogens can wreak havoc on

your skin and you will see your skin

getting completely annihilated inflamed

red irritated it might feel burning it

might feel itchy and you just can't seem

to get it under control and products

your skin might have tolerated for your

whole life all of a sudden will feel

like the worst thing to possibly put on

the surface of your face

so what are signs again of an impaired

skin barrier like i just said redness

flaking

irritability

itchiness

anger pain

burning

basically

all of the negatives in one

and

what causes

what are the what are the root causes of

damaging a skin barrier well let's first

start with intrinsically so

psychologically believe it or not

distress can inflame your skin barrier

because your cortisol levels are out of

whack and that will affect your skin

genetically some people are predisposed

to having a broken skin barrier but that

is a really long topic for another day

and certain medical conditions like

diabetes can break your skin barrier and

you know predispose you to having broken

skin in some places ulcerations etc but

most causes of a broken skin barrier are

actually external so extreme weather

variations and we are living in a day

and age where yesterday i kid you not it

was 60 degrees and today it was snowing

so extreme

fluctuations in weather temperature

um

allergens pollen irritants this is where

sometimes people who have never been

allergic to fragrance all of a sudden

break their skin barrier become allergic

to fragrance because their skin barrier

was disrupted can develop allergies

what else can we say alkaline soaps

soaps that are extremely

basic in their ph which we'll get to in

a minute

over exfoliating that is a big one

that is a big one all of you guys

i feel like exfoliating acids when i

recorded this video over a year ago i

was like it's kind of underestimated

people don't exfoliate then 2021

happened

and everybody became chemist and

everybody started over exfoliating their

faces and the amount of broken skin

barriers and breakouts that i was seeing

in my office from over exfoliating alone

like people using the biloji crochet p50

twice a day every day was insane so over

exfoliating and that's on you um

steroids topical steroids overuse of

topical steroids can break your skin

barrier over time and i mean there's a

bunch of other ones but those are just

kind of hitting the top of the nail so

remember i talked about ph and alkaline

soaps

the reason that can disrupt your skin

barrier is because our skin barrier is

actually slightly acidic

yes we are a little

vinegary

people

okay

um not because we are bitter at life but

just because we're acidic we're a little

spicy like that all of us even the

sweetest of the bunch have an acidic

skin barrier mantle

and why is our acid mantle in place why

does it even exist why does our skin

need to be acidic

because this is the genius of skin

having that slight acidity

enables it to kill bacteria

viruses

fungi

fungi fungi it's still debatable as to

what you want to call it but funguses

whatever infections it helps you ward

them all off and maintain a healthy skin

so when you're using a soap that is too

basic you're over stripping that acidity

when you're over exfoliating you're

getting rid of that acidity when you're

over doing it you're also breaking that

away

making your skin vulnerable to all of

the aggressors in the world because the

world i'm telling you guys is an

aggressive place not just emotionally

but also physically and so

i will tell you this

most often than not

at least in today's day and age and i

would honestly say 7 out of 10 times the

reason your skin barrier is disrupted is

because you my friend

are way overdoing it

so how can you repair your skin barrier

first and foremost and second and third

and fourth and fifth is simplify your

skin care routine and i blame

the media for this

we went on a k beauty craze where all of

a sudden we thought we need 30 steps in

our skincare routine now i myself have

done videos where i talk about various

steps to your skincare routine but if

you listen to the words coming out of my

mouth

i often talk about alternating nights

and not doing everything on the same

night so simplifying your skincare

routine is first and foremost now how do

we simplify our skin care routine the

root

of simplification is focusing your skin

care on one skin issue

focusing it on the most pressing skin

issue and trying to help that issue

first and then tackling the next so that

is golden rule number one

rule number two

once you have focused your skincare on

your skin issue

now we can tailor it by using a

hydrating cleanser for example

especially if our skin berry has already

been disrupted

we want a skin cleanser that is going to

nourish

and really feed our skin

gone are the days of super super super

super stripping super foamy cleansers

foaming cleansers now can actually help

maintain your skin balance but i would

prefer it be a non-foaming maybe call me

a person of habit i still would prefer a

non-foaming cleanser because with foams

there are other additives in there to

make them foam and those additives

themselves can be irritating so you want

a nourishing calming cleanser ideally

with a ph closest to your skin's ph so

closer to approximately five-ish i

actually really like this one by aveeno

they have their common restore

nourishing cleanser for sensitive skin

and i like it because it is also

fragrance free so when your skin barrier

is disrupted you do want to stick to

fragrance-free products and this is a

cleanser i like a lot as you guys can

see it is very thick

it is a gel cleanser is this cleanser

going to be the best cleanser for you

that is going to get your makeup off and

wash your face and do everything all at

once probably not but is it going to

help you get to where you need to be so

you can start living a more healthy skin

life absolutely so that is number one

number two

when it comes to exfoliating acids when

your skin barrier is absolutely

inflamed insane

then we're gonna step back on

exfoliating for a minute okay we're

gonna take it easy and i'm gonna tell

you this

quit it

quit it for a few weeks

you will not become a wart

you will not you will not you will be

okay it is better to go through a period

where you are just focusing on

nourishing your skin

okay

without overstripping it because you're

thinking you're going to try to

compensate for maybe you haven't

exfoliated in 24 hours

and you're going to allow your skin to

calm down

and once you decide to re-enter the

exfoliating game i would strongly advise

you do not go for the strongest thing

right away throw away that red

exfoliating acid from the ordinary or

the sakura baby facial from what are

they called drunken elephant

you want to go for something that is not

as insane or intense okay

usually even for a polyhydroxy acid a

pha

lactobionic maltobionic those acids tend

to be gentler and easier on the skin and

maybe i would say you would only do it

two times a week at night that's it for

a few weeks and we go from there

so that is exfoliating acids

now

after we have

talked about the exfoliating acids a lot

of people

are scared of occlusives but occlusives

like this guy is going to be your best

friend

because this occlusive petrolata

vaseline does not deserve the bad rep

that it gets and putting a thick layer

of all over your face is going to really

lock in hydration on your face and quite

frankly i you'll use this if your my

skin barrier was super inflamed after

even using a strong humectant something

that is glycerin-based and the one that

i love the most and i've spoken about

this a million times and is actually

currently in my shower in my bathroom is

la roche poses sicoplast bone b5 because

it is glycerin based and it has zinc so

that is gonna help calm it and if my

skin barrier is super inflamed i would

put a thick layer of this guy on top of

it

vaseline itself has been proven to block

nearly

99

of water loss so if anything if you

don't want to use even a humectant or a

moisturizer before it i don't blame you

because you want less is more just use

this

and this is not going to be in layer of

voleda and i love

skin food especially for the lips when

you have a broken lip

because i really just like the texture

but

skin food for example has essential oils

and essential oils are not going to be

your friend if you have a broken skin

barrier because you might actually

develop an allergy to it or become even

more irritated so i would avoid the

essential oils altogether

um

so this is a great occlusive

another one that people love is lanolin

and this is called a nipple cream

because women use this while they are

breastfeeding but lanolin is actually

what is in aquaphor it is a wool oil

derivative um so it is not vegan but you

can also use lanolin as an occlusive not

not an exclusive and occlusive and then

finally

the french are obsessed with

homeoplasmin which is another occlusive

that you can actually try super quick

intermission i'm about to mention a

product which i did not give a proper

introduction for but this is a super

rich emollient that is going to help

replenish the lipids within your skin

barrier

i think triple lipid by skinceuticals is

one that is the perfect

combination of two percent ceramides

four percent cholesterol and two percent

fatty acids now do those three

components ring a bell ding ding ding

they were the glue that were holding

your cornea sites together when i was

talking about the cement and it's a

little pricey i'm not gonna lie the

texture is just divine

but the reason it's pricey is because

ceramides are very expensive to

formulate with take it from me um i've

now entered the other side of the

conversation and they are very very very

expensive to formulate with so that's

why usually when you find something of

quality with ceramides it tends to be on

the pricier side but i do really like

this particular product it is silky it

is smooth and it is so beautiful and

last skin barrier health is not just

reserved

for the face we also have our bodies to

worry about and this one by isdin is

uridine lotion which has urea and urea

is also a very strong humectant uh one

that is not to be underestimated

and i love the scent of this it just

feels completely beautiful and lovely so

there you have it

these are the occlusives and the

humectants that i would strongly

recommend you use my husband is just

staring at me like a stalker in the

corner but i'm going to ignore him um so

i strongly recommend you guys use these

occlusives and last completely last i

want to talk quickly very quickly for

two seconds about hands and feet but

hands more specifically because of all

the hand washing we've been undergoing

for the past two years i love this guy

by o'keefe's working hands it is a

glycerin based hand cream and what i

would tell you is if you have a broken

skin barrier especially of your hands

you may get more examines

rashes on your hands really cracky etc i

would use a very generous amount of this

baby

and i would go to sleep and i know this

sounds weird but in latex free gloves

not cotton gloves latex free

plasticky gloves because it will

definitely absorb

better

if you are wearing a cotton glove

you're basically just absorbing the skin

the hand cream in the glove but that is

hands

and comes to lifestyle

invest in a humidifier if the

environment is very very dry if you are

in a very humid environment you do not

need to moisturize as much because like

i said both extremes can actually worsen

your skin barrier health and break it

down so maybe skimp on the moisturizer

in very humid environments and just

focus on maybe an occlusive at night

only and if you're in a very dry

environment

load up on the humectants and the

occlusives and invest in a really good

humidifier and with that

i am dr shireen idris i apologize for

being slightly all over the map this

evening but it has been a crazy

two hours and anybody there with two

toddlers under the age of four will know

what i'm talking about

i hope you have a beautiful and

uneventful saturday i'll see you guys

next week

[Music]

you