Products to repair your skin barrier

What are you actually repairing?

The outermost skin layer, called the stratum corneum, limits water loss and helps keep harmful substances out. Its cells sit within a matrix of fats. Ceramides are part of those fats and are important for barrier function. Dryness, flaking, roughness, itching and stinging with skincare can signal a problem, but those symptoms do not identify the cause by themselves.145

Which products should you buy?

Make a fragrance free moisturizer your main purchase. Moisturizers help maintain barrier function, even when the jar has not given the job a dramatic name. Pick the texture for the amount of dryness rather than treating every barrier cream as interchangeable. A richer product holds in more moisture, but the richest option is not automatically the right choice for every area.26

Ointments are greasier than creams, which is a texture difference rather than a character flaw. If your face has dry and oily areas, moisturize the dry patches rather than applying the same heavy layer everywhere. For seasonal dryness in otherwise normal skin, lotion can be enough. Skin holds less moisture with age, making a cream a useful choice for people aged 50 and older.26

Which ingredients are worth looking for?

Ceramides are fats naturally present in the skin's outer layer. Skincare formulas use them to help improve or restore barrier function. A ceramide moisturizer is a sensible option, rather than a reason to buy several separate products containing the same ingredient. Cholesterol and fatty acids are also natural barrier fats used in skincare.15

• Humectants attract and retain water. Glycerin and hyaluronic acid are moisturizing ingredients to look for.
• Occlusives reduce water evaporation by forming a protective surface layer. Examples include petroleum jelly, mineral oil and dimethicone.
• Emollients soften and smooth the outer skin layer by filling cracks.
• Urea and acidic preparations can sting scratched or cracked skin. For dry, peeling skin, avoid exfoliation rather than trying to remove every flake.

Choose fragrance free products, especially for dry or sensitive skin. A noncomedogenic label means a product is intended not to block pores; heavy, occlusive moisturizers can still aggravate acne. Natural or organic wording is not a shortcut to choosing something suitable for sensitive skin, because plant ingredients can aggravate allergies.26

How to use your barrier repair routine

1. 1Test a new moisturizer on a limited area before applying it widely, especially if you have had reactions.
2. 2Wash gently with warm, not hot, water and a mild, fragrance free, soap free cleanser. Massage it on and rinse it off without prolonged scrubbing.
3. 3Apply moisturizer immediately after washing, while skin is still damp. Smooth an emollient gently in the direction of hair growth rather than rubbing hard.
4. 4Reapply when skin feels dry or tight. Choose a product you can comfortably use at least twice daily; very dry skin needs more frequent application.
5. 5Use broad spectrum sunscreen with SPF 30 or higher daily, alongside shade and protective clothing.

An emollient soap substitute cleans without normal soap's foam, which saves the bubbles from taking credit for the work. For dry or itchy skin, a product suitable for washing can replace ordinary soap. Mix a small amount with warm water, spread it over skin, rinse and gently pat dry. If stinging continues after rinsing, ask a pharmacist for a different product.7

What should you pause or keep separate?

Avoid harsh soaps, scrubbing and excessive exfoliation. If skin around a pimple is broken, ease back on acne treatments there and focus on gentle care while it heals. If you use a steroid cream or another treatment for a skin condition, leave 20 to 30 minutes between that treatment and an emollient. Ask the treating clinician which should go first so you do not dilute or spread the treatment.17

How long does barrier repair take?

Moisturizers reduce dryness and water loss, but trapping moisture and recovering from ongoing damage are different jobs. The moisturizing benefit is greatest during the first six hours after application, so regular use matters. Improvements from barrier care habits typically take three to four months to become apparent. Older skin replaces its barrier more slowly. Worsening symptoms need attention sooner, not a longer trial of the same cream.16

When is another product not the answer?

Stop using a product that causes a new rash. An allergic reaction can develop even after years of using the same product, and a rash can appear hours or days after contact. If you cannot identify the trigger, a dermatologist can investigate. Seek care for raw skin, a blistering or recurring rash, or dryness that becomes painful, cracked or bleeding. A moisturizer cannot replace treatment for an underlying skin condition.236

Ask a pharmacist or clinician about persistent burning, stinging or inflamed hair follicles after using an emollient. Keep emollient soaked clothes, bedding and dressings away from flames and cigarettes, including when the product contains no paraffin. Use a clean spoon or spatula to take cream from a tub, and watch for slippery surfaces after washing with emollients.7