Skin Barrier and The Importance of Ceramides
Last month, I had the absolute pleasure of being invited to talk at the Sigma Pharmacist Summit in Hobart on behalf of CeraVe, part of the L’Oreal Dermatology Division. The talk provided valuable education for Pharmacists about the skin barrier and the importance of maintaining this barrier focussing on eczema.
Discussing Ceramides and Skin Barrier at the Sigma Pharmacist Summit 2024
But because Winter seems to be never ending at the moment, especially in Tasmania, I thought I’d share the information with my patients and followers because it applies to winter dry skin as well!
The epidermal skin barrier is like a wall that protects your body via multiple mechanisms including the acid mantle, microbiome and immune cells. It keeps the good stuff, like water, inside your skin and blocks out bad things, like germs and irritants. When this barrier is strong, your skin stays hydrated and healthy. If it's weak, your skin can get dry, itchy, and more prone to infections. Ceramides, which are natural fats in your skin, help keep this barrier strong and working well.
Summary of how our skin wall is built!
so, What Are Ceramides?
Ceramides are a type of lipid (fat) molecule that are naturally found in high concentrations within the cell membranes of skin cells, they are part of the natural moisturising factors that our body makes.
Ceramides are a crucial component of the skin's barrier function, making up about 50% of the skin’s outer layer, the stratum corneum. They help to hold skin cells together, forming a protective layer that limits moisture loss and shields against environmental aggressors such as pollutants and bacteria.
Simply put, if our skin was a brick wall with the cells being the bricks, the ceramides would make up the mortar holding it all together. If the mortar isn’t there or is made up of the incorrect ingredients the bricks fall apart creating an impaired dry, flakey wall. If the wall falls down or cracks, we lose more water from the skin and are more susceptible to infections and irritants.
How the ceramides contribute!
why does the barrier break?
There are genetic and environmental factors that are associated with altered levels, composition and/or synthesis of ceramides in the skin barrier which leads to a compromised barrier. The wall falls down and leads to increased loss of water from the skin resulting in flaky, itchy, and sometimes cracked skin.
Genetically, there can be a defect in the composition and synthesis of ceramides in the skin leading to conditions such as atopic (allergic) dermatitis and eczema.
Environmental factors that increase this water loss even further, and exacerbate xerosis (dry skin) are:
Low Humidity
Indoor heating or cooling
Over or aggressive cleansing and exfoliation
Loss of water then creates more issues such as pH changes allowing pathogenic bacteria to thrive and increasing inflammation.
So to fix the barrier we need to help it along by:
Maintaining the physiological pH (between 4 and 6)
Reducing inflammation
Maintaining and replacing ceramides and other fatty acids
Benefits of Moisturisers:
We know that moisturising helps dry skin and particularly those with Eczema or Dermatitis. It decreases the amount of steroid creams and ointments needed, reduces itching, reduces the number of flares and improves quality of life.
Choosing the Right moisturising products
So are they all equal? In short - No.
Not all moisturisers are the same. In fact, they have differing roles depending on the mechanism of action.
Simple occlusives (ointments) form an artificial barrier on the skin surface and trap moisture kind of like a tarpaulin on a wall that has a hole in it e.g petrolatum, dimethicone
Emollients smooth the skin and increase suppleness by filling the gaps between dry skin cells. Like new mortar in the brick wall e.g. glycerin, oils
Humectants increase the water content of the skin. They help to hold water in the bricks turning them into a sort of sponge. e,g hyaluronic acid, urea
An optimised moisturiser hydrates AND restores the barrier. Therefore it needs occlusives to trap moisture, emollients to smooth and humectants to hydrate. Adding ceramides and other fatty acids further enhances these actions.
Products I recommend with Ceramides:
Several brands offer high-quality ceramide-containing products designed to support the skin barrier and provide relief for dry, sensitive skin. And before you read on here are my disclosures - The talk I did was on behalf of CeraVe HOWEVER they also actually do make amazing products all containing Ceramides (hence CeraVe).
CeraVe Moisturizing Cream: This rich, non-greasy, fast-absorbing cream is ideal for dry and very dry skin. It contains three essential ceramides and hyaluronic acid to help restore and maintain the skin’s natural barrier.
CeraVe Hydrating Cleanser: A gentle, non-foaming cleanser that hydrates and helps restore the protective skin barrier with ceramides and hyaluronic acid.
CeraVe Healing Ointment: Designed to protect and soothe dry, cracked skin, this ointment is formulated with ceramides to help restore the skin barrier.
Other products I highly recommend are:
La Roche-Posay Lipikar Balm AP+: This intensive moisturizing balm is formulated with shea butter, niacinamide, and ceramides to help replenish the skin's essential lipids and provide long-lasting hydration.
SkinCeuticals Triple Lipid Restore 2:4:2: This anti-aging treatment is formulated with a patented lipid ratio of 2% ceramides, 4% cholesterol, and 2% fatty acids to help restore the skin’s external barrier and support natural self-repair.
Universkin: The entire range helps the skin to produce its own fatty acids via the inclusion of Camelina Oil which is rich in omega 3 fatty acids, the added peptides nourish and soothe the skin rebuilding the barrier. The best part about this is it is completely customisable to your skin and can be safely used after procedures.
By incorporating ceramide-rich products into your skincare routine, you can improve skin hydration, reduce inflammation, and enhance overall skin health. As research continues to uncover the benefits of ceramides, they remain a cornerstone in the treatment and management of dry and sensitive skin conditions. Other tips on repairing your skin barrier if you find yourself with sensitive, reactive skin are in the image below.
As always - Yours in Total Skin Health,
