Can I repair my damaged skin barrier? Part 2/2

Hi, I am interested in laser resurfacing for sun damage and acne scars. However, despite looking after my skin with moisturizer and SPF 50, my skin is very sensitive all the time. I am assuming that I have somehow permanently damaged my skin barrier. If that is the case, can people with a damaged skin barrier still have CO2 or Erbium laser resurfacing? I realize that a skin patch is taken beforehand, so if that is okay does that mean that any risk is minuscule? Thank you for any advice.

So, Part II is on repairing your barrier layer if you think it’s been compromised. If you think you may have an allergy or sensitivity to ingredients in skin care products, then you may need your dermatologist to help you define these allergies better. Please remember that skin diseases compromise the barrier. If you have an undiagnosed or untreated skin disease, the measure below are less likely to help.

Your skin barrier is your outer dead layer (stratum corneum), and the epidermis where there are all sorts of lipids, cells and the natural gel between the cells which is partly hyaluronic acid. You want your epidermis to attract and retain the natural water in it (transepidermal water loss or TEWL), and also the lipids. Various things can “strip” the barrier temporarily. It can take up to 30 days to restore this layer after it’s been injured. Longer on the body.

Most common causes of decreased barrier function now:

  • Too many skincare products with too many irritating chemicals
  • Too much exfoliating or scrubbing
  • Laser or device procedures without good postcare and time to heal
  • Sun damage
  • Allergies/eczema

The importance of skin rest and how to do it:

  • Stop every single skin care product you are using.
  • Find a bland cleanser and moisturizer you know your skin can tolerate. Examples are CeraVe, Cetaphil, Aquaphor, etc. Organic is fine as long as it doesn’t have a long list of extracts and ingredients.
  • Find a zinc oxide 10-20% sunscreen with no other chemical sunscreens in it and in a bland base. You may have to try several before you decide on one. Look on Amazon, your pharmacy, etc.
  • Use oral Vit C 500-1,000 mg a day, Vit D 1-2,000 iu a day, and make sure you’re getting at least 30-50 grams of protein daily; more if you’re very active.
  • Do this for 2-4 weeks morning and night with no cheating! If you’re not sure at 2 weeks, then go the full 4 weeks.
  • If you have acne, keep up any acne meds, but talk to your doctor about whether they could be irritating your skin.
  • Stay hydrated.

Other ways to try to restore this layer:

  • See your dermatologist if you’re not making progress or getting worse on this after several weeks. You may need “patch testing”.
  • Do a “use” test. Do the skin rest above and then…add your own products back one at a time a week apart to see if you can identify one or two products that are the culprit.
  • If that doesn’t work, try again with a week or two of skin rest, then look for a product line with very few chemicals in it like Goop perhaps. If you can tolerate that then you can try branching out one at a time to products that are more effective and have more “actives” in them.
  • Unfortunately, at this point in time, many of the organic products aren’t very effective and many of the engineered science based products have too many chemicals in them. Sigh.

I Hope this Helps,

Dr. Brandith Irwin, MD
Founder of SkinTour
Follow my skin tips and travels on Instagram!

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