Dry Skin is an inevitable part of aging. “Clinical studies have shown that the level of the skin’s Natural Moisturizing Factor (NMF) drops with age, leading to dry, flaky skin and a compromised barrier,” says Peter Konish, senior director of innovation and product development at skincare provider NeoStrata. And as scientists have learned more about the true nature of the stratum corneum, it has become increasingly clear that proper hydration is essential for maintaining the skin barrier. Just as the body cannot survive without water, the skin cannot function efficiently without adequate hydration.
“Healthy cells exist in an anabolic state, which is the ‘building’ condition of the cell that allows it to maintain physiologic functioning; dehydrated cells, on the other hand, revert to a catabolic state, resulting in cellular hypoxia, cellular damage and toxin buildup,” explains Huntington, New York-based plastic surgeon Elliot B. Duboys, MD. “From an aesthetic standpoint, dehydration compromises cellular functioning resulting in a dull appearance, increased sensitivity and signs of aging.”
More specifically, enzymatic reactions necessitate hydrated skin, says Leslie Baumann, MD, founder of the Skin Type Solutions Franchise System, which independently tests skincare products for efficacy and helps doctors choose products to sell. “Skin hydration is crucial because enzymes that make things happen require water,” she explains. “Water helps the enzymes fold correctly so that they are properly activated. Most cellular processes have particular 3D shape requirements for the molecules, which are influenced by the presence of water. Put simply, water makes the cells work better, whether it is repairing damage, producing important structures or breaking down toxins.”
In addition to aging and environmental concerns, such as sun exposure and harsh cleansers, certain topical skincare ingredients—including alphahydroxy acids (AHAs) and astringents like benzyl peroxide—can lead to irritation and dryness. Common medications, such as statins used to lower serum cholesterol, can also deplete the cholesterol essential for synthesizing the stratum corneum’s lipid membrane. What’s more, popular aesthetic treatments such as peels and laser resurfacing, as well as antiaging topicals, can actually exacerbate skin dryness.
“Any good age management product must contain a retinoid, and since retinoids down-regulate sebum production, they can lead to dry skin, especially in climates with a drying combination of low temperatures and low humidity,” says John Kulesza, president of skincare formulator Young Pharmaceuticals. “That means an effective moisturizer is essential for those using age management products.”
Most skincare professionals would agree that steering patients toward effective moisturizers is necessary. The challenge is choosing among the myriad products now available. Early moisturizers contained a mixture of ingredients classified as occlusives, emollients or humectants. “Occlusive agents, such as squalane, one of my favorite ingredients, and silicone—which is especially useful in preparations for sensitive skin because it is nonreactive—seal in moisture, as do emollient esters such as isopropyl palmitate,” says Kulesza. “Petrolatum (Vaseline), one of the most effective occlusive agents, has been in use for 150 years. It is still the main ingredient in ointments used to protect the skin after treatments like peels and laser resurfacing where the skin barrier is compromised.”
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