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Hi guys. Welcome back to the treatment room. I am so happy to be with you. Thank you for tuning in. I know you tune in because you want to learn more about skin. You want to better understand it and take care of it. And I really think the main way in which we can take care of our skin health is by understanding the importance of our skin barrier. So I'm dedicating today's episode to this topic. It's going to be a little sciency, so feel free to take out a notebook, take some notes. I think it's so important to understand the skin barrier. We hear this phrase all over social media. You would almost think it's a new, new term. But I can assure you it is not. And it is actually vital to your health. We can get so obsessed with our skin, right? I do ask my clients in consultations what they would like to change or improve about their skin. It might be acne, discoloration, fine lines and wrinkles, but it's really difficult to treat any of these aesthetic concerns when you have a compromised skin skin barrier. And how do you know if you have a compromised skin barrier? We're going to get into that. I want to share some ways in which you could be harming your barrier, some ways in which we can support it, and if you're currently dealing with a compromise barrier, stick around until the end of the show. I want to share the exact routine that I would recommend to somebody who is dealing with a compromised skin barrier. The other day I had a little breakout. It had been a few months and so this quickly humbled me and reminded me of what my clients go through on a day to day basis. Which I actually appreciate when that happens because I like to stay connected to how you guys are feeling. I never want to lose sight of that, but I had this breakout and it's amazing how much one or two pimples can really consume mental space. And in researching for this episode, I was really reminded of how much our skin does for us. And I don't think we give it enough credit or appreciation on a day to day basis. We can just be constantly thinking I wish this was better, I wish this wasn't there. But let's talk about what the skin barrier actually does for us, because I think it's really amazing. Our skin was made with intention, for really every square inch. Every square inch serves a purpose. And we wouldn't be here without our skin barrier. So the skin barrier serves three primary purposes. The first is again, not to look perfect, not to look poreless, not to resemble an Instagram Paris filter. The main purpose is to protect you. The skin barrier is responsible for keeping harmful substances out of our skin. This could be pollutants, pathogens like Candida, UV allergens, really all stressors. So we have our skin barrier to thank for keeping the harmful substances out of our system. The skin barrier also defends the the good. So it helps to keep water in the skin. I'm sure you have heard of trans epidermal water loss. The whole goal of healthy skin barrier is to minimize transepidermal water loss. This keeps our skin functioning well and looking healthy, plump and glowy. Lastly, the skin barrier also helps to transport nutrients and oxygen to our skin. When we talk about the skin barrier, this is the outermost layer of the skin. If you were to google skin structure and look at a picture which I do recommend, so you can see a visual representation. The skin barrier is of course the top outermost layer. This is what we estheticians can legally work on. It is also known as the epidermis or the stratum corneum. And this is the the outermost layer of the skin, which protects the body from the outside world. It is also the thinnest layer of the skin. And if you google a picture of the skin structure, you will clearly see that the stratum corneum is much thinner than the other two layers. So there's three layers in total. Again, top layer is the stratum corneum. And then beneath that we have the dermis. This is the middle layer of the skin. It contains connective tissue, hair follicles, blood vessels, lymphatic vessels and sweat glands. Then beneath that we have the deepest layer of the skin. This is the hypodermis. This is made of fat and connective tissue. The hypodermis stores fat cells for energy reserves, helps to insulate the body and protects our muscles and internal organs. So if you were to fall down, the hypodermis is what is protecting your internal organs from the impact of that fall. But for today's episode, we're really concerned with the epidermis. And there's also A term known as the lipid matrix that is responsible for keeping the epidermis intact. And a really great visual for the skin barrier is thinking of kind of like a brick wall where the bricks are the cells and then there is that glue like substance in between the bricks that is keeping them together. And so this is our lipid matrix. It is comprised of cholesterol, fatty acids, and ceramides. So these substances are the glue that holds skin cells together. And when the glue is compromised, this essentially creates cracks or holes in the skin barrier. And it is easier for aggressors to invade and for inflammation to occur when you have an extremely compromised barrier. This can be characterized as atopic dermatitis, also known as eczema. And I've had a lot of questions about eczema from other estheticians. Eczema is a chronic relapsing, inflammatory skin disease characterized by itch. It is also known as the rash that itches and the itch that rashes. It's kind of this vicious inflammatory cycle that's just super uncomfortable and itchy. If you have ever used a strong retinoid on the neck and you've noticed a lot of irritation, redness, itchiness, prime example of dermatitis. And why does dermatitis happen? There is increasing evidence that impaired skin barrier function is causative for atopic dermatitis. It is believed that a defect skin barrier facilitates the transport of allergens and irritants into the skin, resulting in skin inflammation. So again, when we have a compromised barrier, when we have little cracks in this lipid matrix, it is easier for those allergens to invade. And that's when the inflammation, the redness, the itching really starts. Many of you want to know, how do I know if I have a compromised barrier? Well, I will say you can definitely have suboptimal skin, skin that's not as healthy as it could be, but you may not necessarily have an extremely compromised barrier. Generally, it is pretty obvious if you do have a compromised barrier. And symptoms would include possibly dry, flaking skin, dull skin, redness, sensitivity, or irritation like a rash or a burning sensation. In my client consultations, I really want to gain an understanding for how compromised my client's barrier might be. I have clients who have really rarely ever experienced symptoms of a compromised barrier. And then I have others who might experience frequent symptoms of a compromised barrier. Stinging, burning, even what I call background irritation that occurs when you've used something that has aggravated the skin, and then you notice that sensation more when you are using other skincare products, even if they are gentle, like a cleanser or a moisturizer. So I am really concerned when a client is experiencing stinging or burning that lasts more than 10 to 15 minutes, when it is frequently something you're noticing in your routine. And I will say when we're treating acne, when we are taking a more accelerated, you could say, aggressive approach to addressing retention hyperkeratosis, that excess buildup of skin cells in the pore, we're going to be using more resurfacing ingredients. So it's not unlikely that at some point in treating your acne you will experience symptoms of a compromised barrier. But the whole goal is to ensure this is really minimized. Let's keep in mind, if you do compromise your skin, it's not damaged for life. And I think that is almost a myth that I kind of see on social media. People might feel that their barrier was compromised and then their skin is just forever damaged from it. The good news is that your skin cells are really great at rapidly renewing your skin barrier will heal itself. Your skin is especially good at this when you are young and healthy. But if you push it a little too far with actives and exfoliation, don't worry that you've damaged your skin for life because it will repair itself in a matter of days. The important thing is just to try to ensure you're not repeating that insult to injury. So you want to try to be aware of what could be compromising your skin. And I'm going to share some information on some common ways we might harm our skin barrier. This is a great time to take some notes. These are great questions to ask your clients who are coming in for treatments or who you are recommending home care and active ingredients for. Because if they are repeatedly insulting or damaging their barrier outside of the treatment room, it's going to be more difficult for them to tolerate the treatments and the actives in the treatment room. So one of the top ways we can damage our skin is through environmental factors. This could be pollution, lack of humidity in the air, extreme temperatures or extreme temperature, fluctuations in climate, going from one extreme climate to another, and sun exposure. I really want to talk about this for a second because I think it is so underestimated in how it can sensitize and compromise barrier function. So I treat a lot of clients in their 20s and although they might have sun damage programmed into their DNA already, they likely aren't seeing the damaging effects quite yet. So oftentimes I'm treating young clients in their 20s and their skin really does look good for for the most part. But they might complain that it frequently feels dry, it feels compromised or sensitized. They have a hard time tolerating products and oftentimes they are skipping sunscreen. Sometimes it can be because they're afraid the sunscreen will break them out. But it is so important to protect that stratum corneum from UV expos that we can incur on a day to day basis. Sunscreen is not seasonal, it's. It's not something you just apply when you go to the beach. It really should be something you wear all year long to protect your barrier health. One of the second and most underrated ways you can damage your skin barrier is using a soap that is too alkaline. Our skin is naturally a little bit more acidic and tends to be around a 5ph. So if you're using a super alkaline soap, this could be stripping your skin's PH too far. And I think a lot of people tend to think, oh, a cleanser is a cleanser, they're all the same. But this is one really important area of your skincare routine that you want to make sure is healthy for you to use on a day to day basis. This is another reason I created my skincare line Free Skin by Tessa. Both my cleansers, Undo and Low Foam are ph balance cleansers that you can use consistently in your routine that will not strip or harm your barrier function. Third is hot water saunas. Essentially just heat, especially dry air or hot water which we commonly use in the colder months when we are bathing and showering. This can really zap skin of moisture, so try to be cautious with your shower temperature. I know we all love a cozy, comfortable, hot shower, but my rule of thumb tends to be if the water temperature is comfortable for your body, it might be too hot for the face. And if your clients are frequently struggling with tolerating their actives, and especially if you already live somewhere that's very cold and dry, try to ask and make sure they're not using water that is too hot on their face consistently. Third and also underestimated are cortisol flares and stress. Stress can really add to inflammation. Also getting a lack of sleep can increase cortisol. So this is where you know the basics. Things like taking care of yourself, managing stress, getting enough sleep are actually really important to supporting healthy skin. Next, of course, exfoliating your skin too much, using products that are too harsh, or using exfoliating products too quickly and too often can absolutely Aggravate the skin barrier. I see this often with tretinoin. If people are not guided on how to use the prescription, how to support their skin barrier, how to ease into using the topical. This can easily strip the skin, make it feel more itchy, compromised, red, peely. So I do want to clarify, Actives are not the enemy. Actives actually are a primary way in which we can strengthen our skin barrier. So yes, using ingredients like vitamin a, vitamin C, AHAs, these can all strengthen the skin. You don't stop going to the gym because your muscles are sore. And it's the same thing with skin care ingredients. These are important ingredients to building up your barrier function and actually maintaining a more organized stratum corneum. Our skin cells should lay like shingles on a roof in an organized way. When they get disorganized, when they're piling up on top of each other, this can also be bad. So active ingredients are important. They are good, but you know, in moderation, in the right frequency for you. And this is another thing I specialize in with my clients. I create a custom personalized routine unique to each person where I really lay out how I want them to introduce the active ingredient and acclimate to it over weeks and months. Because if you choose the wrong formula, the wrong ingredient, you're starting too hard, too fast. This is when we can compromise our barrier. And at that point you need to stop everything. You need to take breaks from the actives and we can't really address the skin concerns. So better to ease into something, to go slow and to give your skin time to adjust to it than to just insult your skin and expect it to accommodate to a program or actives that are just too harsh. Next, lack of topical moisture. So I'm always emphasizing the importance of hydration to my clients. A healthy skin barrier needs both water and hydration and ceramides. So I am always emphasizing to my clients to make sure their skin feels properly moisturized, to use hydrating serums, masks, even occlusives if absolutely necessary. Necessary to really seal in that hydration and protect their barrier function. Hydration goes hand in hand with exfoliation. This is another aspect of my program, making sure not only we're using the right active ingredients, but properly restoring our skin, giving it the ingredients and nutrients it needs to heal and support itself. Lastly, I think it's really interesting to note that genetics and health, immune system health, can actually be related to barrier function. So we do know that several skin related autoimmune disorders like lupus Scleroderma, even diabetes can affect wound healing and barrier health. So what are some ways in which we can actually support our skin barrier? So let's start with omega 3 fatty acids. There are a number of studies which are now showing that consuming derivatives of omega 3 fatty acids can actually influence the skin barrier by decreasing inflammation and acting as immune modulators. So I'll share a couple different studies that I thought were interesting. So there is a study on flaxseed oil high in ala. This was shown to improve tool skin hydration, skin scaling and roughness in female study subjects after 12 weeks of daily consumption. Another study evaluated hemp seed oil ingestion and hemp seed oil contains both omega 6 and omega 3 fatty acids. Subjects reported improved skin dryness and less use of dermal medications with the hemp seed oil. Lastly, fish oil is another big one. One study found that a four month supplementation with fish oil led to an overall 30% improvement in clinical atopic dermatitis score. And while these studies are small, they do suggest that consuming oils rich in omega 3 fatty acids has the potential to improve skin barrier function. Of course, you can also obtain fatty acids through diet consuming fatty fish like salmon, olive oil, olives and avocado. Next, I want to mention probiotics. So probiotics are now being studied as having potential benefits for a number of infectious diseases and types of inflammatory skin conditions. So the effects of probiotics on the skin barrier may be linked to their effects on immune regulation and expression of skin barrier proteins. Studies in mice and skin models have shown decreases in pro inflammatory cytokines as well as improvement in skin hydration tool and the production of skin barrier proteins. And talking about probiotics fish oils reminds me of one of my favorite supplements from Face Reality. They have a probiotic and fish oil dual supplement. So that is a really good one to check out. Or if you are a client of mine, feel free to ask me about it in our next meeting. Next, you can support your barrier health by considering what is in your environment. This could be allergens, irritants or pollutants. It could be a scented laundry detergent or makeup product. It could be smoke or cigarettes. It could be cleaning supplies and chemicals that you're commonly using in your home. So being aware of all those things I do believe is important. Next, if you are constantly dealing with symptoms of a compromised barrier or atopic dermatitis, it's really important to consider common food allergens which might be cow's milk, eggs, peanuts, tree nuts, soy Wheat, fish and shellfish, even rice, sesame seeds and certain oils can trigger atopic dermatitis. So food allergies are really important to consider. And if you are unsure of if you have food allergies, a doctor can perform a skin prick test, a blood test, or have you try an elimination diet or oral food protocol. And if the allergy is confirmed, avoiding the food that triggers your atopic dermatitis can absolutely improve your symptoms. Next on my list is refraining from over washing or over exfoliating. And now I am an advocate for cleansing twice a day and cleansing as needed to remove makeup or to remove sweat. Sweat is actually a really interesting trigger for skin inflammation. So sometimes I think we can wrestle with should I cleanse my skin? Should I leave it be? What's, what's better for my skin? And so I would say be mindful of a the type of cleanser you are using. Again, I recommend my free Skin by Tessa cleansers for a gentle PH balance cleanse. But try to be mindful not to cleanse your skin, you know, more than two to three times a day. But I do suggest cleansing your skin after sweating as this can actually further irritate the skin. But just being mindful that you're not overdoing it and making sure you're using the right quality cleanser, being sure to limit hot water on the face, also limiting bathing, saunas and baths. I think saunas are a really interesting talking point because we have to understand the nuance. Saunas can be really healthy for detoxing our body. But if you are frequently going to saunas, and I understand this because I've been on a mold protocol and oftentimes my doctor has suggested taking a hot bath every single night. Going to the sauna one or two times a week and you know, I guess you have to be mindful of the priority but really being aware of your skin's barrier, not pushing it if it is feeling on the verge of being irritated. Making sure to replenish your skin with moisture and cleansing as needed after sweating or sauna. As another tip I have for those with a compromised barrier, when you are taking a hot shower or hot bath, try to apply a hydrating face mask. This can help to minimize the effects of tulle. I will share my favorite for a compromise barrier at the end of the episode. Next, of course wearing sunscreen, which we went over and then being mindful of of artificial heat, air conditioner and fans. So I really noticed this in the first phase of treatment with my clients when they're just getting acclimated to actives. I noticed this a lot in the summertime, which was excess dry skin caused by sleeping with a fan right next to you or AC blasting in your room overnight. You know, sometimes we need it to be comfortable. But just be aware that these type of lifestyle things also since it is, you know, fall and winter now, really blasting heat in your home, working close to a space heater, turning your heater up in your car up to full blast, all these things can compromise the skin barrier by pulling moisture out of the skin. So if you need to use these things to regulate temperature, making sure you're really taking your taking care of your barrier. In addition, and when I am, you know, starting my acne care program with clients, if they're getting adjusted to actives, we may need to adjust some of these lifestyle things a little bit. Make sure your fan isn't blowing super close, you know, to your face. And if you do use one, possibly supplementing with a humidifier. I love a humidifier. It can really support barrier function. Because our skin does crave a little more humidity, usually levels between 40 to 60% are recommended. So I do have a favorite humidifier. I will also link this one in the show notes. But adding a humidifier to your common space if you work from home, your office or your bedroom, because we're obviously in our bedroom for many hours while we're sleeping and this is when our skin is already more prone to moisture loss. So let's get into the exact routine I'd recommend for somebody dealing with a compromise barrier. First and foremost, it's so important to identify whatever was insulting your skin. Maybe it was an active ingredient, an allergen, hot water, something in the lifestyle overuse of saunas, you might have to stop that activity or that product and until the skin is more back to baseline. But just know it shouldn't take your skin weeks or months to heal from the insult. Our skin is really efficient at rapidly repairing itself. The cells will renew. So you just need to try to stop whatever was harming your skin in the first place. And do have a healthy skin routine to support the skin barrier. So and I'll also clarify, I think you know, your routine does not have to be this. It can be very simple and at the end of the day, moisturizing the skin, being really gentle with the cleansers, you are choosing protecting the skin using some sort of occlusive to seal in hydration and moisture. Those are all, you know, helpful elements of healing a skin barrier. But if you're asking me for my absolute favorites, this is what I would do. Even though there's not just one way to heal your skin barrier. So first of all, when it comes to cleansing, just be mindful when your barrier is kind of on the fritz, you may have to back off over cleansing or cleansing twice a day for a little bit. And you may just find splashing with water is really all your skin can handle. I do recommend cleansing at night, so probably just once a day when your skin is really compromised. And my favorite cleanser for a compromise barrier is My Free Skin by Tessa Undo. This is a very gentle cleansing lotion and it is packed with anti inflammatories and one of my favorite ingredients, which is helichrysum italicum extract. This works to inhibit the effects of cortisol, which we talked about earlier in the show as something that can aggravate the skin barrier. So it's very soothing and calming and intended to improve the skin barrier with use rather than the inverse harming it. And my Undo has a ph of 5.3, so really close to your skin's natural ph. You can use Undo as a makeup remover, but you can also use it as a daily or hydrating gentle cleanser. Next is a toner. And I think a lot of people will argue toners aren't essential. And I agree they're not essential. But if you can use one, I actually think it's a very beneficial step for a compromised barrier because when you have washed your face when it's wet, your skin is the most vulnerable. So this is a great time to apply anti inflammatory ingredients and humectants. And one of my favorites is the Glymed Skin Recovery Mist. This is a calming, soothing toner and I like it for a compromised barrier because a lot of toners are intended to be applied with a cotton round or by, you know, patting, rubbing the skin. And when the barrier is extremely compromised, I think it's helpful to kind of reduce any type of friction on the skin. So I like that this is just a very fine mist that you can apply to your skin. And I am a fan of layering humectants, hydrating ingredients to help build the barrier when it is especially compromised. I know when my skin is super dry and compromised, it is soaking up every ounce of moisture. And although I could simply just apply a moisturizer, I find my skin benefits from the layers of hydration. So that's just my personal method and preference. After toner, I do love to apply a hydrating serum and so with serums and when you have a compromised barrier, I think you really want to, you want one for hydration, you want one that has ceramides and lipids. And so for a hydrating, anti inflammatory serum, I love my complex serum. This also contains helichrysum metallicum extract, similar to Undo. It also contains antioxidants like green tea, red tea and white tea. And I love complex. It's kind of like a first aid serum when your skin is hot, stinging, burning, irritated, when somebody has maybe had a reaction in the treatment room. Because helichrysum metallicum extract is, is anti allergic, it is anti inflammatory, it's antimicrobial. So really calming, healing and beneficial for inflammation. After I've applied a hydrating serum, I think it's so important to emphasize ceramides. Ceramides are one of the three critical components of our lipid matrix. So I love the glymedic protective skin serum. This contains ceramides and it's just like a soothing blanket for dry or irritated skin. I love bringing this serum out in the fall and winter. It is a favorite for any of my clients who are struggling with getting their barrier back on track or who just have constantly dry, flaking skin. It just feels like liquid gold for a compromised barrier. So I love that one. And then my favorite moisturizer right now I am actually working on a moisturizer, so more on that soon. But I do love the glymed barrier cream. This also contains ceramides and amino acids. I actually like this moisturizer for a compromised barrier because it doesn't absorb or sink into the skin right away. It almost acts as a second shield. So it's really nice that it almost takes a minute for it to absorb because when your barrier is compromised, you actually don't want the moisturizer to absorb too quickly. So I love that one. And then as my occlusive, my favorite is the glymed cell protection balm. I've probably gone through 20 tubes of cell balm. It's an OG for me and I think it is, is the best occlusive I've seen on the market. Do you need cell balm? No, you can pick up petroleum jelly. Petroleum jelly is actually great for a compromised barrier and it can really help heal your skin by providing a seal and kind of smoothing down the cuticle, the rough edges of flaky dry skin. But I think of cell balm as kind of adult petroleum jelly. It's a little more sophisticated. It has yeast, beta glucan, which is great for inflammation. And this product is truly just incredible. I would consider it basically medicine for anybody who's dealing with a compromised barrier or eczema, atopic dermatitis. You will feel a difference after one night of use. So I have to have at least two tubes of cell balm in my house at all times. I also apply it to lips, to feet, soles of the feet which can get a little cracked. Also hands, I didn't bring this up in the episode but oftentimes our hands can actually get more compromised than our face and we want to protect our hands because when we have cracks in our hands, when we have super dry skin, it is easier for pathogens, irritants, allergens to enter our skin. So you want to keep your hands moisturized and protected. Especially in the fall and winter when we are washing our hands more often, the air is really cold and dry outside. So I love cell balm for so many reasons. I just feel like it's a staple to have on hand. And if you are frequently dealing with dry skin or a compromised barrier, you can take a pea size of cell balm, combine it with your moisturizer or apply it over moisturizer to create a seal and I just think it is fantastic. Next I do want to mention a mask that I would recommend. You can use this two to three times a week as a hydrating, rejuvenating skin treatment. And my favorite, favorite favorite mask. You've seen this on Instagram if you follow me. This is my bath mask. I love the Glymed Rejuvenating Peptide mask AKA the Rose mask. This is packed with peptides and amino acids. It is so well tolerated by all skin types and it feels really cooling on the skin. Pro tip. You can also pop it in the fridge before you use it for a little extra anti inflammatory boost. But if you deal with compromised dry skin in the fall winter, apply this mask when you are taking a shower and it will help to prevent against tools and losing water and moisture in the skin. And you don't need a compromise barrier to use this mask. Anyone can benefit from it. It helps to really plump and hydrate the skin. So I love that one and it just feels really luxurious. Feels like a little pampering moment to use. And let's not forget managing stress, taking care of yourself, doing self care is also a great way to support your skin barrier. Last but not least, sunscreen. So when you have a compromised barrier, I do think mineral SPFs are better tolerated and less likely to aggravate the skin. And I know we can all vary so much with our preferences for spf. Some people like one that feels thick and hydrating, others want one that is more lightweight. Others want a tinted spf. So I have a lot of favorites. I love the IS Clinical Extreme Protect SP spf. I really like Jan Marini's physical Tinted SPF face. Reality makes a great mineral SPF that my clients love. It does have a little bit more of a mattifying effect, so kind of the opposite of the extreme protect from IS Clinical. But there are definitely good options out there for all preferences. Lastly, I do love Cirella's Quench and Protect spf. That one is nice and hydrating. Not quite as thick as the IS Clinical, but really I there as long as you wear sunscreen you don't feel like it clogs your pores or irritates your skin. I'm just happy you are wearing one. That is all I have for today's episode. I know this was a lot of information. Thank you so much for tuning in, for being curious about your skin and supporting this show. I love you guys so much. Please be sure to share on social media if you enjoyed this episode or texted to a friend. I cannot wait to talk to you more. So I will see you back then. And thank you again for tuning in.