Finally corneotherapy is making its name and principles known in the skin care industry. I've been preaching this philosophy to my clients for years! Please read the article in Associated Skin Care Professional's Skin Deep July/August 2014 Issue.
BY KATHRYN MAZIERSKI
Understanding the skin barrier is essential for an esthetician. Supporting this important system is the first step in correcting any inflammatory skin condition: acne, rosacea, and a host of others. An amazing body of scientific discovery on the topic of corneobiology—the study of the skin barrier—has been produced by researchers such as Peter Elias, Richard Gallo, Albert Kligman, Hans Lautenschläger, Lars Norlén, and others. One of the things this research reveals is that dermatologists, estheticians, and other skin care professionals may unwittingly be recreating the inflammatory processes they are trying to treat. We
routinely strip away the skin’s first line of defense, the acid mantle, as a side effect of our treatments and, too often, we do not pay enough attention to restoring it. Any time you see redness in the skin, it is a sign that the skin barrier has been compromised.
The Skin’s Barrier Functions
The role of the stratum corneum (the skin’s outer layer) is to protect us against
environmental hazards while preventing water loss from the skin. It contains an entire set of defenses—Kligman counted 16 separate types of barrier function operating within this skin layer. All are interconnected, co-regulated, and interdependent. If one barrier function is compromised, others will also be affected. The barrier function that most estheticians are familar with is the permeability barrier, which prevents transepidermal water loss (TEWL), and, in the other direction, prevents allergens, irritants, microbes, and pathogens from entering the body through the skin. To understand how we can support this permeability barrier and repair it when it becomes damaged, we need to know a little about three lipids that are found in the stratum corneum.
THREE VITAL LIPIDS
Under a microscope, the stratum corneum looks similar to a brick wall. The corneocytes are the “bricks,” embedded in “mortar” that is made up of multiple sheets of lamellar membranes. These membranes are the permeability barrier, and they are made of a mixture of three different lipids: ceramides, cholesterol, and long-chain free fatty acids. These three lipids account for up to 10 percent of the dry weight of the stratum corneum, and they work together to waterproof the skin.
The proportion of the lipids is vital for correct skin barrier function. All three must be present, and normal skin requires a ratio of 1:1:1 (in other words, each of the three is present in the same amount). If the epidermis overproduces or underproduces one of the lipids, a good permeability barrier cannot form.
Skin problems are the result. An example is atopic dermatitis, a chronic inflammatory skin condition in which ceramides are not produced in sufficient quantities. Clients with atopic dermatitis need more ceramides, so a 3:1:1 ratio is used in products aimed at these clients.
Although ceramides are a popular ingredient, the well-informed esthetician must realize that ceramides on their own are not the key to skin barrier repair, because all three key species of lipids within the permeability barrier are equally important. All three lipids must be present in sufficient amounts, and in the correct ratio, for the condition being treated.
The Acid Mantle
The stratum corneum’s first line of barrier defense is the acid mantle on the surface of the skin. The acid mantle has many tasks. It contains trans-urocanic acid, our natural defense against ultraviolet (UV) radiation—this acid is responsible for filtering out around 70 percent of the UV-B rays that we are exposed to. Deeper within the skin, a key protein called filaggrin is metabolized (broken down) to provide essential barrier components.
On the skin surface, these components are further degraded to produce what is known as “natural moisturizing factor,” which plays a role in keeping the epidermis hydrated and overall barrier function. Maintaining the skin’s surface at its natural, acidic pH level is critical for proper skin barrier function. When we strip away the acid mantle, the consequences include increased TEWL, chronic dry skin, various inflammatory conditions, and even an increased risk of skin cancer.
What else happens when the acid mantle is removed?
First, the skin’s pH rises, making it alkaline instead of acidic. In response, the stratum corneum releases inflammatory cytokines in an attempt to trigger more lipid production. Normally, this would be a good thing and would help return the whole system to a healthy state. However, if this cytokine cascade is continual, chronic inflammation sets in. The result is a very thin, leaky, and permeable skin barrier.
In other situations, increased skin pH may release serine proteases, which block lipid production. In this case, lipids stay trapped within the corneocytes instead of forming the permeability barrier. The result is complete failure of the skin barrier system.
Raising the pH of the skin for sustained periods of time can bring on or heighten the symptoms of acne, atopic dermatitis, rosacea, photodamage, and other conditions—not only affecting the epidermis, but also the dermis. Keep the skin acidic!
Corneotherapy: Restoring the Skin Barrier
When the skin barrier has been compromised, simply using anti-inflammatory ingredients is not enough to restore it. We must pursue treatments that return the barrier to its natural state of balance. This area of skin care is known as corneotherapy or skin barrier therapy.
An important goal of corneotherapy is to generate the three lipids that form the permeability barrier. When we provide these to the skin in the correct ratio using topical corneotherapeutic products, the synthesized lipids make their way through the stratum corneum to be processed along with those that were generated within the skin, forming the lamellar membranes that make up the permeability barrier. The lipids in corneotherapeutic products must always be chemically identical to those within the stratum corneum. Restoring the acid mantle (in other words, getting the skin back to an acidic pH) is the first step in restoring barrier function. This will:
• Turn off inflammatory processes within the epidermis.
• Allow the permeability barrier to start reforming.
• Improve the skin’s antimicrobial defenses, decreasing penetration of allergens and pathogens.
Do Barrier Repair Creams Work?
As the terms barrier repair and corneotherapy become more widely known, they have started to show up more often in product marketing. Many manufacturers who use these terms do not provide any supporting data that their products do what they claim. On closer inspection, many so-called barrier repair products do not contain the ingredients needed to get results.
They may even cause more harm to the skin barrier.
Here are the most common reasons why a barrier repair product does not work:
• It does not contain all three of the necessary lipids:
ceramides, cholesterol, and long-chain free fatty acids.
• It does not contain the correct ratio of those lipids.
• It has an incorrect pH.
Poor formulations often use silicones or other occlusive ingredients in an attempt to “block up the gaps” and prevent further TEWL. These substances impede the natural functionality of the skin barrier instead of restoring it. This means some products touted as barrier repair products actually have the opposite effect—a situation that should be of great concern to any skin care professional.
Getting it Right
With all this in mind, what are the basics you need to know in order to practice effective corneotherapy? Here are the key points:
• Respect the integrity of the epidermis, starting with the first lines of barrier defense.
• Keep the skin’s surface pH acidic.
• Restore the antimicrobial barrier and natural UV-B filters.
• When looking for a barrier repair product, use only those that provide ceramides, cholesterol, and long-chain free fatty acids in the 1:1:1 or 3:1:1 ratio.
At the same time, these are the things to avoid:
• Any procedure or product that decreases hydration.
• Mineral oils and other petroleum-based products.
• Products that contain emulsifiers. These have the side effect of destroying the lipid structures within the permeability barrier.
• Products that contain fragrance.
• Products that contain preservatives.
With a better understanding of the structure and function of the skin barrier, estheticians will recognize the importance of treating it with the respect it deserves. Overexfoliating, harsh or incorrect modalities, and incorrect product formulations all work together to create an inflammatory situation for your client.
The key to success in treating skin starts with a full assessment of the health of the skin barrier and the correct strategies to begin the repair process. Once the barrier is restored, wonderful and lasting results can be achieved for your client.
by Corporate Educator, Daniel Clary
(Osmosis Our Medical Skin Care)
Niacinamide, one of the powerhouse ingredients seen throughout the Osmosis line, effectively increases the skin's metabolism, allowing your cells to properly communicate with each other for repair, support barrier function, and to regulate desquamation. That's right, when your skin's metabolic rate is performing at its most optimum level via Niacinamide application - cells naturally exfoliate, UV damage and oxidative stress is repaired, and your skin's first line of defense, your barrier, is intact and ready to defend your largest organ. Unfortunately, like all biological systems, our skin metabolism slows down as we age - this is the reason we begin to form fine lines and wrinkles, and we tend to pack on that weight a bit easier! The metabolic rate can slow even further by extrinsic and intrinsic factors, such as sun exposure, smoking and poor sugar rich diets. Fret not though, Niacinamide is here to the rescue.
Niacinamide is the active form of Vitamin B3 (Niacin) and is by far one of the most important components of proper cellular function, acting as a precursor in over 300 chemical and enzymatic reactions in the skin and body. It has several medicinal applications including anti-inflammation, reversal of photo immunosuppression and an increase in cellular lipid synthesis. Topically, our patented liposomal Niacinamide will increase ceramide production for improved barrier function, repair photo aged skin, regulate unwanted pigmentation, decrease sebum production, and return your cellular turnover rate to normal. Systemically, it's involvement in the energy cycle of your cells, will allow free fatty acids and glucose to be more efficiently used and burned as fuel, versus being stored as fat, all while increasing your own native energy without artificial central nervous system stimulation. A win on both ends!
Did you know that the average skincare product provides less than 5% penetration. It is important to use products that offer a high penetration rate. The fact is skincare products should have a good delivery system in place. Your products should be formulated to help rebuild, repair, remodel and preserve the epidermal layers of the skin while building collagen and strengthening elasticity. A liposome delivery system is key to product penetration.
Liposomes are microscopic spheres that are so tiny making the absorption almost perfect which solves many problems for special nutrient deficiencies within the skin. Products which are poorly absorbed or which have a normal molecular size inhibit efficient absorption providing very little nutrient value for our skin cells. Normal absorption is in the 3-5 percent range, liposomal absorption is 90 plus percent!
Does your skincare products have this system in place. I have the perfect solution. I can help you get that healthy radiant skin you have always wanted without using harsh ingredients, chemicals or causing inflammation.
If you're like me, you've been frustrated dealing with hyperpigmentation... You may have tried all the latest skin potions and procedures only to find little or no improvement or worse yet, the condition worsens... The reason why hyperpigmentation is so hard to treat is that the melanocyte is influenced by so many factors and usually it is not just one thing that went awry but many. When any of the following "directors" or signalers are overstimulated the result is the overproduction of pigment.
Source: The Concise Guide to Dermal Needling. Cell Function. page. 48-49, 96-97
Not All Collagen is Created Equal - Why Collagen Induction Therapy Produces Natural Collagen NOT Scar Collagen
In any anti-aging situation , growth factors need to be stimulated by some means. Typically this is accomplished through controlled wounding. Several different types of growth factors are released according to the type of wound incurred. Growth factors are responsible for orchestrating and regulating cellular function and repair after injury. An ideal skin rejuvenation wounding or treatment would both improve the penetration of any active ingredient and wake up the fibroblast.
Unfortunately most rejuvenation treatments rely on dramatically invasive chemical peels, light or radio frequency to burn the skin, which leads to the release of TGF-B1 and TGF-B2 (transforming growth factors), TIMP-1, and Heat Shock Protein 47. These generate a fibrotic response that promotes scar collagen (thick, parallel oriented bundles.)
By contrast collagen induction therapy or dermal needling results in increased TGF-B, FGF-7 (keratinocyte growth factor), and EGF (epidermal growth factor)which promotes natural collagen, with scarless wound healing.
Click here to learn more and set up an CIT appointment!
In the early stages of wound healing the fibroblasts produce hyaluronic acid which helps stimulate cell renewal. In fact, one of the reasons fetal wound healing is scar-less is there is an abundance of hyaluronic acid. Studies have shown that hyaluronic acid applied topically during a wound dressing are associated with quicker healing and reduce scarring. Oral Glucosamine taken in adequate amounts during the first few days of surgery or trauma enhance hyaluronic acid production in the wound thus also promoting swifter healing with fewer complications related to scarring.
Three main factors create the environment in which acne can exist and ALL must be present for acne to occur.
1. Hormone Irregularities
2. Toxic Buildup
3. Genetics Tendencies
Or illustrated by this equation:
(Hormone Irregularities) x (Toxic Buildup) x (Genetic Tendencies) = Acne
Hormone Irregularities and Toxic Buildup
1. Congested liver, clogged and sluggish bowels
2. Nutrition deficiencies and dietary factors
3. Food allergies
5. Acid PH balance
7. Sleep disorders
*Test for Candida Overgrowth: In the morning before you eat or drink anything, make a large spit into a glass of water. Wait an hour. If you see legs or strings of saliva there is a moderate candida overgrowth, if the spit sinks to the bottom there is a more advanced candida overgrowth.
This is the most important factor and unfortunately cannot be controlled or deactivated.
The only genetic difference between acne sufferers and non-sufferers is that sufferers seem to have oil glands that are sensitive to even the slightest elevation in androgen levels. There could be other genetic factors that differentiate non-sufferers from sufferers such as the size of the oil gland, the skin type and other, unknown hereditary factors. At present, the most prominent genetic component in the formation of acne seems to be the over sensitivity of the oil gland receptors.*
Steps to Alleviate Acne
Do you or someone you know have the desire to eliminate acne holistically...? We can help you achieve this goal!
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Scientific research suggests that elevated levels of estrogen and progesterone can result in an increased growth of yeast in the body. Yeast is primarily housed in the digestive tract and may be culpable for as many as 30 percent of the acne cases seen on an annual basis. We can also increase yeast levels by eating sugar, which provides yeast populations with fodder to propagate. This propagation can then lead to imbalances in flora (healthy bacteria) that line our digestive tracts. This, in turn, allows for further yeast overgrowth.
The most common yeast population among Americans (relevant because of diet) is called Candida albicans, commonly referred to as Candida. Candida in associated with vaginal yeast infections and thrush. It may be a surprise but yeast infections originate in the intestine. When Candida levels fall out of balance, the yeast emits toxins that travel through the body via the body (via the blood stream) and result in a variety of physiological imbalances. If left unchecked, toxic yeast may rise up and disturb hormone production, impair immune function, and generally wreak havoc on many organs with the skin being the common victim.
The use of antibiotics to treat acne (used to counteract the bacteria that feed of the sebum in the skin) can cause an additional suppression of the immune system plus negatively affect digestive health which will inevitability exacerbate the development of acne. In my opinion, the colon and its related toxin build up is the primary source of acne. Suffice it to say that acne could be greatly reduce to changes in one's diet, colonics and detoxes (do your research and consult your physician as appropriate).
1. The product should be chirally correct.
2. Non-toxic (i.e. no parabens, fragrances, etc...)
3. Formulated with a delivery system such as liposome technology that allows ingredients to penetrate into the dermis.
4. Ingredients that penetrate should be time tested (independently) to stimulate collagen production and improve the health of the skin. Beware of marketing hype that uses fancy terminology.
Q - Can aging be reversed?
A - Skin will return to its most ideal state if there has not beem scarring and if it is given high levels of the nutrients it relies on to function optimally, and it is not continually subjected to ongoing inflammation. This means you cannot use irritants, you cannot exfoliate, you cannot get sunburns. You must increase circulation and maximize non-traumatic ingredients that encourage the skin to live up to its potential. We must also increase our immune efforts to repair and remove the scar tissue. This is best done by activating macrophages. Finally, we need to make repairs at the cellular level to the actual damaged DNA until we can achieve productions levels of antioxidants and enzymes that match the skin of our youth.
Q - Why do I get facial hair?
A - There are two components to facial hair: your genetic makeup and the influence of testosterone. Certain ethnicities have higher levels of villous activity. Other women are effected by ovanian cysts, low body fat levels, and the effects of hormone-laced dairy products.
Q - Why am I getting acne after age 30?
A - This coul dbe from ovarian cysts. It could be poor elimination and a need for more regularity. It could be elevated yeast levels. It could be a sluggish liver. It could be a buildup of a particular toxin.
Q - What are those bumps on my kids' arms?
A - Those goose bumps are what known as keratosis pilaris. I believe they are related to digestion. Exfoliation helps little, but internal options like probitics and/or anti-fungals may be more beneficial.The skin on the back of the arm is sensitive, which is why aggressive topical remedies are not tolerated well.
Ben Johnson, MD "Transform Your Skin Naturally", 2010
to dermagrace cosmetic rejuvenation blog and information center. If you're looking for dramatic and long lasting skin improvements…look no further. My goal is to provide the most authoritative skin care protocols, research and articles. Everyday I search for relevant and reliable information. I look forward to any comments or questions.