Flakes, roughness, redness, cracks, fish scales, alligator skin, oh my! Seems easy enough for estheticians to identify these symptoms of dry skin, especially since dryness and dehydration are common issues for clients. In fact, chronic dryness and dehydration are major issues since consumers often tolerate flakiness, thinking it will eventually go away.
Although skin types are usually classified as dry, normal, oily, and combination, dry skin isn't necessarily a static condition. Dehydration is a condition that may affect all of these skin types. As a professional esthetician, you must consider several different factors each time you address a client's dry skin, determine immediate treatment, and advise long-term home care.
First, understand what is going on beneath the surface. Next, select the appropriate treatment, products, and ingredients, based on a thorough skin analysis that includes the client's history. Finally, take advantage of your captive audience: educate the client about the reasons and remedies for dry skin and dehydration. In this way, you can maximize and prolong the benefits of the treatment, while showing the client how to manage and even prevent the condition in between visits.
Setting the Scene
The stratum corneum is often compared to a "brick and mortar wall" that protects against the outside world.
For normal skin, this "wall" is a hydrolipid film that consists of a matrix of moisturizing factors and naturally produced lipids that keep skin hydrated and protected from the external environment. The key to healthy skin is the capacity to attract moisture and retain it.
Corneocytes, or "bricks," are protective skin cells that contain proteins and natural moisturizing factors (NMF), which pull in moisture.
Lipids, or "mortar," are composed of ceramides, fatty acids, and cholesterol, which are natural oils surrounding the corneocytes that regulate skin permeability, lock in moisture, and keep skin supple.
Dry skin occurs when the building blocks of its surface matrix are damaged, missing, and left unrepaired. This outer layer of protection is compromised, like a brick and mortar wall that becomes damaged and steadily breaks down. Mature skin tends to suffer from dryness because with age, the body slows down its natural production of oils.
Genetics, aging, disease, and various stressors can cause the disruption of skin's natural moisturizing factors (NMF) and lipid levels. The result? A damaged protective barrier triggers a state of dehydration or transepidermal water loss (TEWL).
Oily skin can be caused by overactive sebaceous glands that produce excess lipids, which is often due to genetics, hormonal changes, products that strip skin of natural oils, excessive use of product, seasonal changes, medications, or stress. Oily skin is prone to acne, but care should be taken not to over-cleanse or over-exfoliate. This can strip the skin of protective oils, causing dehydration. It may seem counter-intuitive, but dehydrated skin can lead to an excess of oil to compensate for the lack of moisture, which is the reason dehydrated skin can sometimes be misinterpreted as oily skin.
Whether it's a matter of dry or oily skin, any damaged and malfunctioning protective barrier prevents skin from retaining a normal moisture level, even if water is present—think of what happens when water is poured into a paper cup punctured with holes. Correcting and repairing this issue has two phases: 1) relieve the dryness with water-loving, water-binding molecules; and 2) protect from further dryness with occlusive products that will keep the water inside and protect the skin from the outside.
However, if this broken surface isn't repaired, skin loses elasticity and displays flaking, redness, cracking, wrinkles, and other signs of aging. At a deeper level, the healthy development of corneocytes becomes compromised, perpetuating further damage in a vicious cycle of dry, itchy, and irritated skin.
What Dry Skin Desperately Needs
Water is absolutely essential to maintain life and health, and skin is especially demanding. Given that healthy, moisturized skin contains 60-70% water and 2-10% lipids, the key to repair skin's broken surface and restore its protective barrier is to replenish moisture and lipids in the building blocks of skin. This water and lipid balance is essential to maintain texture, elasticity, and the skin's overall health.
When faced with dryness and dehydration, it's easy to react by using a lot of occlusive oils or heavy creams. However, layering more waxes and oils on the skin will prevent outside moisture from getting in, and perpetuates the cycle of dehydration. Start at the source: moisture needs to be added first, and afterward, occlusive products will help seal in that moisture.
Treatments for dry and dehydrated skin should include products that will deliver moisture, help skin retain moisture, and maintain a healthy water/lipid balance. The first order of business in the facial room should be the skin analysis, with a problem/solution approach to determining the specific cause of dryness and dehydration and how to treat it.
Dry Skin Solutions
Exfoliation is an essential step in helping healthy skin cells to develop. Be careful not to over-exfoliate dry skin, which can cause the skin to over-compensate in response by triggering excess oil production. Alpha hydroxy acids, such as mandelic acid, should be gentle enough to clear away debris and smooth out rough texture so that moisturizing ingredients may be absorbed. Avoid the use of harsh peels and clay masks that draw moisture out of the skin.
After exfoliation, it is important to immediately replenish lost moisture and pave the way for healing dry skin. Look for skin care products that feature a combination of humectants, emollients, and occlusives, which work together to hydrate the skin, lock in moisture, and heal the protective barrier.
Humectants enhance NMF production by attracting and helping skin retain water, improving the hydration of the stratum corneum.
Emollients smooth out flakiness and help restore lipid levels, which accelerate barrier repair. Emollients include light oils and may also have occlusive properties that prevent water from evaporating.
Occlusives take the place of the damaged protective lipid layer. They create a protective barrier that locks in moisture and include oils, butters, waxes, and silicones. Botanical oils and butters are increasingly popular in skin care products, since they help prevent water loss, help reduce redness, and absorb quickly.
Choosing the appropriate type of moisturizer is also essential. Since moisturized skin depends on a combination of water and lipids, such as oils, waxes or butter, use products that not only seal in the natural moisture factor, but are age-appropriate.
Gel-based creams are best for hydrating younger, normal to dry skin that is suffering from dryness and dehydration due to seasonal changes or environmental conditions such as cold, dry, thin air at high altitudes.
Mature skin benefits from butter and oil-based moisturizers and balms. Remember, the larger the molecule, the more outside protection you'll have. Oils and butters sit on top of the skin and protect it from chafing and extreme dryness, with minimal chance of skin irritation.
Acne-prone skin may be dry and dehydrated, but choose a light moisturizer instead of applying heavy oils. Rich products may upset the lipid balance, clog pores, and prevent moisture from getting in, which only worsens the signs of dehydration.
Mature skin will revive and blossom when sleep masks are used overnight: the rich texture is ideal for dryness and photo-damage, and skin will be hydrated and dewy the next morning.
Ingredients for Dry Skin: Some Friends and Foes
Review the ingredient lists on your skincare products and encourage your clients to do the same for their products at home. Ingredients on labels are listed in descending order by weight, so think twice before choosing a product that has water listed as one of its primary ingredients, since the presence of water in a formula doesn't necessarily equate to moisturized skin. When it comes to treating and healing dry skin, remember the moisture trinity: humectants, emollients, and occlusives.
Check the top of the list for hyaluronic acid, which is a potent humectant that absorbs moisture, expands it up to 1,000 times, and allows skin to retain that moisture. Look for this ingredient as the base of skin care products, because it hydrates skin better than water (which can also dilute the product). Hyaluronic acid at a high molecular weight (such as 800-1,000 kDa) provides extensive moisturization and elasticity. Studies have also shown that hyaluronic acid at a low molecular weight (50 kDa) penetrates the stratum corneum even more effectively.
Glycerin and urea are other popular hydrating agents which, like hyaluronic acid, are part of the natural moisturizing factor (NMF) in skin. Applied after exfoliation, they are also well-absorbed and continue to provide hydrating benefits even after the product has been washed off.
For those consumers who prefer natural humectants, honey pulls moisture from the air and retains it. The acidic and anti-irritant properties of honey help break down and clear away the flakiness of dry skin without causing skin sensitivity. Its vitamins and minerals such as calcium, copper, magnesium, niacin, pantothenic acid, and thiamin provide nourishment and replenishment to help heal and balance dry, dehydrated skin.
Sodium PCA and ceramides are emollients that are also powerful components of skin's NMF, with strong moisture-binding properties. These popular humectants also create a barrier that reduces the loss of moisture, preventing skin cells from drying out.
For those consumers who prefer botanicals, Sacha Inchi seed oil and butter are exotic yet very effective occlusives, containing up to 85% omega-3 and omega-6 essential fatty acids that deeply moisturize, repair, and maintain the barrier function. Cupuaçu seed butter contains vitamins A, B, and C as well as mineral nutrients (calcium and selenium) that improve moisture retention and promote barrier repair. Abyssinian oil, evening primrose oil, moringa oil, baobab oil, baobab butter, and shea butter are also popular and effective, and lack a heavy fragrance that would irritate already sensitized skin.
Beware of the Moisture-Busters
Salicylic acid and benzoyl peroxide are often successfully used to kill acne-causing bacteria, exfoliate, and reduce the size of pores, but these ingredients can dehydrate and irritate dry skin, increase flakiness, and damage the barrier function even more.
Retinoids are known as powerful wrinkle-smoothers, but can cause irritation and dryness as a side effect, so ingredients like retinol, retinyl palmitate, tretinoin, isotretinoin, and other derivatives of vitamin A would be too harsh for dry skin.
Sodium lauryl sulfate and other lathering sulfates found in cleansers and toners can cause irritation--try an oil-based or cream-based cleanser instead.
Avoid facial toners that contain SD alcohol, isopropyl alcohol, or denatured alcohol, which are used to enhance the absorption of other ingredients and provide a smooth finish, but these alcohols can dry out and erode the skin surface almost immediately. (Note that cetyl, cetearyl, and stearyl alcohols are skin-friendly fatty alcohols that enhance texture and help keep other ingredients stable.)
Reasons and Remedies for Dry Skin
Determining the specific cause of dryness or dehydration is paramount in treating clients effectively. Take the treatment a step further by talking to your client about the reasons underlying temporary or long-term symptoms of dry skin, and give suggestions how to manage, treat, and prevent dryness in between visits.
Problem: Seasonal changes with wind, cold air, and low humidity pull moisture away from the skin surface and weaken the protective barrier.
Solution: Apply moisturizers or serums more frequently and use a humidifier in the home.
Problem: UV rays penetrate the skin, depleting NMF and lipids.
Solution: Use SPF 30+ every day and reapply frequently. Avoid spending time outside in the middle of the day, when UV rays are the strongest, even on overcast days.
Problem: Lack of exfoliation causes a build-up of dead skin cells that prevents the skin from absorbing moisture.
Solution: Use ultrasonic exfoliation tools or mild hydroxy acids (such as mandelic) two to three times a week.
Problem: Long hot baths, showers, or soaks in jacuzzi tubs break down lipid barriers in skin, leading to moisture loss.
Solution: Take warm showers, limit the amount of time in water, and apply moisturizer immediately after drying off.
Problem: The body's natural oil production diminishes with age. Prescription medications such as diuretics, retinoids, and antihistamines may dry out skin. Low humidity, indoor heating, air conditioning, and recycled air in planes dries up moisture in the air and the skin. Harsh, irritating ingredients in skin care products or makeup dry out skin and break down lipids.
Solution: Use products that include humectants, emollients, and occlusives to maintain the moisture/lipid balance of the stratum corneum.
Problem: Internal causes of dryness include physiological or medical conditions such as diabetes, vitamin deficiency, thyroid disease, eczema, and psoriasis.
Solution: Advise your client to consult a board-certified dermatologist.
From Dry to Dewy
Everyone deals with dryness at some time, whenever there is an imbalance in the water/lipid ratio of the stratum corneum, when there is not enough oil to create a barrier and lock in moisture. External causes such as environmental factors and lifestyle choices can lead to dry skin conditions, with symptoms that may be temporary or longterm. Internal causes include age, genetics, and physiological or medical conditions such as hormonal changes, diabetes, vitamin deficiency, thyroid disease, eczema, and psoriasis.
For most clients, simple measures can be taken to treat, reduce, and prevent the symptoms of dryness and dehydration. Make sure that exfoliants are used properly, so as not to aggravate dryness by stripping skin of essential lipids. Choose the appropriate moisturizer for skin type and age, which will maintain the water/lipid balance of the skin's natural protective barrier. Teach your clients how they can modify their skincare routine, lifestyle choices, and everyday behaviors in order to prolong the effects of their facial treatment and keep their skin looking healthy, even during seasonal changes. Encourage consistent, ongoing home care so clients can transform their dryness and dehydration into a dewy, healthy-looking glow. Remember: As you treat, educate, and encourage your clients, your role as their skin care expert extends beyond the walls of your treatment room.
Founder and CEO of Le Mieux Cosmetics and PurErb Herbology-based Skincare & Aromatherapy, Janel Luu has over 35 years experience in the beauty industry as an educator, researcher, and formulator. She has taught over 37,000 skincare professionals and physicians on topics ranging from anti-aging cellular technology to centuries-old Meridian techniques.