Skin Barrier Repair: Signs Your Skin Barrier Is Damaged & How to Fix It

[Intro] Hey, everyone. Welcome back to Facially Conscious Welcome back to Facially Conscious, with myself, Trina Renea, esthetician, Dr. Vicki Rapaport, dermatologist, Rebecca Gadberry, the cosmetic ingredient guru, and our fabulous overly-educated consumer, Julie Falls. 

We are gathered here together with you to talk about this crazy world of aesthetics. It's confusing out there in this big, wide world. That's why we're here to help explain it to you all, subject by subject. We will be your go-to girls. And from our perspective, without giving medical advice, we will keep things facially conscious. 

Let's get started.

00:59 Trina Renea: Hello, hello, hello, ladies, and welcome back to Episode 17 on skin barrier and barrier repair, which is kind of a takeoff on what we did last time. How are you guys doing? 

01:10 Julie Falls: Very well. Sounds very sexy. Skin barrier and barrier repair.

01:17 Trina Renea: Are we talking about our derriere repair? 

01:22 Dr. Vicki Rapaport: Dermatologists are all about barrier, so I cannot wait for this one. 

01:25 Julie Falls: Oh, good. Please educate us. 

01:27 Trina Renea: That's your whole business basically, kind of, right? On the skin.

01:31 Dr. Vicki Rapaport: There are a lot of rashes that come about if people's barriers are not intact, yes. But it's not my whole business. 

01:38 Trina Renea: No, I know. But I mean, a lot of your business is about the barrier. 

01:42 Julie Falls: Isn't barrier just skin? 

01:45 Rebecca Gadberry: Well, it's the very surface, the very top of the skin called the stratum corneum. And we're going to be posting an illustration of that on the show notes. So if you want to see the relationship of the barrier called the stratum corneum where it sits on the epidermis, which is the lower part of the top part of the skin, and then the dermis, which is where wrinkles occur and sagging, and a lot of your visual aging occurs, you'll be able to see those different layers on the show notes so that you'll have an idea better about what we're talking about. 

02:20 Dr. Vicki Rapaport: Oh, show notes with images. Do you have that with you now? 

02:23 Rebecca Gadberry: I do.

02:25 Julie Falls: I have all kinds of images. I think there's big ones of these in your office hanging up. 

02:28 Rebecca Gadberry: That big one that you have right there, that's the one we're going to be posting.

02:33 Julie Falls: Okay. 

02:36 Trina Renea: So, basically, to the audience, our barrier is our very surface of our skin, the part that everybody stares at and you see. That can get cracked or rash or dry or dehydrated. 

02:54 Julie Falls: Inflamed. 

02:54 Trina Renea: That is the part of the skin that protects the lower parts of the skin, right? 

02:59 Rebecca Gadberry: Yeah. We used to think of it like Saran wrap over the skin. That nothing got in, nothing got out, everything was just nice and like Saran wrap. Well, we now know that it's not anything like Saran wrap. 

03:18 Trina Renea: I was going to say kind of. 

03:19 Rebecca Gadberry: It's highly porous. It's selectively porous. In other words, certain molecules will get in where other molecules won't. But by choosing the right molecules to get in, we can influence the skin underneath. That's a skin penetration episode, which we’ll add to our topics. We're going to have to do one every day in order to fill all of the ideas that we have. 

03:44 Trina Renea: The barrier also protects your skin from getting things that shouldn't be in there.

03:50 Rebecca Gadberry: Like smog and cigarette smoke, bacteria, mold, yeast, fungus in the air. We also need to be careful of irritants that could be on the skin. For instance, irritating ingredients like benzoyl peroxide. If you use too much of it, it's going to irritate the barrier. 

You can also use oils like essential oils or fragrances on the skin. Too high amounts, you're going to irritate the skin. The only reason you get irritation is because something is penetrating the skin. 

04:26 Trina Renea: Also, if you have dirty makeup brushes and you don't clean them, or they used them on someone else, a makeup artist, you could get a staph infection. Is that what it's called? Staph?

04:38 Dr. Vicki Rapaport: Yeah. Also, just generally speaking with COVID and everybody using all the sanitizing and just overcleaning their hands. 

04:45 Trina Renea: Drying up that barrier.

04:47 Dr. Vicki Rapaport: Yeah, absolutely drying it out, messing with the skin's microbiome, which is the naturally occurring microorganisms that sit on our skin. We have viruses. We have bacteria. We even have fungi and we have yeast. We have so many bugs on the skin, as we were saying earlier. 

And when you mess with the microbiome or the skin flora, the natural skin bacteria and other things, then allergens get in and irritation occurs and inflammation occurs, which makes people itchy, dry, age faster, all the stuff you don't want. So you want to keep up your skin barrier no matter what.

05:25 Trina Renea: Speaking of that, I've been hearing a lot more today about probiotic ingredients for the skin and putting them in products, like people using probiotics to protect the surface. 

05:37 Rebecca Gadberry: Do you think that's another topic? 

05:38 Trina Renea: It could be, but…

05:40 Rebecca Gadberry: It definitely is. 

05:41 Trina Renea: I mean, I'm like, I honestly don't even know. I would love to talk about that. 

05:47 Rebecca Gadberry: Well, there's things like postbiotics that are on the market. The probiotic is the organism that is beneficial to the skin. The prebiotic is what that organism eats. Those are things in our body. Popcorn is a prebiotic. It's really good for your microorganisms. So if you love popcorn like I do, I wish…

06:09 Trina Renea: With butter and salt? 

06:11 Rebecca Gadberry: Butter and salt not so much, but the popcorn itself is great. Butter and salt kind of goes to other issues, so don't overdo it. But there's also other fibrous materials that are used as thickeners in cosmetics that we now know are helping to feed the microbiome on the skin. Those are things like xanthan gum and carrageenan that actually help to feed your natural population of those microbes. 

06:41 Trina Renea: Which keeps your skin stronger or…? 

06:42 Rebecca Gadberry: Keeps your microbes stronger. And then if you look at postbiotics, postbiotics are the products that the bugs make. I don't like to call them bugs. That the bacteria…

06:58 Dr. Vicki Rapaport: Microorganisms. 

06:59 Rebecca Gadberry: The microorganisms make.

07:00 Dr. Vicki Rapaport: It's sexier.

07:02 Rebecca Gadberry: And some of those postbiotics actually strengthen the barrier of the skin.

07:07 Trina Renea: Are you talking about their poop? 

07:09 Rebecca Gadberry: No, I'm talking about their proteins. 

07:13 Trina Renea: Is that a sexier word for poop? 

07:15 Rebecca Gadberry: No, it is not. Fecal matter from bacteria. 

07:21 Trina Renea: From the microbiomes? 

07:22 Rebecca Gadberry: No. 

07:23 Trina Renea: You said something that they extract. 

07:25 Rebecca Gadberry: They excrete. 

07:26 Trina Renea: Excrete, which to me sounds like…

07:28 Rebecca Gadberry: Poop. 

07:29 Trina Renea: Yeah.

07:30 Rebecca Gadberry: Yes. When all you have is a hammer, everything looks like a nail. When all you know is poop, everything looks like poop. 

07:38 Trina Renea: Well, what else do they excrete? Slime?

07:40 Rebecca Gadberry: They excrete proteins. And these proteins, just like our bodies are made up of proteins, just like proteins are made by our cells to make up our bodies, these microorganisms make up proteins, and these proteins help our bodies operate. So we have formed a synergistic living arrangement with them. Without them, we can't live. Without us, they can't live. They make proteins. 

08:10 Trina Renea: Wow, that’s deep. 

08:13 Rebecca Gadberry: They make proteins that help repair our barrier on our skin. So these proteins or these microbes we need in order to help maintain our barrier. 

08:25 Trina Renea: So when we have a bad barrier, our barrier is broken or weak or dry…

08:30 Rebecca Gadberry: Has holes in it.

08:31 Trina Renea: Yeah. Does that mean because our microbiome is not flourishing or living how it should? 

08:38 Rebecca Gadberry: Probably not. It's more like you have too much stress that influence those little keratinocytes that Dr. Vicki was talking about in the last episode. They make the lipids. If the keratinocytes are not healthy, they don't make the lipids in proper ratios. 

The lipids that make up the mortar of the brick-and-mortar wall that is the stratum corneum or the barrier come in different groups. There's ceramides, there's different types of cholesterol, there's fatty acids, and then there's essential fatty acids. If those are not all produced in the proper ratio, then you have a problem with an intact barrier. You can get a weak barrier that has holes in it, and then bad things come in. Like, your irritants or the cigarette smoke or irritating ingredients like alpha-hydroxy acids or Retin-A can be irritating on a skin that is not intact. So we need to build up that barrier before we can introduce really strong acids, for instance. 

09:51 Trina Renea: So if somebody has a barrier that's not good, what do they do? What do you do?

09:56 Rebecca Gadberry: You mean that's not healthy? I think of it in terms of healthy and unhealthy, or intact and not intact.

10:05 Trina Renea: Or dry and itchy and cracky. 

10:08 Rebecca Gadberry: Right. Uncomfortable, like we were talking about.

10:12 Trina Renea: What do you do? Like what do you buy?

10:14 Rebecca Gadberry: You can have scaliness. Well, you need to buy things that are going to help and improve that barrier. One of those things is the slugging we were talking about in the last episode, where we put moisture on the skin either after a hot shower, mildly warm shower, or washing your face or steaming or misting, like we were talking about. 

And then you cover the face with either pure petroleum jelly, which is trademarked Vaseline, or Aquaphor, like you love, Dr. Vicki, or another ointment that is highly occlusive. In other words, it kind of blocks off the barrier of the skin from releasing any moisture. 

And when you block off that barrier, it traps the moisture in the stratum corneum or the barrier, and it increases the water content. Therefore, you feel like you have a plump, healthy, comfortable moist skin. 

11:15 Dr. Vicki Rapaport: And patients with eczema, it's now considered part of the treatment, besides obviously giving them medications. Part of the treatment in maintaining their eczema is to teach them about moisturizing and how important moisturizing is. 

11:26 Rebecca Gadberry: Right. 

11:27 Dr. Vicki Rapaport: Basically, it can be as simple to repair your barrier as putting on the right moisturizer. Moisturizers with ceramides, moisturizers with glycerin, moisturizers with butter, certain shea butters or other oils. But it has to be part of the treatment plan because if we're not training them to moisturize, their eczema is just going to come back. It will never get better. 

11:49 Trina Renea: So if somebody has an itchy skin from eczema or some kind of just dermatitis from the weather, is it okay to put a barrier, like Aquaphor over that itch?

12:03 Rebecca Gadberry: It's essential. 

12:05 Dr. Vicki Rapaport: Are you saying because the barrier is broken, so all the stuff will go in. Is that okay? Like all the products will go in more because there are holes in the skin? 

12:11 Trina Renea: No, just because if it's itchy. Like if you have a rash, can you put Vaseline over a rash? 

12:16 Rebecca Gadberry: Actually, Vaseline I don't think helps as much as, let's say, a ceramide lotion. 

12:22 Dr. Vicki Rapaport: And it is okay to put grease. I say grease is like my overall arching description of moisturizers. And the ingredients are part of the reason why Rebecca is here, because she's the ingredient queen. But, yes, it's okay to put Vaseline on. 

Will it help? I don't know. It might make you feel better. But ceramides might be better there. Also, other hydrating elements in so many products out there, which, again, I recommend to my patients and they change every year. My favorites change every year. 

But for instance, like I get eczema on my neck. I didn't even know I had eczema until I was in medical school in Philly. And Philly had crazy cold winters. All of a sudden, I had this rash. Okay. I knew exactly what it was. I was like, “I've never had eczema before.” 

I was in my 20s. So I know that I was predisposed genetically. That alone living in L.A. never happened, but put me in a different weather pattern and it came out. I tried to Vaseline and I tried to moisturize. It didn't get better. 

Finally, I go to the dermatologist back then. They gave me steroids, topical steroids. Of course, it cleared up right away, because topical steroids decrease inflammation, because the problem with dry, dry, dry skin or when you kind of mess with the barrier is there's so much inflammation, because all these other allergens are coming into the skin. Remember? Because the barrier is not there.

Calm down the inflammation, the skin feels supple. Within like one or two applications of the cream, and the skin feels supple. 

13:46 Trina Renea: With the cortisone?

13:46 Dr. Vicki Rapaport: With topical steroids. Topical, right. And then if I didn't continue to moisturize, it would have just come back. So then the moisturizing maintenance was the key, and it never came back. It was kind of incredible. 

13:55 Julie Falls: Wow. 

13:56 Trina Renea: That happened to me one year when I worked in your office, Dr. Vicki. I got something on my arm. It was like, you're like, “Oh, that's eczema.” 

I'm like, “I don't have eczema. I've never had eczema.” And then we treated it like that with cortisone. And then I've never gotten it again either. It's so interesting how that can happen. 

14:12 Dr. Vicki Rapaport: Well, it kind of has to be the perfect storm, in a way, to have— again, you're predisposed, even though you might not know. Maybe an ingredient got on you or maybe the weather was really dry, or who knows hormonally what was happening with you or what other stressors were in your life and it happened. It doesn't necessarily, luckily, happen again on you, but people with full body, lifelong eczema, they do struggle. You know, we love these barrier moisturizers.

14:38 Trina Renea: So what does it feel like when you have a healthy or unhealthy barrier? Like, how does someone know? 

14:45 Rebecca Gadberry: Well, a healthy barrier feels comfortable. Your skin feels normal. 

14:51 Trina Renea: So not dry or oily. 

14:52 Trina Renea: Not dry or oily.

14:52 Dr. Vicki Rapaport: Or tight.

14:54 Trina Renea: Or tight. 

14:54 Rebecca Gadberry: Or super tight. You might feel firm, but that's a difference between tightness and firmness. Tightness is uncomfortable. It's like after you wash your skin with something super degreasing. 

15:13 Trina Renea: Like a bar of soap. 

15:14 Rebecca Gadberry: Like a bar of soap. 

15:16 Dr. Vicki Rapaport: Do people use bars of soap? 

15:17 Rebecca Gadberry: Oh, yes, they do. 

15:17 Trina Renea: Oh, yes. I have clients who tell me. 

15:21 Rebecca Gadberry: Of course. Madam Dermatologist, of course they do. 

15:24 Dr. Vicki Rapaport: I actually have a patient that washes her hair with a bar of soap.

15:26 Trina Renea: What?

15:27 Dr. Vicki Rapaport: Well, she's like 80, but it's hysterical. I love it.

15:29 Rebecca Gadberry: I was going to say we used to wash our hair with a bar of soap. 

15:31 Trina Renea: Right. I used Ivory soap to wash my face until I was like 31.

15:38 Rebecca Gadberry: It's 99.9. What is it? 99.9% pure soap, so it's pure drying to the skin.

15:44 Trina Renea: Oh, my God. But it's Ivory.

15:48 Rebecca Gadberry: But when you use a cleanser that's too strong for your skin, your skin feels tight because the lipids between the cells or the mortar between the bricks actually is dissolved and carried away when you rinse your skin. So the cells that remain are pulling together more tightly, and your skin feels tighter. And about a half an hour later, you're going to start to see flakiness on the skin, because there's no glue or mortar to hold the cell or the brick to the skin. 

So we can create an artificial dry skin and artificially damage, and when I say artificially, it's not done by the body. It's done by you with products. We can create a damaged barrier by the products we use. 

Some of the things that will damage a barrier is a short-term use of high percentage, low pH, alpha-hydroxy acids.

16:48 Trina Renea: Which are glycolic, lactic, tartaric, malic, all those. 

16:53 Rebecca Gadberry: Right. And we'll do an episode on that too. 

But also, the cleansers that you're looking for is pure soap. And the way that you can tell a soap bar from a cosmetic facial cleanser, so to speak, is that the soap bar will not have ingredients on the package. The product that's a cosmetic for your skin will have the ingredients. Those are things like Dove that are super-fatted soaps, but they're for the skin, so they're going to have the ingredients on there. 

Soap, back in 1938, when the FDA started regulating cosmetics, the soap industry said, “Well, soap is used for a number of things, not only to wash our hair and our faces and our bodies, but also to wash the dishes and to clean the laundry. We use it one-size-fits-all. So you can't regulate our products like you do cosmetics.” So soap was left off of the FDA definition of a cosmetic.

So when ingredient lists had to start being put on the package in 1977, soap wasn't regulated as a cosmetic, so it didn't get ingredient list. So the way that you can tell a soap, and it's going to be too strong for your skin and damage your barrier, is if it doesn't have the ingredient list on the package. It's not good for your skin. 

18:23 Trina Renea: So all of you out there who use bars of soap on your face, don't do it. Or your hair. How stripping. 

18:30 Rebecca Gadberry: And in hard water areas, they will leave a film over your skin. If you want any good ingredients to get in there, it's not going to get past that film. The way you tell if your product is leaving a film is take a bowl of water, swish your product around in it, and then take a glass that you can see through, dip it in. If it rinses completely from the glass, it's okay. It's not going to leave a film. If it doesn't, if there's like a soapy or whatever mess on there, then it's not good for your skin. 

19:07 Trina Renea: Another project for my daughter. 

19:08 Rebecca Gadberry: Yeah, another project. 

So the other aspect of a cosmetic product that you want to avoid is a cream, a moisturizer or a body lotion or a milky cleanser with too much emulsifier in it. The way you can tell if it has too much emulsifier in it is if it soaps up on the skin or it creams out. If it turns white on your skin, there's too much free emulsifier, that's going to get in between your cells as well. 

19:40 Trina Renea: Are you talking about like when you put lotion on and it makes that white film?

19:44 Rebecca Gadberry: Right. That's called soaping up, or soaping out. What it does is it does something called washing out the skin where the emulsifier doesn't just make sure water and oil sticks together in the product. It also will take water and bind it to the lipids in your skin, between your skin cells. If there's too much emulsifier, when you go to rinse your skin, the lipids between your cells go away. 

So it's like a vicious circle, or what I call a viscous circle. Because what happens is you put the moisturizer on. It's too strong. It's got too many free emulsifiers in there. It soaps up. It dissolves your lipids. You wash it off later in the day, your skin gets dry and tight. So you think you need more moisturizer. So you put more of what caused the problem in the first place. And it's a vicious cycle of moisturizer, dryness, more moisturizer, drier, more moisturizer. 

So you see it a lot probably, Dr. Vicki, the results of that as well.

20:55 Trina Renea: When clients come to me and they say that even cleansing their skin stings, that is a compromised barrier. 

21:06 Dr. Vicki Rapaport: Yes. 

21:06 Rebecca Gadberry: That's right. 

21:06 Julie Falls: Interesting. 

21:06 Trina Renea: That is one way you can tell. And a lot of times that's caused by stuff you do to yourself. So, over exfoliation, over scrubbing, putting too strong acids, too much retinol, Retin-A, and layering, layering, day after day, and you're starting to kill your barrier, right? 

21:26 Rebecca Gadberry: Too much excitement over your skincare products. 

21:31 Trina Renea: Right. So when clients ask me, I mean, when they tell me, “I have sensitive skin,” right away I say, “From life? Like from birth, you've had sensitive skin or just right now? For how long has this been going on?” That way I know, oh, it's caused by something you're doing, or not.

21:51 Rebecca Gadberry: If you have sensitive skin, you have a damaged barrier. 

21:55 Trina Renea: From birth, even? 

21:56 Dr. Vicki Rapaport: From whatever. 

21:57 Rebecca Gadberry: From whatever. And it needs to be repaired. If it's something you're doing, you need to stop doing it. So you need to find out as their esthetician what they're doing so they can stop. 

But regardless, that barrier needs to be repaired, whether it's from birth or whether it's from something they're doing.

22:13 Julie Falls: Yeah, but sometimes you inherit things like rosacea from genetic. 

22:17 Rebecca Gadberry: Especially Scandinavian, British Isles. 

22:23 Dr. Vicki Rapaport: And I think as a dermatologist, I'm so impressed with products these days. They're so much more potent. They're so much more effective in what they say they're doing. The acids are stronger. The retinols are stronger. 

I used to laugh and say, “Ah, over-the-counter products can't really do much harm,” but it's just not true. You can over-product yourself because the products have gotten better. So I think it is good to, when patients do come in, I love when they bring their stuff in so I can see. 

Now, of course, I can't always tell because sometimes the ingredients are on the box. So if you're going to the doctor or the esthetician, and you have your products— well, I guess now, you can just look that stuff online, but sometimes it was just fruitless because I couldn't tell. I had no idea what those products were. 

But looking the products up, the ingredients up is nice, but also we don't sometimes know the percentages, but we can usually tell with the basics, like what they might be doing to injure their skin, and it not just being a genetic problem. 

23:18 Julie Falls: I have a question. If maybe you've been taking really good care of your skin and you have kind of self-educated and you have facials on a regular basis and you see a dermatologist, but you want to eliminate things like hyperpigmentation and whatever. You work up, eventually, a routine where you are layering. I'm talking about myself. You're layering your acids, which has recently proved to be life-changing for my skin. That I'm using more and I'm layering as compared to some people who talk about the fact that they were using too much. Maybe they were acid virgins, and it was like, “Oh, this is great. Let's…”

24:08 Dr. Vicki Rapaport: Do more.

24:09 Julie Falls: Yeah. I'm just curious. How do you say to your patients, “This isn't for you”? Because I'm a sensitive skin person too, but I can handle it. 

24:22 Trina Renea: Well, it also depends on what products you're using and what you're layering and what the percentage of acids are in those products and how each person's skin handles it differently in that blend. It's really a trial and error. 

But you know as a person, if your skin starts getting too tight or too dry or irritated or burny or stinging to pull back, you know. So you've found a place now where you can, you've figured out a rhythm with your products. 

24:56 Julie Falls: I guess my question is, do you tread lightly? Do you go slowly when you're trying to introduce new things?

25:05 Dr. Vicki Rapaport: Right. Absolutely. Building up is the key. For instance, acne. I love for acne patients I love benzoyl peroxide. Some can absolutely not handle it at all. They just get rashes. Other people can handle it once or twice a week. And then we build up slowly over weeks to months, to maybe doing it every day. 

And then we have to switch it around in the winter. They can't do it in the winter at all, but they could do it in the spring and summer, again, because of the weather. So, yes, whether it's retinol, we increase it over time to eventually we give them prescription Retin-A. If they can even ever handle it, we go up in the strength of Retin-A. Once they finish the tube of 0.025, if they can handle 0.05, we'll go there. And then exactly finding the balance. 

So I tell patients to be consistently inconsistent. If they need to back off, back off, go right back on and go slow, and build. You are really good with your products. You know what your skin can handle. Now, you've come to the point where you have finally reached the point where you can layer these products that some people probably couldn't even use by themselves. 

26:04 Julie Falls: And yet I still can't use Retin-A. 

26:06 Dr. Vicki Rapaport: And you still can't use Retin-A. 

26:07 Rebecca Gadberry: I’ve never been able to.

26:08 Dr. Vicki Rapaport: Which is your personal problem. 

26:12 Trina Renea: The one thing I tell people, and I'm sure you do too, Dr. Vicki, is when we're trying to put somebody on a glycolic or a retinol or something like that, that when you first started, it might be a little bit dry or it might affect your skin a little bit. But you’ve got to be consistent with it. So whether we say do it once every three days for two weeks and then go to every two days, but you have to be consistent with it for your skin to get used to it, to the ingredient. 

26:41 Rebecca Gadberry: There's a study on that. It was about 25 years ago. It was done down at Tulane University in New Orleans. What they found was 10% lactic acid at a 3 pH applied twice a day, once a day or twice a day, for about two months actually helped to repair the barrier. 

So if you are faithful with your AHA and you've got to build up to it, like you're saying, Dr. Vicki, then you can help to repair the barrier. That makes the skin better tolerate the AHA.

27:19 Trina Renea: Right. So I say like don't give up. Just call me if it's happening and we'll slow it down. We can slow it down, but I want you to continue to use the product. 

27:28 Rebecca Gadberry: Yeah, don't stop all together.

27:29 Trina Renea: Don't stop. 

27:30 Rebecca Gadberry: And another thing that all of these responses have in common, whether it's a change of seasons or AHA or retinoic acid sensitivity, is a damaged barrier. Remember that our barrier is damaged in the winter more so than in the summer. 

27:30 Trina Renea: Right. Definitely weather related.

27:53 Rebecca Gadberry: So, Julie, when you are getting your routine organized, and you really find something wonderful, you might have a change of seasons or a change of location, or you might take a new drug or get off of a drug. 

28:08 Dr. Vicki Rapaport: Or go through menopause.

28:10 Rebecca Gadberry: Or go through menopause, or have stress more so than normal. All of these things will contribute to damaging your barrier. You might change your diet. You might become a vegan, in which case you need to make sure— Vegan, I guess. We say vegan back in the ‘60s. 

28:26 Dr. Vicki Rapaport: Vegan.

28:27 Trina Renea: Vegan.

28:28 Rebecca Gadberry: Vegan? Okay. But you're going to need more oils in your diet if you are a vegan. 

And what I said in the last episode about food not getting to your skin, one of the things that does get to your skin is an increase in oils and fats. 

28:44 Julie Falls: That's good to know.

28:45 Rebecca Gadberry: So that does help you.

28:45 Trina Renea: You mean like eating omegas and fish oils and stuff like that? 

28:48 Rebecca Gadberry: Yeah, fish oils and omegas. Those also strengthen the walls of your capillaries and help you grow new vessels. So it's going to help with the nutrition and the hydration of the lower skin as well. 

29:04 Dr. Vicki Rapaport: And just to tap into that lactic acid comment about that study in Tulane, from the dermatologist's perspective, people with dry skin on the body, not talking about the face right now. I know this is really a lot of face talk, which is great. But like dry legs, ichthyosis, dry eczema, eczematous skin, we love to recommend lactic acid. Lac-Hydrin is the common one. Lac-Hydrin is the key.

And I explain to the patients, “Yes, it's lactic acid. It might sting for 10 seconds, but it will help slough the dead skin, but it also seals in the moisture.” When you get all that dead skin off that isn't sloughing off, you can actually seal the moisture and better. 

And some people can't use it for more than once a week. Then, eventually, they're using it every day for the rest of their life. So you can build a tolerance to certain products that will be really good for you. 

I think the key is getting coached. I think it's hard for people to see an esthetician or a dermatologist. This is why these podcasts are great. But if people are having problems, they have to seek help. You can't just constantly try products on their own, if you're having lots of problems. 

30:02 Trina Renea: Try things. That's how you get sensitized skin, I think. 

30:06 Rebecca Gadberry: Yeah. And that, again, is a damaged barrier. I want to drive that home. 

30:11 Trina Renea: Damaged barrier. 

30:12 Rebecca Gadberry: You have a damaged barrier. That underlies everything else and how your skin responds to something. 

30:20 Trina Renea: How does azelaic acid help with rosacea? Does anyone know? That's an acid that they use in the ingredient. 

30:30 Dr. Vicki Rapaport: That’s Finacea. 

30:31 Trina Renea: Finacea, yeah. 

30:33 Dr. Vicki Rapaport: You're going to catch me…

30:34 Rebecca Gadberry: I think we should have an episode on rosacea. 

30:38 Trina Renea: We’ll talk about rosacea and what helps it and why.

30:42 Julie Falls: I'm on three new medications right now. 

30:45 Trina Renea: Yeah, Julie has it. I have it a little too. 

30:47 Rebecca Gadberry: Yeah, I have it too. 

30:49 Julie Falls: Everybody has a little bit. 

30:50 Rebecca Gadberry: Dr. Kligman analyzed my skin for rosacea. 

30:55 Trina Renea: Do you say you have mites?

30:55 Dr. Vicki Rapaport: Arnie?

30:56 Rebecca Gadberry: Albert.

30:57 Dr. Vicki Rapaport: Oh. I'm thinking Arnie Klein. Albert Kligman in Philly? 

31:00 Rebecca Gadberry: Yeah, not Arnie Klein. Albert Kligman. 

31:02 Dr. Vicki Rapaport: In Philly? 

31:04 Rebecca Gadberry: No. He was in New York and giving a lecture. I was sitting in the front row. He kept looking at me and looking at me. When I got up to leave, he said, “Miss, you have rosacea. You need to have something done about it.”

31:20 Dr. Vicki Rapaport: Always a dermatologist. 

31:20 Rebecca Gadberry: Always Albert, yes. 

31:21 Dr. Vicki Rapaport: It's hard to not see things on people when you see. It's hard. I wish sometimes I just had a filter for derm and a filter for real life.

31:28 Rebecca Gadberry: I know. 

31:30 Dr. Vicki Rapaport: Because I just constantly am diagnosing patients. 

31:32 Rebecca Gadberry: I want to go up to people and say, “You need to do this,” or, “Take care of your baby,” or, “Do this for your child.” 

31:38 Trina Renea: Oh, my God. I like it when Dr. Vicki tells people that they have barnacles on their face. 

31:43 Rebecca Gadberry: I have them on my back. 

31:46 Julie Falls: I have a red-headed daughter. When she was a baby, in the fairest skin…

31:51 Rebecca Gadberry: She'll have a thinner barrier. 

31:52 Julie Falls: We would be at a pool or the beach, and strangers would just come up to me, with this gorgeous, little, curly-haired, redhead baby. “Is she wearing sunscreen?” Just strangers. I suddenly get a t-shirt that says, “Yes, she's wearing sunscreen.” It was insane. 

32:11 Trina Renea: Oh, my God. They're, like, all worried about her. 

32:13 Julie Falls: It's so funny. 

32:14 Trina Renea: Did you know that redheads need a lot more sunscreen? 

32:17 Dr. Vicki Rapaport: Is that like if you're smoking or drinking champagne and you're pregnant, people come up to you and say, “Are you sure you should be doing that?”

32:22 Trina Renea: I had my baby screaming on the plane to Chicago for like 45 minutes out of control, and I had so many mothers on that plane come up to me going, “Let me advise you on what to do.” I'm like, “Please…”

32:37 Julie Falls: How about somebody just saying, “Let me hold her for you and help you?” That’s what you needed. That’s what I would have done.

32:43 Rebecca Gadberry: One question I get is if the barrier is intact, how does anything get into the skin from your skincare products? 

32:50 Trina Renea: That is such a good question, and I don't even know the answer. Tell me.

32:55 Dr. Vicki Rapaport: It depends. Micro droplets and microspheres and little pockets of…

33:02 Trina Renea: Liposomes?

33:04 Rebecca Gadberry: Right, liposomes.

33:05 Dr. Vicki Rapaport: Of ingredients and perfectly placed.

33:07 Trina Renea: Peptides. 

33:09 Rebecca Gadberry: The percentage that you put on the skin. Some of it will not go through, some of it will. So sometimes you need to load up the skin in order to get enough of it through. 

For instance, on vitamin C, if you take pure ascorbic acid, you put it on the skin, you're going to need a slug of pure ascorbic acid on the skin for some of it to get through. The problem with that is that it goes through so quickly, it will travel through the entire skin and be released into the bloodstream or wherever within minutes, or within like an hour. So we've got to trap the vitamin C in the skin in what we call a reservoir of vitamin C. 

So we will use molecules to help deliver the vitamin C into the skin and then it's held there. And you don't need as much of the vitamin C. Ascorbic acid you might see on the label, you're going to need a lot of it. 

But something like, and here's an ingredient that's going to be in the show notes, tetrahexyldecyl ascorbate. I know we both love that ingredient, Dr. Vicki.

34:19 Trina Renea: Good luck spelling that. 

34:22 Rebecca Gadberry: And tetrahexyldecyl ascorbate is the stablest form of vitamin C. You only need 2% of it to deliver what would be equal to 20% vitamin C, free vitamin C or ascorbic acid. 

34:34 Dr. Vicki Rapaport: Secret ingredient notes. 

34:36 Rebecca Gadberry: It's a wonderful ingredient. 

34:37 Trina Renea: One thing about the barrier is some ingredients you want for the surface of the barrier, some you want to go in and repair cells in the barrier. Some you want it to go down into the epidermis. So there's multiple ingredients in a product that are working at different levels. 

34:56 Rebecca Gadberry: Targeted delivery. And the lipids that hold the cells together, the mortar and the bricks, ingredients, especially oil-loving ingredients, like the oils that we were talking about in the last episode, that are your “moisturizing oils”, they'll travel into the skin through those lipids in the skin. 

35:20 Trina Renea: So if you're lacking mortar in your bricks…

35:24 Rebecca Gadberry: The lipids.

35:25 Trina Renea: Right. What is going to be an ingredient that you want to look for that will fill that mortar back up, let's say?

35:35 Rebecca Gadberry: One of the things about slugging Vaseline or petroleum jelly is there was a study done by Dr. Peter Elias back in the early ‘80s. He is a dermatologist at the University of California in San Francisco. He discovered that applying an occlusive coating over the skin, petroleum jelly, Vaseline, will repair the moisture barrier or the barrier of the skin within about 16 hours. So it is one of the fastest barrier repairs.

36:12 Trina Renea: How?

36:14 Rebecca Gadberry: Because it occludes and then the skin…

36:17 Trina Renea: Then the skin creates the mortar back? 

36:20 Rebecca Gadberry: Creates the mortar. Because remember, the cells in the epidermis, the lower part of the skin underneath that's right underneath the barrier, it creates the barrier. 

Other ingredients might be our ceramides. You're going to look for ceramides in products. You might see a word like hydroxyceramide. As long as you see “ceramide” in the ingredient name, that's going to be beneficial to... 

36:45 Trina Renea: For barrier repair.

36:47 Julie Falls: Rebecca, I'm sorry, when you were talking about vitamin C, what was the name of that?

36:51 Rebecca Gadberry: Tetrahexyldecyl ascorbate.

36:57 Trina Renea: That's a big word. 

36:58 Rebecca Gadberry: It's a big word. Its trade name is BV-OSC.

36:58 Julie Falls: I don't see it. Disodium EDTA.

37:05 Rebecca Gadberry: Okay, that's a chelating agent that takes metals out of water so your product is more stable. 

37:14 Julie Falls: Ascorbyl palmitate?

37:15 Rebecca Gadberry: Ascorbyl palmitate. Ascorbyl palmitate is a fatty vitamin C, but tetrahexyldecyl ascorbate is much more effective. That's tetra, T-E-T-R-A, hexyl, H-E-X-Y-L, decyl, D-E-C-Y-L. That's all one word. Ascorbate, second word. A-S-C-O-R-B-A-T-E. And the trade name is BV-OSC. 

37:54 Trina Renea: Will sometimes that will be on an ingredient list? 

37:56 Rebecca Gadberry: I'm sorry, BVSC. Yeah, tetrahexyldecyl ascorbate will be on your ingredient list. It should be about the middle of the ingredient list, upper middle. 

38:08 Trina Renea: The whole word or the abbreviated? 

38:09 Rebecca Gadberry: The whole word. If you use a trade name on an ingredient list, that's illegal. 

38:15 Dr. Vicki Rapaport: You got to pay. 

38:17 Trina Renea: You got to pay to plug it. 

I'm going to say let's wrap up this barrier repair episode, and we're going to get deeper into it in episode 17 A, where we're going to talk about common barrier repair ingredients to look out for. 

So, what are our takehomes from today, everybody?

38:37 Dr. Vicki Rapaport: Well, we didn't touch on not smoking to keep your barrier up. 

38:41 Trina Renea: Well, how many people smoke these days? 

38:42 Dr. Vicki Rapaport: I think a lot. 

38:44 Rebecca Gadberry: Here in California, only 13%.

38:46 Trina Renea: What? 

38:47 Rebecca Gadberry: In California, only 13%. But in the Midwest, quite a few people still smoke.

38:53 Trina Renea: So can you smoke and not have a damaged barrier? 

38:55 Rebecca Gadberry: No. 

38:58 Trina Renea: What? How about misting your face with pollution solution mist? 

39:04 Rebecca Gadberry: Pollution solution mist is a formula that I developed 20 years ago. Trina, I think you offer that for sale, don't you? That has some ingredients in it that help to protect the barrier lipids from oxidizing when cigarette smoke comes in contact with them. 

The problem with cigarette smoke, I've actually written an article about cigarette smoke in the skin. If we want to post it on the show notes, we can, because there's a lot to cigarette smoke in the skin. But cigarette smoke will oxidize lipids between your skin cells. When that happens, they are no longer effective as a barrier.

39:44 Trina Renea: So people who don't want to quit smoking, what can they do?

39:46 Dr. Vicki Rapaport: Put up with a damaged barrier, and collagen…

39:49 Trina Renea: Wrap their face in a towel while they smoke?

39:52 Julie Falls: I don't really want to give them any kind of suggestions but quitting.

39:57 Rebecca Gadberry: They can't do anything because cigarette smoke works inside the body and on the skin. And when it's working inside the body, it's working on the bottom layers of the skin to damage, age, cause pigmentation changes, damage collagen, so your wrinkles are deeper. You get your whistle lines, you get crow's feet around your eyes, you get discolorations in the skin, and you get dehydration and a damaged barrier. 

What can you do to help protect from cigarette smoke? Stop putting your skin around cigarette smoke. And that has to do with secondhand smoke that's being blown in your face as well as when you blow it out your mouth. 

40:42 Dr. Vicki Rapaport: Yeah. And I would say for a dermatologist, smoking lines are the most difficult lines to improve. People will have come in telling me that they've done CO2 resurfacing lasers. They've done microneedling. They've done this. They've done that. What else can I do? And they have these deep, deep, deep lines. 

And yes, we can do Botox. Yes, we can do fillers. But you can never really make them that much better. I tell them, “Look for 50% improvement.”

And of course, people don't think about that when they're smoking when they're 16, 17, 18, or starting through their 20s and 30s. I know it's just a cosmetic problem, but it's a very difficult problem to improve. 

41:15 Trina Renea: That is the one problem, I think, those lip lines that people have. Like, they can get facelifts, they can fill it, they can do everything. It doesn't take it away unless you look like a lion. 

41:27 Dr. Vicki Rapaport: And I love your pollution solution mist is cool, but you would have to bring that with you with every cigarette. You're going to spray that stuff after every cigarette. If people are two-pack-a-dayers, hell no. 

41:38 Rebecca Gadberry: I don't even know who tested that for me.

41:38 Trina Renea: Before and after.

41:42 Dr. Vicki Rapaport: And who knows how much improvement it would really make? The point is, I agree with Julie. The recommendation is just quit.

41:49 Rebecca Gadberry: Quit. But how we tested pollution solution mist is we asked a group of our employees who smoked and drank to go into a smoky bar for an evening. They sprayed half of the face with this mist and they left the other half exposed. And they sprayed it like every 15 minutes to half an hour. And at the end of the night, the part that was sprayed was moist and hydrated and comfortable, and the part that wasn't was dry.

42:18 Trina Renea: Like a prune.

42:19 Rebecca Gadberry: Like a prune and was dry and tight. That lasted until the following evening. It took that long for the skin to repair itself.

42:28 Trina Renea: Wow. Dang. Well, if you need some pollution solutions…

42:34 Rebecca Gadberry: We're not supposed to be plugging any products.

42:37 Trina Renea: Just kidding. Okay. So what are our takeaways today? Don't smoke.

42:43 Julie Falls: That's a big takeaway. 

42:44 Rebecca Gadberry: Oh, yeah. 

42:46 Trina Renea: If you feel stinging on your face, your barrier is damaged. What’s another takeaway?

42:52 Rebecca Gadberry: If you have tightness on your face, your barrier is damaged. If your skin gets red or is sensitive, you have barrier damage. If your skin is flaky or ashy, you have barrier damage. There are so many things that will damage your barrier. 

43:09 Trina Renea: Another takeaway is it's okay to use Vaseline or Aquaphor on your face at night with a little bit of hydration, water, mist, or something. 

43:17 Rebecca Gadberry: Maybe once a week. 

43:18 Trina Renea: Once a week. 

43:18 Rebecca Gadberry: Don't do it every night.

43:21 Julie Falls: My takeaway is seek professional help if you need to find out what's going on, if you're experiencing any kind of extreme. 

43:28 Trina Renea: Go to the dermatologist, yes. 

43:30 Julie Falls: Exactly. And maybe mention to your doctor if you want to start upping certain products, make sure you get the green light. 

43:40 Rebecca Gadberry: My takeaway is just because something, a routine works for you for a certain amount of time, doesn't mean it's going to continue working for you. This is one reason to continue to evaluate your skin. If you think a professional can help, an esthetician will be able to evaluate your skin. If you see an esthetician, you should see an esthetician at least every season, if not every 6 to 8 weeks. 

And the moisturizer that you used as a teenager or in your 20s is probably not the moisturizer you should be using in your 50s. 

44:21 Trina Renea: Yes. You may need to change that. Because our skin does lose oil as we get older as well.

44:28 Rebecca Gadberry: Right. And if your cleanser is too strong and your moisturizer soaps up or whites up, it's too strong for your skin and that's creating a damaged barrier. 

44:40 Trina Renea: All right. We’ll talk more about these…

44:43 Rebecca Gadberry: Dr. Vicki hasn’t said anything. 

44:44 Dr. Vicki Rapaport: No, I did. I said smoking.

44:46 Rebecca Gadberry: Oh, you said smoking too as your takeaway? Okay. 

44:49 Trina Renea: Don’t do it. You mean that?

44:52 Rebecca Gadberry: Yeah.

44:53 Trina Renea: What about marijuana? Sorry, I just had to throw that out there. What about smoking pot? Same?

44:57 Dr. Vicki Rapaport: The same thing. Yeah. 

45:00 Rebecca Gadberry: Different chemicals. 

45:02 Dr. Vicki Rapaport: If you need CBD or a THC, I do think it is actually pretty amazing medication for a lot of things. I'm not against that at all. I know it's hard, but just don't smoke it, don't vape it. I say, eat it, tincture it, drink it, but I would not recommend smoking it. 

45:19 Rebecca Gadberry: Because the smoke has other chemicals in it that are not transferred in a solid. They're better for your body, the solids are. 

And I think we're going to spend an episode on CBDs as well. And when we talk about barrier repair ingredients in episode 17 A, we'll talk about CBDs for barrier repair.

45:42 Trina Renea: Okay. All right. Well, it was lovely hanging out with you, ladies. I'm going to go repair my barrier with a little bit of Aquaphor.

45:50 Julie Falls: Sounds good. 

45:50 Dr. Vicki Rapaport: I'm going to go drink some water. 

45:52 Trina Renea: I'm going to go drink some wine, and then barrier repair. 

45:57 Julie Falls: I'm going to go slug. I'm going to slug some Vaseline. 

45:59 Trina Renea: I'm going to go slug. 

46:01 Rebecca Gadberry: Your Pinot Noir has the most resveratrol in it. 

46:05 Trina Renea: Yes. I'll drink Pinot Noir or Mezcal. I'm not sure yet. All right. 

46:10 Rebecca Gadberry: I didn't know Mezcal was a wine. 

46:12 Trina Renea: It's not. I'm thinking of where I'm going to go. 

All right, ladies, nice talking to you. We'll see you next time. 

46:20 Dr. Vicki Rapaport: Okay, everybody. Bye. 

46:21 Trina Renea: Bye.

46:22 Julie Falls: Bye. 

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