Dry skin may be one of the most common client complaints, especially when working with mature clients. The first step in addressing this problem is to differentiate between dryness and dehydration. It is important to separate these two issues initially in order to determine potential causes. Once this has been done, the whole picture can be evaluated to develop an effective treatment plan. There will often be overlap, and the two issues usually impact one another directly. Fortunately, there are a range of modalities available from traditional treatments to cutting-edge technologies to help comfort and treat both dry and dehydrated skin.
Indications and appearance of dry skin
Dry skin is a skin type that is related to oil production. Skin is genetically predisposed to inadequate oil production, which leads to chronic dryness, or skin may become dry as oil production decreases with age. Skin with normal oil production will have a light hydrolipid film composed of oil, as well as perspiration and moisture from the air. The t-zone may produce more oil than other areas. Commonly, clients observe oil in the t-zone and believe that they have overactive oil production. Many believe that skin with no oil whatsoever is the healthiest and so, even those with normal oil production may resort to stripping their skin with harsh cleansers in order to remove all traces of it. It must be explained that they need this film to keep skin properly protected and hydrated.1
Dry skin presents with a lacking or nonexistent hydrolipid film. It may appear tight, dull or may show signs of premature aging.1 This dryness and lack of barrier function is a leading cause of dehydration because, with no protective barrier, skin is susceptible to transepidermal water loss (TEWL). In this case, even if enough water is being taken in, the skin will be unable to retain that hydration. According to international esthetic educator, Florence Barrett-Hill: “There is a simple law of physics that can be applied to TEWL and that is: Oil sits on top of water. Logically, if we wanted to retain water within the epidermis or to slow down water movement, the oil phases of the skin are the key to achieving this.2”
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Potential causes. Because dryness is a skin type, those afflicted are simply genetically predisposed to inadequate oil production. However, several factors can worsen this type of skin or make otherwise normal skin feel dry by reducing surface oil. Some of these factors include powdery makeup that absorbs the oil, using harsh products that strip away oil instead of those that are additive and protective, as well as certain medications.1
Indications and appearance of dehydrated skin
Dehydration is a skin condition that is related to the water content of the skin.1 Dehydrated skin can include epidermal dehydration, dermal dehydration or both. Each has different causes and treatments and, much like dryness and dehydration, these two conditions often overlap and closely impact one another. Well-hydrated skin will appear smooth and dewy on the surface. The epidermis will be plump, supple and bounce back easily, indicating good elasticity. Epidermal dehydration is indicated by crepiness or small lines that form when the skin is manipulated during skin analysis. Scales may form in the case of more severe, chronic surface dehydration. Dermal dehydration causes depletion of the dermis and will ultimately result in deeper wrinkles that are visible on the surface of the skin, as well as elastosis and sagging skin.1
Potential causes. Common causes of epidermal dehydration include lifestyle choices, such as smoking, medication or illness; a diet high in salt or stimulants, such as coffee; environmental factors, such as seasonal changes and the artificial indoor environments caused by both heating and air conditioning; or sun damage, which can cause moisture loss and lead to dermal dehydration.1 Additionally, those with redness-prone or rosacea skin can often experience a higher rate of epidermal dehydration, because the heat present with their condition can encourage TEWL, especially in the instance of impaired barrier. Although drinking enough water is vitally important to hydrated skin, this alone cannot prevent dehydration. Even if a client drinks the right amount of water, if the skin’s barrier is impaired, the water is likely to be lost through TEWL.
Oil infusion. When steam is not contraindicated by any other skin concern, an oil infusion can be an effective way to help correct barrier impairment to address dryness. This will generally improve epidermal hydration. In order to perform an oil infusion, a noncomedogenic oil should be applied to the skin after a thorough-yet-gentle cleansing, toning and exfoliation. The oil should remain on the skin as steam is applied and left in a comfortable position for 10–15 minutes. The heat and moisture from the steam will allow the oil to facilitate barrier repair.
Red LED light therapy. Use of the red LED light can improve all aspects of dryness and dehydration. The red LED light can improve barrier function by increasing oil production and skin perspiration to enhance the hydrolipid film.1 Although an adequate barrier will not ensure proper hydration; generally, proper hydration cannot exist without a functional barrier. Additionally, red LED light will help improve function in the dermal layers. Red LED light therapy has been shown to “trigger repair mechanisms that stimulate fibroblast activity and new cell growth for tighter, rejuvenated skin.1” This increase in activity boosts collagen and other proteins that are critical for the skin’s ability to retain hydration. This increase in important skin proteins simultaneously improves elastosis caused by chronic dehydration.
Niacinamide. This potent form of vitamin B-3 takes a multifunctional approach to hydration by addressing several aspects of dryness and dehydration simultaneously. By dramatically boosting ceramides and fatty acids in the stratum corneum, topically applied niacinamide has been shown to have an overwhelmingly positive impact on barrier function.3 In one study, niacinamide was shown to reduce TEWL by 20% throughout 24 days.4 Additionally, niacinamide has been shown to improve microcirculation in the dermis, which provides numerous benefits, especially for mature skin.3 Look for niacinamide in a wide range of topical skin care products.
Multi-weight hyaluronic acid. Hyaluronic acid is well-known as one of the most effective skin-hydrating ingredients. However, it is not always used to its potential when only one type is included in a formulation. By featuring multiple weights of hyaluronic acid, different aspects of hydration and skin health are addressed. Normally, when hyaluronic acid is discussed, medium weight is the type talked about, which helps draw moisture to the skin for general hydration. The introduction of a low-weight hyaluronic acid allows hydration to penetrate deeper and more quickly in order to aid in improving elasticity. Additionally, a high-weight hyaluronic acid sits nearer to the surface of the skin and acts similarly to a dermal filler, helping improve surface hydration, and make fine lines and wrinkles appear less visible. This technology can be put to use by choosing serums and moisturizers that incorporate multiple weights of hyaluronic acid.
Acetyl hexapeptide-37. As the “buzz” associated with peptides winds down, they have now earned their place as powerful skin care tools. One peptide in particular takes a novel approach to improving hydration, even for the most sensitive of skin. Acetyl hexapeptide-37 works with aquaporin 3, a protein found naturally in the skin, to regulate the way hydration moves between the basal layers of the epidermis and the stratum corneum to improve overall hydration.5 Acetyl hexapeptide-37 has also shown promise in collagen production. This powerful anti-ager was shown to boost the synthesis of collagen I by 61% in vitro.5 One important consideration when working with acetyl hexapeptide-37—and all peptides—is repetition. In order to see the best results possible, any product containing these ingredients should be applied to the skin repetitively so that the peptides can signal the skin consistently.
Keeping skin healthy
The best approach to dry or dehydrated skin is to look at the situation as a whole by performing a thorough skin analysis, and asking detailed questions about lifestyle and skin care habits. Only by piecing together multiple potential causes can the correct treatment be determined. Whether new technologies or more traditional treatments are chosen, the key to correcting dry or dehydrated skin lies in determining the initial cause and helping the skin to compensate, balance and repair.
- A Camenzind, Euro Institute of Skin Care Program Reference Guide, Swiss Skin Care, Inc., Renton, WA (1996)
- F Barrett-Hill, Advanced Skin Analysis, Virtual Beauty Corporation Ltd., Orewa, New Zealand (2004)
- P Begoun, The Original Beauty Bible, Beginning Press, Renton, WA (2009)
- D Bissett, Topical niacinamide and barrier enhancement, Cutis 70 6 suppl 8–12 discussion 21–23 (Dec 2002)
- www.lipotec.com/en/products/diffuporine-reg-peptide (Accessed Mar 18, 2014)
Erin Ferrill is a licensed esthetician and the national training and development manager for HydroPeptide. In this role, she prepares, coordinates and conducts on-site and web-based education on topics relating to peptides, stem cells, and product knowledge. Ferrill also serves as a Look Good ... Feel Better program volunteer for the American Cancer Society. She can be reached at firstname.lastname@example.org.