Managing Eczema and Protecting the Skin Barrier

The skin is made up of layers known, in combination, as the skin barrier; each layer plays a fundamental role in protecting the body against external aggressors, and the efficacy of this function is essential for optimal skin health. Without the shield of these protective layers, toxins and bacteria can penetrate skin causing conditions like breakouts, dehydration, redness, and flaky or itchy skin. With the upcoming National focus on Eczema and Psoriasis Awareness, leading Oculoplastic Surgeon & Facial Aesthetics Doctor, Dr Maryam Zamani and Dr Amélie Seghers (Consultant Dermatologists at The Clinic by Dr Maryam Zamani), share their insights around managing these chronic skin conditions.

Understanding Eczema and Psoriasis

Dr. Maryam Zamani explains, “When either eczema or psoriasis is present, it indicates a compromised skin barrier leading to heightened skin sensitivity and irritation. The answer to resilient skin immunity and a robust skin barrier lies in the utilization of protective, hydrating, and barrier-enhancing ingredients in your skincare”.

Dr. Amélie Seghers emphasizes the chronic nature of these conditions, stating, "People often believe they can outgrow these issues, but the reality is that once afflicted, the potential for a recurrence always exists. The focus should be on control and reducing flare-ups, rather than seeking a definitive cure”.

Distinguishing Eczema from Psoriasis

“While psoriasis is characterized by well-defined plaques with thicker scales, eczema manifests as ill-defined plaques with finer scales,” Dr. Seghers points out. She adds, “Eczema commonly affects the inner parts of limbs like elbow folds and behind the knees, whereas psoriasis is more prevalent on external areas such as the elbows or knees”.

Strategies to Manage Flare-ups

Dr. Zamani elaborates on factors that can weaken the skin barrier, “Some of the internal and external factors that can damage the skin barrier include; a humid or dry environment, allergens, irritants, pollutants, over-exfoliation or over-washing, stress, and sun exposure - which have all been linked to atopic dermatitis (eczema) and psoriasis flare-ups”. On managing flare-ups, Dr. Seghers advises, “Regular use of moisturizers is paramount as they fortify the skin barrier and alleviate dryness. Opt for gentle cleansers and hydrating moisturizers, prefer mineral sunscreens over chemical ones, and sidestep potent ingredients like retinol and chemical peels during flare-ups to prevent further barrier damage.”

Individuals with sensitive skin should exercise caution with potent skincare ingredients. While active ingredients like retinol and vitamin C have their benefits, it's crucial to choose formulas that also soothe and hydrate, ensuring the skin barrier remains intact.

Skincare Recommendations

Dr Maryam Zamani recommends ceramide rich skincare as it helps maintain the skin barrier, prevents moisture loss, and retains hydration. A natural alternative used to treat inflammation, reduce pain, irritation and redness is CBD Oil. Dr Zamani advises “those with aggravated skin conditions such as eczema, psoriasis and acne will greatly benefit from the calming properties of the oil”.

Offering alternatives for those wary of steroids, Dr. Seghers mentions, “Calcineurin inhibitors such as Protopic or Elidel are non-steroidal prescription creams. Though they might take longer to show results and can be pricier, they are effective. For widespread eczema, light therapy could be beneficial, but it doesn't guarantee improvement for everyone”.