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Top 30 Skincare Questions Answered - Part 3

November 15, 2022

Over the years, we have been asked so many different skincare questions, many of which are the result of all the myths and misconceptions circulated online. We have therefore compiled top 30 questions, and have gone through 10 of them focusing on anti-aging and collagen in the last article (here), and another 10 on pigmentations and pore care (here).

Today, let's focus on cleansing, and eczema and rosacea.

First of all, stop using foaming cleansers, cleansing brushes, and scrubs. Secondly, choose one that contains lactic acid (a gentle, hydrating type of AHA), salicylic acid (BHA), or enzymes, to gently break up dead skin cells and clear pores, without the risk of irritations.

With a gentle, non-foaming cleanser, be it a cleansing cream, lotion, or gel, even the driest, most sensitive skin types can wash their face twice a day without drying or irritating the skin.

High quality cleansers these days are filled with hydrating, nourishing ingredients, which means, instead of making the skin dry, they can actually add nourishment and hydration back to the skin.

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Let us give you a few reasons:

Remove traces of skincare from the previous night
Unless you don’t use any skincare products at all, chances are, there will be residue of products from the previous night left on the skin surface no matter how much they get absorbed by the skin throughout the night, whilst some products are actually designed to form a film on the skin for protection and repair purposes. Now, if you don’t wash everything off in the morning, the ingredients in the morning skincare routine won’t be able to penetrate the skin and do their job. Your makeup will not glide on as smoothly as it should either.
Wash away dead skin cells and oils accumulated throughout the night
Your skin enters the most active state of self-repair and cell turnover when you sleep, so although you may not see it, there is likely dead skin cells and unwanted sebum on the skin or in your pores. In fact, there may also be saliva, sweat, or even traces of hand cream, hair oil etc. It’s therefore necessary to wash them off in the morning.
Rid the skin of bacteria and irritants
Circulated air from your fan, air conditioner or heater can kick up dust, mold and other environmental irritants, They can fly in from your open windows and land on your face. Let’s not forget bacteria, hair products or dust mites on your pillow case, blanket, or even the person sleeping next to you! You wouldn’t want that on your face the whole day until you wash it off at night now, do you?

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Actually, it does. For instance, many cheap oil cleansers use mineral oils or synthetic oils as base, but they can easily clog pores. Whilst, soap and foaming cleansers (most drugstore cleansers are foaming) give you that squeaky clean feeling, but because of their SLS/SLES content and alkalinity, they may greatly harm the skin.

Sodium lauryl sulfate (SLS) or sodium laureth sulfate (SLES), strip the skin of its natural oil, and can damage the skin’s lipid barrier, thus weakening its water retention ability, which leads to dryness and pre-mature aging, as well as its defence ability in stopping harmful bacteria and pollutants from entering the body through the skin, resulting in dryness, irritations, redness, and inflammations like eczema and dermatitis.

In addition, they are both alkaline. SLS for instance, has a pH of 7.5 to 8.5. Whilst, bar soap generally has a pH range of 8.0 to 10.0 (even handmade soap is considered alkaline). This alkalinity can increase the skin’s natural pH, disrupt and damage the skin barrier, strip the skin of its important oils, deteriorate the skin's natural water retention and defence function, resulting in dry, itchy, and inflamed skin, as well as worsened eczema and dermatitis symptoms and flare ups.

Remember, cleansing is the first step to skin care, and the key to achieve healthy, radiant skin, thus investing in quality cleansers is investing in your future skin health.

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Good question. Actually, the best way is to first remove all makeup and sunscreen, wash your hair and shower, and then cleanse the face after shower.

There are two reasons for that:

The steam from your shower can help soften the clogged dirt and oil in the pores. If you cleanse first then shower, the softened dirt and oil won't get removed, and would instead harden again and stay in the pores. However, if you remove all your makeup and sunscreen and then shower straight after that, the now softened dirt and oil clogged inside the pores, thanks to the steam, can be easily removed once you step out of the shower.
Hair products often contain silicones and other ingredients that make hair smooth and soft. That is all good. Unfortunately, when we wash our hair, water mixed with shampoo, conditioner, hair masks, and even dirt, often get to our faces. More often than not, we simply wipe it off with our towel, or worse yet, with the same towel we dry our hair. These ingredients then stay on the skin, and may cause irritations, redness, or worsen already existing acne and other skin conditions.

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Remember, physical scrubs with particles like beads, shells, salt and sugar, are not oil-soluble and thus cannot get into the pores and unclog them. This means they will do nothing for your acne, blackheads and blemishes.

But most importantly, physical scrubs, besides removing dead skin cells on the top layer of the skin like acids do, also slough away healthy skin cells. It may also cause micro-tears on the skin, as well as wounds in existing acne, thereby creating an opening for bacteria to attack the skin. Therefore we do not recommend physical scrubs of any kind.

The truth is, there is no one simple answer. However, what we do know is it can be a combination of genetics, the skin’s microbiome and gut health, and environmental factors.

For certain eczema sufferers, their skin genetically lacks filaggrin, a protein that strengthens and maintains the skin barrier, resulting in the skin’s inability in keeping moisture in, and bacteria and irritants out, which then leads to inflammation. For others, it is related to an abnormal regulation of the immune system that tends to promote inflammation.

Recent studies have also drawn a link between eczema and the health of the skin’s microbiome, as research have found that most eczema patients have an over-proliferation of bad bacteria on their skin, while lacking the good bacteria that help prevent inflammation. Whilst, gut health, which can be affected by what we eat and drink, has been shown to be closely associated with the appearance of eczema as well.

What also triggers and aggravates eczema are environmental factors and irritants, including sulphates, alcohol-based products, dust, mites, face mask, temperature fluctuations, humid weather, cold air, illness, insect bites, mold, pollen, certain fabrics, etc.

Stress and anxiety also play a role in provoking systems. When under stress, the body releases cortisol, which increases inflammation throughout the body. This can directly lead to skin inflammation and an eczema flare.

Same goes for rosacea. It is essentially an inflammatory skin condition that can be caused by a combination of factors such as genetics, the skin's microbiome, gut health, a protein that normally protects the skin from infection called cathelicidin, stress, anxiety, and other environmental factors. Symptoms can include flushing and redness, acne-like bumps, patches of dry, irritated skin, and swelling, and can be triggered by pollutants, sunlight, heat, and various foods and drinks, and might flare up for a few weeks at a time or longer.

In other words, while certain skincare products, like those with probiotic live cultures, will help, you also have to tackle it with a multi-angle approach, especially from within.

It’s like you know eating chips would give you acne. You can use different skincare products to help ease those angry bumps, but even the best and most expensive products won’t stop those acne from coming back if you don’t stop eating chips.

When people talk about probiotics, gut health is probably the first thing that comes to mind. What many people do not realize is that the surface of the skin is home to an equally diverse array of microorganisms, such as bacteria. These microorganisms, both good and bad ones, form our skin microbiome that provides the first line of defense against environmental aggressors, toxic substances, and harmful organisms.

Unfortunately, when this balance is off, which can be caused by genetics, pollution, products that damage the skin barrier such as foaming cleansers, toners with alcohol and benzoyl peroxide, or even household cleansers, etc., a lot of skin issues will arise.

For instance, researches have found that people with eczema, rosacea, dermatitis and chronic acne are missing the good bacteria on their skin that help prevent inflammation, and have an overgrowth of bad bacterias, resulting in inflammations and disrupted skin immune function.

Topical probiotics, aka the “good” live bacteria cultures, work by secreting anti-bacterial, antimicrobial and anti-inflammatory substances that penetrate bad bacteria and kill them before they trigger an inflammation, whilst providing a protective shield to keep bad bacteria from reaching skin cells, inhibit the growth of bacteria, yeasts, fungi, and viruses, as well as calming parts of the skin cells that want to react to the bad bacteria, thus stopping them from sending an “attack” message to the skin’s immune system that leads to redness, swelling, patchy skin, or acne-like bumps.

This is why probiotics are excellent for skin with issues such as eczema, rosacea, psoriasis, topical dermatitis, and acne.

However, treating inflammations is not the only skincare benefit probiotics can provide.

For example, probiotics use different mechanisms, such as by lowering pH, to preserve skin health and to inhibit the growth of pathogens——an acidic skin environment is very important as it discourages bacterial colonization and provides a moisture barrier.

Studies have also demonstrated that used on wounds, probiotics can exert an immunomodulatory effect by inducing “wound healing-promoting substances”, such as cytokines and growth factors, and produce certain bacteriocins that can sustain a wound-healing process.

One point to note though, is that products that claim to contain probiotic often comprise ingredients such as fermented ingredients like Lactobacillus ferment, meaning they do not actually comprise living bacteria, and therefore are not technically probiotics. Also, even if a formula claim to contain live cultures, moisture, as in a water-based formula, can be threatening to the well-being and effectiveness of these little guys. In addition, some preservatives, natural or otherwise, would render any probiotic cultures inert and therefore useless, unless the preservative systems are crafted to address “bad” bacteria without harming the “good”.

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One very important thing for eczema and rosacea skin is to repair and strengthen the skin barrier.

While the body is made up of up to 70% water, the outermost layer of the skin, aka stratum corneum, is made up of ceramides, cholesterol and saturated fatty acids. Together they create a water-impermeable, protective layer to prevent excessive water loss, and act as a barrier against the entry of bacteria, irritants and pollutants.

The problem is, a lot of things can damage the lipid barrier —— changes in temperature and humidity, constant rubbing of face masks against the face, face scrubs, foaming cleansers, face picking, inappropriate use of skincare products, pollutants and irritants, UV exposure, and so on.

And unfortunately, the lipid barrier of eczema and rosacea skin is fragile to begin with, as studies have revealed that the levels of lipids needed for a healthy barrier is severely insufficient in eczema and rosacea skin.

Healthy Skin Barrier vs. Damaged Skin Barrier

To make things worse, the levels of the lipids needed for a healthy lipid barrier decline with age, making things even worse for eczema and rosacea sufferers.

There are a few things you can do to repair and strengthen the skin barrier:

Use a Face Oil
By replenishing the skin with lipids, antioxidants, vitamins, minerals and polyphenols that are abundant in oils, not only will the skin feel moisturized, the skin will also be able to fortify itself, retain optimal moisture, fight free radicals, stimulate collagen production, and maintain a healthier, stronger barrier to effectively lessen symptoms of eczema and rosacea skin.

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Avoid Harsh Cleansers
By stripping the skin of its natural oil with harsh and drying ingredients, such as a foaming cleanser, not only will the skin struggle to balance its water/oil protective structure, and as a result, produce excess oil that will clog the pores causing congestion and breakouts, the skin's lipid barrier may also be damaged, which opens the doors for bacteria and irritants to attack the skin.
Consider Washing Face with Distilled Water
We just talked about how the alkaline pH of soap disrupt the skin barrier. Guess what, according to official data, the pH of water in Hong Kong is between 8.2 and 8.8, meaning it is alkaline. While alkaline water is good for our body internally, it is not so great for the skin for the reason mentioned above, as in it could damage the skin barrier, and lead to dryness, itchiness, acne, inflammations, and eczema/rosacea flare ups.

Thus, if you are suffering with eczema and rosacea on the face, you should really consider washing your face with distilled water, which has a pH of 5.8 to 6.7 and void of impurities, so that you are not actively disrupting your already compromised skin barrier twice daily.

pH and impurities aside, don't forget that hot water and prolonged exposure to water, can rid the skin of its natural oils, while speeding up trans-epidermal water loss. It is therefore best to avoid rinsing the face using water that is too hot, and try to keep your wash up sessions short.

The main function of ultra nourishing moisturizers or balms, which usually consist of a high concentration of occlusive ingredients like petrolatum, lanolin, mineral oil, beeswax, and shea butter, is to help lock in water by physically forming a barrier on the skin, whilst only giving the skin minimal amount of water and oil. Because of their heavy texture in nature, they can influence the natural skin renewal cycle by sticking the dead skin cells to the skin instead of letting them shed naturally. This layer of accumulated dead skin cells would trap oils, bacteria and dirt inside the skin, clog pores, and even create an oxygen-free environment that acne bacteria love, and kill off ‘friendly’ bacteria that keep skin healthy. Oils on the other hand, do not create this problem on the skin, and hence, are better for eczema and rosacea skin.

Of course, it doesn't mean you shouldn't use moisturizers at all. In fact, the best combination is use a face oil first, then a light layer of light moisturizer on top. Just remember to choose a moisturizer that doesn't contain the aforementioned occlusive ingredients.

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The answer is yes, but it has to be done strategically.

Contrary to popular belief, eczema and rosacea skin need exfoliation too. As mentioned above, skin affected by eczema or rosacea has a severely reduced lipid content. Without the supply of internal moisture, cell turnover slows dramatically. With a buildup of dead skin cells on the skin surface, bacteria gets trapped inside, which then leads to further inflammation. The accumulation of dead skin cells at the top also signals the epidermis to stop creating new cells as quickly, and the mother cells deep in the epidermis will stop dividing and creating new cells, which ultimately slows down the entire cell regeneration and renewal process. When old, damaged cells remain in the skin, eczema and rosacea symptoms linger. It is therefore imperative to remove dead skin cells, and increase skin turnover, so healthy skin underneath can reveal itself.

By using the gentle and hydrating Lactic Acid, Mandelic Acid, Lactobionic Acid, or Gluconolactone, you can remove dead, unhealthy skin cells that are causing itchiness, flakiness and roughness, increase skin turnover so healthy skin underneath can reveal itself, and also help serums, oils, and other topical treatments penetrate the skin better.

However, it is best to avoid physical scrubs and glycolic acid, as the former is designed to scrub away the top layer of skin, including healthy skin cells that form your skin’s protective barrier, as well as causing micro-tears in the skin, and the latter has the smallest molecular structure in the acid category, which means they get deep into the skin, and may cause irritations.