Emollients / Moisturisers
|Best used: AM Or PM||Caution: Occlusion can cause acne||Best for: Dry skin|
|Comments: Get your skin care fundamentals right |
|Mode of action: Humectant||Science Score:|
What is the science behind emollients & moisturisers?
Emollients refer to a myriad of products that contain oils such as mineral oil (synthetic), natural oils, shea butter & other compounds. These include, in descending order of thickness, ointments, creams & lotions. Ointments contain the highest percentage of oil, whilst lotions contain mostly water with little oil.
How can emollients & moisturisers help my skin?
Protection & Barrier Function: Emollients protect the skin from the outside, especially important if the skin’s barrier function is compromised from skin disorders such as acne, rosacea, dermatitis & most commonly, skin care induced skin irritation. A compromised epidermis (outer layer of skin), allows bacteria & possible chemicals/irritants/ allergens to cause more harm to the skin. Frequent use of emollients preserves & protects the skin.
Hydration: Moisturisers, as the name suggests ‘hydrates’ dry skin. The science behind hydration is actually preventing water loss from the skin (TEWL or trans epidermal water loss).
Aids in ingredient delivery: Emollients act as the ‘mortar’ of a brick wall (bricks are the skin cells). Hydrating the ‘mortar’ or gaps present between the skin cells allows deeper penetration of skin care actives including retinol, ascorbic acid & niacinamide. Simple emollient use 30 minutes before application of your chosen ingredients enables these molecules to work harder without increasing their concentration.
Reducing inflammation: Emollients packed with ceramides or squalene can reduce inflammation of the skin, in turn normalizing red blotchy skin.
When is the best time to apply emollients?
For normal skin individuals the optimal time to apply moisturisers or emollients is on slightly damp skin, after a shower or bath. Emollients help ‘seal in’ water by preventing trans epidermal water loss (TEWL).
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What order do you apply face products & skin care?
It really depends on what you want to achieve. Applying a moisturiser before an ‘active’ such as retinol can reduce or slow down the penetration of retinol. Adding a moisturiser at the same time of application can decrease the concentration of your ‘active’. Moisturising in between product applications can decrease the potential side effects of your ‘actives.’ For example hyaluronic acid can reduce the unwanted side effects from retinol such as drying & skin flaking.
Do serums go on before a moisturizer?
Most dermatologists would pick serum then moisturiser. The order goes something like this- cleanse, pat dry, serum & finish off with a moisturizer. Cleansing provides skin hydration that allows serums to work harder (more absorption). Once the serum goes on, a coat of moisturizer can ‘lock in’ the moisture (it actually reduces transepidermal water loss).
Can moisturisers & sunscreens mix?
Yes, but you should use your moisturiser first before using a cream-based or lotion-based sunscreen. Do not dilute your sunscreen with moisturizer as the SPF rating is dependent on the correct application amount. The application order is moisturiser first, sunscreen then makeup if required.
What are the differences in lotions, creams & ointments?
A lotion is a mix of water and droplets of oil, is lighter weight than cream, and is non-greasy with easy absorption into the skin. Lotions are best for normal to slightly dry skin types. Creams are thicker in consistency than lotions and provide a barrier that keeps skin ultra-hydrated. Creams are best for dry to very dry skin. Ointments are very greasy and not cosmetically elegant. They are however the most occlusive emollients & are well suited for atopic dermatitis or post laser healing balms.
Which is better lotion or moisturizer?
Lotion has a higher water content than moisturizer. It works on top of the skin & is lighter to use. Moisturizers are therefore thicker than lotions, and are more effective for treating dry skin—especially in the winter. Pick an emollient depending on your skin care needed.
Can I use hyaluronic acid as a moisturiser?
Depends. Read more…Hyaluronic acid (HA) is a naturally occurring molecule found in the deeper layer of skin, namely the dermis. Over the past decade, mostly due to the popularity of dermal fillers, hyaluronic acid has been a key ingredient in skin care due to the super hydrating effect of this compound (in theory). HA serum, creams, gels & masks are compatible with all single skin care actives, meaning it can be used as a hydrating base. Furthermore, as it is immunologically neutral, it is the ingredient of choice if you have sensitive skin.
Here is the catch. HA is best under your skin, not on your skin. The best way to get this molecule under the dermis is to either inject (AKA dermal fillers) or deliver via tiny needles (mesotherapy). As a moisturizer, the efficacy depends on the water gradient of the skin vs the environment. In higher humidity climates, HAs pull water into the deeper layers of skin. In low humidity, HAs can pull water from the deeper layers. Hence the true efficacy of HAs depends on the humidity of your environment. Regardless this is a cheap, benign & flexible moisturizer.
Does fragrance in your moisturizer really matter?
This depends on your skin type & skin history. If you have normal skin, it matters very little. If you have a compromised barrier function or have been sensitised, yes, it matters a lot. If you are super paranoid with things, choose fragrance free. End of discussion.
Fragrance-free typically means just that: no fragrances have been added to the product. The catch is even fragrance-free products are not always free of fragrance. A natural ingredient or essential oil, acting as a fragrance, might not be listed as such. Many fragrances are synthetic, masking toxins that could contribute to skin reactions and allergies.
Unscented products might include a fragrance as well. To mask unpleasant chemical odors, products may include additional synthetic fragrances that could trigger allergic reactions. Many “natural” ingredients may also be lurking on ingredient labels disguised as fragrances.
If you have reactive skin & think you may have issues with fragrances & other chemicals, see a medical dermatologist who has a special interest in patch testing. This is a complex medical investigation that can determine if you have particular allergies to skin care ingredients.
What is a non-comedogenic moisturizer or emollient?
Non–comedogenic means that a product contains ingredients that won’t clog or block the pores on your skin. This can be empirically measured with a number. The higher the number the more likely that the ingredient may clog pores. Zero (0) is highly non-comedogenic whilst five is almost certainly comedogenic. Hence in theory anything rated a 0, 1, or 2 is generally considered “non comedogenic.”
This rating is flawed, as real world experience may show that a non-comedogenic product may increase acne for the end user. Comedogenic testing was devised in the 1970s using rabbit ear models. Unless you are treating blackheads on the Easter Bunny’s ear, this testing is not foolproof. Obviously take note of the ratings, but don’t be absolutely guided by the labelling.
What is the best moisturizer for acne prone skin?
Do you need to moisturize if you have acne? It really depends on a few factors. Acne itself is classified as an inflammatory disorder with a compromise in the skin’s natural barrier. A suitable moisturiser can establish barrier function & aid in skin healing. Other factors come into play, namely other skin care ingredients that you may be using to fight acne. These topicals can lead to skin irritation, including dryness & sensitivity. Examples include benzoyl peroxide, retinoids including retinol, tea tree oil, & witch hazel. The use of a non-comedogenic moisturizer can decrease the dryness associated with application of ‘anti-acne actives.”
What is the best moisturizer for oily skin?
Lighter preparations such as lotions are best for oily skin. The idea of frequently moisturizing if one has oily skin seems like a paradox, however there is solid scientific evidence that supports the frequent use of suitable emollients in this skin type- especially if you have the habit of stripping or removing oil. By applying a thin coat of protective emollient, your skin’s feedback loop is tricked into thinking there is adequate oil (sebum), hence your oil gland will actually decrease sebum production. Try it. It works.
Dermatologists know that if you suffer from moderate to severe excessive oil production, a condition known as seborrhoea, the best solution is to actually target the sebaceous gland responsible for excess sebum. We employ retinoids or anti-hormone medications to achieve this reduction in oil.
* Disclaimer: I am a procedural dermatologist. If you suffer oily skin, there is no skin directed procedure to sensibly target the oil gland (apart from PDT with ALA) or Carbon Spectra Laser Peels (great for shrinking pores). Your best port of call is with one of the medical dermatologist @cliniccutis
What is the best moisturizer for dry skin?
If you have super dry skin, an ointment is best, followed by a cream. Dry skin equals more oil, less water in your emollient. Here is a sensible way to approach extremely dry skin-
- Have quick cool showers. Long hot showers dry skin & accelerate water loss. Use a soap substitute such as QV or Cetaphil Wash.
- Apply an ointment emollient of your choice after a shower at night. Apply to slightly damp skin.
- Use a cosmetically elegant emollient cream in the morning. Obagi Luxe is a classic.
* For people with excessively dry skin secondary to atopic dermatitis, seborrheic dermatitis, perioral dermatitis, psoriasis etc… consult a medical dermatologist for advice & management. My colleagues @cliniccutis can assist.
Should you moisturise if you don’t have dry skin?
Yes. This is because moisturisers can enhance penetration of skin care actives such as skin acids, retinol, niacinamide & others. By ‘hydrating’ your skin, molecules can penetrate deeper into the skin. Frequent emollient use also builds or maintains good skin barrier function, meaning more evens skin texture.
How often should I moisturise?
Once to twice a day if you have normal skin, three to six times a day if you have dry skin/eczema. Be guided by your skin specialist. The best times to moisturise are after a bath or shower as emollients ‘seal in water’ (they actually reduce epidermal water loss).
Should you moisturise your face at night?
Night time is the best time to apply emollients & moisturizers. Whyt? Because hydration or more accurately prevention of water loss can be prevented during your sleep. If you have very dry skin, use a thicker emollient such as an ointment before bedtime & swap to a lighter cream or lotion during the day.
Are there any side effects of emollient use?
Pick an emollient based upon your skin’s hydration. The only side effects from emollient use are acne or itchy skin from sweat production or very rarely, allergies. This is common if your skin is easily congested or prone to acne. These can occlude sweat glands, causing itch, especially in the hotter months of summer. Allergic reactions to emollient & moistures are usually due to preservatives or fragrances. Finding out what you are exactly allergic to requires patch testing by a medical dermatologist.
Can moisturisers be mixed with my skin care actives?
Yes, most moisturizers can be mixed with retinol, retinoic acids, niacinamide, ascorbic & skin care acids. There are some caveats, for example with ascorbic acid the best bioavailability is when the solution is pH 2.5 (ish). Hence when you mix say a neutral pH moisturiser with your low pH ascorbic acid, this will increase the pH of your vitamin C, in turn decreasing the activity of this active. You are better off separating application time by 30 minutes.
What are parabens, found in most emollients?
Parabens are preservatives including methylparaben, propylparaben, and butylparaben. These chems give cosmetics a longer shelf life.
Used in a variety of beauty and skin care products, parabens have been studied for their potential health risks. Since parabens are not listed on the USDA National Organic Program (NOP) list, they may still be included in products marked as organic. Paraben allergy is common in the CONTEXT of a dermatology patch test clinic. Most dermatologists will recommend paraben free make ups & products if you have sensitive skin including dermatitis and or rosacea.
What moisturizers do dermatologists recommend?
Possibly our recommendations are biased as dermatologists see the pointy end of bad skin, namely acne, sensitive skin, rosacea, eczema, allergic skin (allergic contact dermatitis) & irritant contact dermatitis. On this basis we generally recommend simple moisturizers as listed below.
- CeraVe Moisturizing Cream
- Cetaphil Rich Hydrating Night Cream
- Obagi Hydrate
- Obagi Luxe
- La Roche Posay Hydraphase Light
- QV Lotion, QV Cream
- Avene Sensitive skin range
- La Roche Posay Cicaplast
Recommendations get really complex if you are positive to patch testing. It really depends what you are allergic to. Allergies include positive tests to propylene glycol, fragrance, SLS, preservatives etc… Discuss your concerns with your medical dermatologist.
Disclaimer: I am a procedural dermatologist. My emollient recommendations are based upon post laser or post-operative care, & hence I am biased to occlusive moisturizers such as QV Intensive, La Roche Cicaplast, Obagi Luxe & others. My prescription patterns are skewed towards post laser resurfacing skin care. Be guided by your skin care professional.
Davin’s Viewpoint on Emollients & Moisturisers
This is one of the most fundamental things you want to get right as together with sunscreen, emollients form the foundation of any skin care routine. This is especially important for patients who suffer from atopic dermatitis, eczema, seborrheic dermatitis, rosacea & even the other extreme- oily skin. As a general rule, for dry skin, choose two types of moisturizers, a heavier occlusive one during the dry low humidity months of winter or when you feel you need extra hydration, & a lighter cream or lotion for daily use. The less ‘ingredients’ the better if you have a dermatological condition, or if you are recovering from a procedure.
Emollients are also useful in protecting your skin from the environment, especially in cases where epidermal barrier function has been compromised, including common conditions such as acne. With hydration of your outer layer of skin (epidermis), it allows skin care actives such as retinol, retinoic acid, niacinamide, ascorbic & skin care acids penetrate deeper, hence making them more powerful, without increasing their concentratoin.
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