Moisturizer as we all know, is the skin product that we apply to the skin daily and the second last step prior to the application of sunblock.

It is one of the major components of our daily skincare routine and it serves not only to prevent dehydrated skin, but it also helps in improving the skin texture and delivering active ingredients to the skin. These active ingredients in turn help to reduce skin inflammation, skin itchiness, pigmentation as well as to improve the healing of wounds.

THE SKIN

Let’s discuss the skin anatomy and its role. The skin functions as a barrier that protects our tissue and body from water loss, infection and chemical and physical stress from the external environment.

The most outer layer of the skin epidermis which is the stratum corneum comprised of corneocytes (skin cells) that are organized in a “bricks and mortar” structure. It plays a key role in maintaining normal skin integrity and preventing transepidermal water loss. Transepidermal water loss is the loss of water from the body internally through the skin.

Water is needed for the skin for various enzymatic processes in the skin, desquamation ( skin shedding), and to maintain the natural moisturizing factor (NMF).

An impaired function is related to transepidermal water loss and associated with skin disease and condition.

HOW DOES MOISTURIZER HELP?

Moisturizers help by forming a shield or a protective layer/barrier to the skin to minimize trans epidermal water loss. It also occludes the break in between the skin tissue that is caused by epidermal trauma.

It protects the skin from friction and soothes the skin while giving it the time to heal from any wound by forming a soft shield on the skin.

It indirectly helps to restore the natural moisturizing factor (NMF), this further helps in the process of desquamation and improving the skin cycle.

WHAT ARE THE TYPE OF MOISTURIZER THAT IS AVAILABLE AND HOW DO YOU CHOOSE THE ONE THAT IS SUITABLE FOR YOUR SKIN?

When choosing the right moisturizer for the patients, I personally always suggest moisturizer based on the type of skin be it sensitive or oily skin, current skin condition and something that suits the patient’s daily routine. From the patient’s sign and symptom, and based on the ingredient which I think would improve the skin and bearing in mind the categories of the type of moisturizer, help me to decide on which product to suggest to the patient.

There are 3 types of main categories:

  1. Humectants
  2. Emollients
  3. Occlusives

HUMECTANTS

Humectant acts by attracting the surrounding water and chemically binding to water. This temporarily helps to hydrates the skin and helping with those fine lines. However, the less attractive fact about this type of moisturizer is that it usually attracts the water from the deeper layer of the skin. Over time, this could cause more dryness to the skin.

One example of humectants is Hyaluronic acid. You often realize after doing some Hyaluronic acid skin booster filler the skin is plump immediately after.

Glycolic acid and Lactic acid is another type of the humectant. It helps by indirectly increasing the skin cycle by promoting skin shedding or desquamation and improve the skin barrier by increasing the level of ceramide in the skin.

The other most well-known and cosmetically marketed humectant and used in the beauty industry is glycerin.

Humectants are usually quite light and suitable for daily usage.

OCCLUSIVES

This type of moisturizer usually prevents transepidermal water loss by providing a protective barrier to the skin and preventing the evaporation of the water from the superficial layer of the skin.

One of the very famous examples and my personal favorite is still Petroleum. An example of Petroleum in the market is Vaseline. It is cheap and it usually helps my patient who requires a balance between preventing dryness that is caused by the application of topical medication.

It is suitable for very dry skin but it is a little greasy in terms of consistency.

Other types of occlusive moisturizers are paraffin, lanolin, shea butter &  squalene.

EMOLLIENTS

These include dimethicone, ceramide, squalene to name a few. They are mainly lipids and oil and help the hydration by forming a protective barrier and filling the gap in between skin cells and lubricating the skin, thus making the skin smooth.

Current clinical guidelines recommend emollients as the first line and mainstay of the maintenance treatment of Atopic Dermatitis.

SUMMARY

Moisturizer is not only used for cosmetic purposes; it is also use by clinician as a therapeutic purpose. Therefore, knowing the formulations, mechanism of actions, side effects, application and direction of use is important to guide the clinician to advise on specific moisturizer for the patient in need of therapeutic purpose.

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