How To Fix Dehydrated Skin According to Science: GET YO’ GLOW HOMIE

by | Last Updated Aug 2, 2018 | Acne, Advanced Skincare, Guides | 212 comments

Hello, everyone! Sorry it’s been a while. :'( I’ve gotten a few requests from Patreons to make a guide on dehydrated skin, so that’s what we’re going to be doing today!

You’ll be learning absolutely everything you need to know about dehydration: what it is, why it happens, how to treat it, what to do if you have acne AND dehydration, some tips to make your life easier and some more goodies.

Let’s waste no time and get into it! 😀

A Note to Those That With Malassezia Sensitivties.

If you’ve been following the protocols from the malassezia treatment guide and haven’t had much success — this article is for you, so don’t overlook it!

For those that don’t know, malassezia is a common yeast that lives on our skin that often causes fungal and / or adult acneseborrheic dermatitis, eczema, psoriasis, and maybe rosacea (among other conditions).

Every now and then I’ll get a comment from someone who’s read that blog post asking why they haven’t been able to clear their skin. When I ask them what their routine looks like, they usually say something along the lines of….

AM

*30 minute sulfur mask

*Wash with ketoconazole shampoo

*Apply benzoyl peroxide

*Moisturizer? What’s that?

PM

*Something else that’s irritating

*Chemical exfoliation, holmes. YOLO.

*Moisturizer is for pansies. Again, why would I use that?

¯\_(ツ)_/¯

That my friend would be the reason you’re stuck in a rut.

You see, the crappy thing about malassezia-conditions (e.g. adult acne, seborrheic dermatitis) is that they are often a sequelae (i.e. consequence) of dehydrated skin!

And here’s where it gets supaaa’ tricky: depending on the severity of dehydration, it might do you no good to throw multiple therapeutic agents on your skin all at once! In fact, it’s probably making matters worse! Especially if you’re not doing anything to repair the skin’s barrier, which skincare actives all too often compromise.

THAT, I think, is one of the scariest things if you’re suffering from dehydrated skin: most people with this condition have gone months, maybe even years, constantly putting products on their face to the point where it’s almost become a mental dependency, and they feel that in order to help their skin they NEED to be aggressively targeting it with several treatments.

This couldn’t be further from the truth, and it’s probably what’s preventing a total remission in the first place. What’s most important when it comes to dehydrated skin is DOING LESS. We should be doing as little as possible with active ingredients, and focus more on replenishing the skin to get our moisture barriers back up and running.

What is Dehydrated Skin?

Dehydrated skin is skin that is both dry and oily at the same time. Quite the paradox, isn’t it?

This occurs because skin is lacking in water, and as a result tries to compensate by producing more oil to keep itself hydrated by keeping water in.

It distinguishes itself from traditionally dry skin, because dry skin lacks both WATER and OIL. Dehydrated skin just lacks water.

  • Dehydrated skin = little water content, and a sh*t ton of oil.
  • Dry skin = little water AND oil content.

That’s one that thing makes dehydrated skin especially annoying. Unlike dry skin, which isn’t very prone to acne because it lacks oil, dehydrated skin is a breeding ground for acne because of the overproduction of oils.

Dehydrated skin is also a symptom / condition NOT a permanent skin type! That’s a huge difference. And why many people find their skin normalizes and becomes less oily / balanced after they’ve successfully treated dehydration.

Lena from Faceonomics said it best,

“[dehydrated skin and] a damaged moisture barrier is like a weak border – it is porous and allows things through that aren’t meant to flow freely. The moisture in your skin shouldn’t just be leaving your skin to the point where it’s depleted by the end of the day. It’s NOT doing its job of holding onto moisture.”

Dehydrated Skin Test, Signs, Symptoms: How to Tell if You Have it.

It’s infomercial time! 

Does your skin feel nice after a cleanse, but is a heaping pile of oil a few hours later? Is it both dry and oily at the same time? Do you feel tightness? YOU DO? On the upper cheeks? OH MY!

And it wrinkles easily when you pull it taut? Almost like it’s paper-thin or somethin’? Interesting.

What about the flakes? You have the flakes too? Around the chin, nose, and mouth area, huh? You don’t say.

Let me guess, there’s also some dullness action going on? Maybe you look a bit “tired” and lackluster? All of the above? My goodness man, then you needa call 555-SIMPLE-SKINCARE-SCIENCE and ask for f.c. asap! 😀

Just kidding….

No, but seriously, if you answered yes to the majority of those questions, or if it was like I was reading your mind, chances are you got yourself some dehydration issues going on!

Paula’s Choice summarized it well by saying,

Dehydrated skin is often accompanied by more than normal or even excessive amount of oil on the skin’s surface. Despite this excess oil flowing through the pores all over the face, skin still feels tight or dry everywhere on your face, and these signs are often accompanied by flaking. (1)

So what is healthy skin supposed to feel like?

“From a clinical standpoint, properly hydrated skin, reflected by a properly hydrated and minimally damaged SC (stratum corneum), appears healthy, is pliable, and devoid of scaling or dryness.” (2)

Why Does Dehyrated Skin Happen? The Importance of The Stratum Corneum (SC).

 

“When the stratum corneum (SC) is desiccated, the degradation of corneodesmosomes by hydrolytic enzymes is impaired, and corneocytes tend to ‘clump’ before shedding, thus causing roughness with visible scaling, flaking, and dullness in appearance, as the features of xerotic skin emerge.” (3)

Woah woah woah. Slow down there, buddy. In english please.

So…. we all have something called the stratum corneum (SC).  This is the protective outermost layer of skin, composed of about 15–20 layers of flattened cells called corneocytes.

  • stratum corneum (SC) = outermost layer of skin. It protects sh*t.
  • corneocytes = cells that make up the SC.

When this awesome skin defender (the SC) is compromised, the corneocytes (i.e. cells that make up the SC) tend to stick and clump together instead of shedding off like they normally should. This results in flakey, dull, rough-looking skin that increases the likelihood of developing clogged pores and therefore acne.

Interestingly enough, scientist had long thought the SC did very little to maintain the overall health of skin. Boy, were they wrong!

“Science of the stratum corneum (SC) has advanced exponentially due to the vision and dedication of a collection of leaders in the field of dermatology…. Several researchers and clinicians over the past 5 to 6 decades have contributed to a wide body of published knowledge that supports our current understanding of how the SC, once thought to be biologically inert, actively contributes to the physiological homeostasis of skin. Additionally, research continues to uncover specific abnormalities of the SC that contribute to certain dermatological diseases and/or impaired epidermal functions, and how some topical and systemic therapies may adversely affect SC integrity and function.” (4)

Fun fact #1: Dr. Kligman, the dude who co-invented  Retin-A (tretinoin), once wrote a paper asserting the SC was just a dead pile of useless cells. And people wonder why tretinoin has such lousy tolerability.

🤔

Well… it turns out the stratum corneum is HUGELY important and not just a dead layer of skin devoid of biological activity and function.

In fact, one of it’s main purposes is to form a barrier to protect underlying tissue from infection, dehydration, chemicals and mechanical stress. (5) And when it’s impaired and not treated like a princess, it can cause all kinds of skin diseases!

“The SC collectively serves to detect, protect, respond, and/or adapt against several exogenous factors. Common exogenous insults to skin include exposure to irritants, allergens, and microbial organisms; climatic changes, especially those which cause low ambient humidity; acute and chronic photo-damage; and iatrogenic insults, such as SC abnormalities associated with certain topical or oral medications.” (6)

In other words, it’s your first line of defense against sh*tty weather, chemical irritants, sun exposure / damage, and harsh skincare products or medications. Moving on….

A major responsibility of the SC is the antimicrobial barrier, which serves to provide protection against invasion and infection by microbial organisms, including bacteria, fungi, and viruses, but also is innately involved with some pathways of cutaneous inflammation. (6)

Oh yeaaaaaaah, and it helps fight off bad bacteria and similar microorganisms, as well as control skin inflammation. And lastly….

SC abnormalities are inherently associated with specific disease states, such as atopic dermatitis, rosacea, and psoriasis. Importantly, SC impairments innately associated with specific underlying disease states do not allow for complete reversal of full SC function as some underlying disorders impart a baseline level of SC impairment even during periods of disease remission.” (6)

I find this last quote a little depressing. It’s basically saying that some skin diseases like rosacea or psoriasis have such intense internal causes, that completely healing the SC is almost impossible with only topical treatments. I kind of disagree, but that’s a topic for another time.

Anyway…. the point is that dehydrated skin, in essence, can be thought of as having an impaired stratum corneum, so DON’T FUX WITH YO’ STRATUM CORNEUM cause if you impair it, it will impair your life. O_o

What Causes Dehydrated Skin?

There are both internal and external causes of dehydrated skin. However, since most people reading this article will fall into the latter category, that is what we will focus on.

“More often than not [dehydrated skin is] the result of using skincare products that contain harsh or skin-sensitizing ingredients. It can also develop from using the wrong products for your skin, which leads to an imbalance. In essence, dehydration can be viewed as your skin complaining that it doesn’t like something you’re doing to it.” (7)

Indeed, and I’d wager that in more than 90% of cases, dehydration is a cosmetic issue! Either from using too many products, the wrong kind of products, or irritating products all of which impact the SC to some negative degree.

Perhaps you’re wondering, “well what the heck should I avoid f.c.?” Good question!

What to Avoid With Dehydrated Skin.

First up on our list….

1. Harsh Cleansers

Cleansers are probably the most destabilizing part of any skincare routine. Even my holy grail (vanicream), as gentle as it is, still inherently compromises the stratum corneum by disrupting key enzymes and stripping the skin of its protective oils. That’s just gonna be a given anytime you cleanse your face / use a surfactant.

“Cleanser surfactants can bind to SC proteins, leading to keratin swelling within corneocytes and subsequent structural damage to the SC as well as damage to and denaturation of key SC enzymes… While it may be impossible for cleansers to have no negative impact on the skin, attempts to formulate cleansers to reduce cleanser-induced damage have been successful.” (8)

If you suffer from dehydrated skin, there is a few things you can do:

1. Change your cleanser to something ultra gentle and pH-balanced.

“One of the most common exogenous (i.e. outside) factors that can cause epidermal damage is over-washing or over-bathing, especially when combined with use of poorly formulated or harsh cleansers, especially true soaps, which are alkaline. Use of a poorly formulated, harsh, or irritant cleanser can induce deleterious effects on the SC, depending on formulation characteristics and specific ingredients (e.g., type of surfactant).

[Generally speaking] strong cleansers that are highly efficient in removing dirt, oil, and other debris from the skin surface are also likely to produce the greatest magnitude of damage to the permeability barrier of the SC through stripping lipids and components of NMF (natural moisturizing factor) and/or damage to SC proteins.” (9)

In other words, the more you cleanse, and the harsher the cleanser you’re using, the worse off you’ll be. If your skin is feeling dry, tight, or squeaky clean after a wash — bad news, dawg! You’re probably not using something ideal.

Make sure to especially avoid bar soaps and anything that has a high pH. If you aren’t familiar with the concept of pH and why it’s important in the context of skincare check out this guide. I go over everything you need to know.

Maintaining healthy skin pH, which is around 4.7, is crucial for getting your moisture barrier back up and running! Do not neglect this!

“Acidification of skin pH has been shown to normalize SC integrity and permeability barrier recovery in neonates with neutral skin pH; expedite SC epidermal barrier recovery; optimize activity of lipid-processing enzymes and processing of LB-derived precursor lipids; and regulate corneocyte desquamation, cohesion, and integrity. In addition, acidic SC pH favors growth of normal bacterial flora, as opposed to an alkaline pH, which is more supportive of the growth of pathogens such as Staphylococcus aureus and C. albicans.” (10)

English translation = maintaining healthy skin pH regulates skin, balances oil production and composition of sebum, allows your dead skin to slough off when it should, and helps facilitate the growth of healthy bacteria and yeast (i.e. the skin flora).

So what kind of cleanser should you be using to accomplish all this? One option is Vanicream Gentle Facial Cleanser! I cannot recommend that sexy stuff enough! It’s cheap, gentle, and effective. What more can you ask for?

Vanicream Cleanser

See Reviews on Amazon

Some other good options I recommend include Avène Extremely Gentle Cleanser Lotion and CeraVe Hydrating Cleanser (Note: this one isn’t 100% safe for malassezia).

There are many other ways to reduce the irritation of cleansing skin, so let’s continue.

2. Try reducing the use of cleanser to once a day! Either AM or PM. If you absolutely must cleanse twice a day, try using only water during one of those sessions.

3. If your skin is ultra compromised and cannot tolerate any cleanser (even vanicream or something similar), try using micellar water! My favorite is the Bioderma Sensibio H2O.

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This was designed for French woman in the 90s, whose skin was so sensitive they couldn’t even use tap water because it was notoriously “hard” (i.e. harsh because of mineral deposits).

4. If you want to go one step further in the gentleness arena, use colloidal oatmeal to wash your face!

See Reviews on Amazon

Collodial oatmeal has very gentle cleansing action because of the naturally occurring saponins, and is particularly excellent for eczema, dry, red, or irritated skin. To this day, I have found nothing more gentle to wash my skin with, and it’s what I used several years ago after I had an allergic reaction to a hydrocortisone cream.

To wash your face with collodial oatmeal, simply mix it with some water and proceed to use it like you would a regular cleanser.

5. Cleanse with only water. This is a good option for those who don’t live in an area where there is “hard water,” otherwise micellar water would be a better bang for your buck.

I know the idea of cleansing with just water might seem gross, but many people have had success with it. In fact, someone made a post about it on reddit just two days ago! The poor dude had literally tried everything from 4 rounds of accutane to 10% benzoyl peroxide, various diets, supplements, exercise etc. Who woulda thought water was the solution?

One of my all-time favorite case studies about using just water to cleanse skin comes from Beautiful Bro on youtube. The dude has AMAZING skin and attributes it partly to not using any sort of facial cleansers. Full video below (click the photo).

Stopped washing face

6. Oil cleanse! Or OCM for short.

Man, I really need to write a guide on this because people keep asking me to and it’s an important one. But in the meantime, here’s a good video explaining what it is and how to do it (bonus points for the ASMR it gives me 😀 haha).

Alternatively, you can do the double oil cleansing method! In other words, cleanse first with an oil, rinse with water, then follow up with a “normal” gentle cleanser like vanicream to remove any residue. This helps lessen / further reduce the irritation of just cleansing alone.

As for what oils to use, I don’t think you can go wrong with Squalane Oil, MCT Oil, or Mineral Oil. These are all very well tolerated, and unlikely to cause breakouts. I suggest staying away from anything else if you’ve never attempted OCM before.

For those wondering, I personally use MCT Oil and have for a couple years. Great stuff and very cost effective!

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To recap on all the tips I just gave above, here they are again without my long unwinding discussion.

  • Change your cleanser to something ultra gentle and pH-balancedVanicream Gentle Facial Cleanser and / or Avène Extremely Gentle Cleanser Lotion are great options!
  • Reduce the use of cleanser to once a day! Either AM or PM. If you absolutely must cleanse twice a day, try using only water during one of those sessions.
  • If your skin is ultra comprised and cannot tolerate any cleanser, try using micellar water!
  • If you want to go one step further in the gentleness arena, use colloidal oatmeal to wash your face!
  • Alternatively, try cleansing with only water! Best if you don’t live in an area with “hard water,” otherwise micellar water is preferable.
  • Oil cleanse or double oil cleanse! Start with either Squalane Oil, MCT Oil, or Mineral Oil.

Alrighty, now for other things to avoid.

2. Chemical Exfoliation

You cannot treat dehydrated skin with chemical exfoliation on the table. You just can’t!

“Certain topical products, including over-the-counter (OTC) skin care products with certain additives (e.g., alpha-hydroxy acids, astringents, abrasive granules, retinol) can induce damage to the SC leading to changes related to SC desiccation and cutaneous irritation. Topical prescription medications intended to treat specific skin disorders or cosmetic concerns may actually cause or exacerbate damage to the SC permeability barrier and possibly other epidermal functions depending on the pharmacological properties of the active ingredient(s).” (11)

Yeah, you heard that right. All those typical acne meds and chemical exfoliation you’re so fond of. No bueno. Sorry to be the bearer of bad news, but this means avoiding the following for at least a month or until your skin has healed:

  • AHAs (glycolic acid, lactic acid, mandelic acid, malic acid, citric acid etc.)
  • Benzoyl Peroxide
  • Ascorbic acid (vitamin C)
  • Azelaic Acid
  • BHA (salicylic acid, betaine salicylate)
  • Clay Masks (bentonite, kaolin)
  • Other acids / peels = TCA, jessner, phenol
  • Retinoids (tretinoin, adapalene, tazarotene etc.)
  • Retinol

Don’t worry! We will discuss how you can still treat acne during this transition period a bit later, so hold on to your little bottoms!

3. Physical Exfoliation.

Most people will say you should avoid any kind of physical exfoliation if you suffer from dehydrated skin. I mostly agree, but I think GENTLE physical exfoliation can be beneficial by helping remove a build up a dead skin cells, which could clog pores and lead to acne.

As for what options you have:

  • Muslin Cloth
  • Microfiber Facial Cloth (those are the ones I use, and they’re very gentle)
  • Konjac Sponge
  • Shaving (I am a guy, and must say you ladies are missing out. Shaving with proper technique is both gentle and a very effective form of exfoliation!)

However, if possible, avoid physical exfoliation entirely or use it sparingly (once or twice a week).

4. Alcohol

Stuff like SD or denatured alcohol (e.g. ethanol, isopropyl alcohol).

Fatty alcohols are A-okay! These include cetyl alcohol, cetearyl alcohol, stearyl alcohol (among others).

5. Fragrances

Fragrances can be sensitizing and aren’t really doing any good for your skin. This includes both synthetic and natural fragrances, as well as aromatic plant oils like peppermint, lavender, tea tree, eucalyptus etc.

6. Environment / Low Humidity.

Cold weather, harsh winds, and low humidity (i.e. when there is less moisture in the air) can all exacerbate dehydration. This kinda sucks because it’s not something that’s completely in our control. However, you can always use a humidifier like this one!

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I’ve had this little bad boy since 2014, and it comes out every every year during “The Winds of Winter.” (That Game of Thrones reference though…. :D)

I leave it running in my room, and it helps cut back on the dryness / dehydration I experience when Christmas time be wrecking havoc on my skin. Ask Santa to get you one!

7. Other

Anything else that is sensitizing like menthol, lemon, baking soda, toothpaste etc.

Also keep in mind that penetration enhancers like propylene glycol, propanediol, butylene glycol etc. can be irritating to a certain degree, and have the ability to make other ingredients comedogenic.

To summarize everything you should be avoiding in one neat quote, here’s a excerpt from a research paper:

“Overwashing; overbathing; use of harsh skin cleansers, astringents, or exfoliants; exposure to irritants; occupational exposures; climatic changes; low ambient humidity; certain topical medications or cosmeceuticals) cause damage and loss (“stripping”) of SC lipids, damage to important SC proteins, and loss of components of NMF (natural moisturizing factor), leading to increased TEWL and desiccation.” (12)

How to Fix Dehydrated Skin. Ingredients to Look For.

Research has shown that it’s generally a good idea to treat skin conditions by replenishing what they lack. (13) Dehydrated skin is no different! It’s all about repairing the moisture barrier and nurturing the stratum corneum (SC) back into full existence.

Remember how I said the SC is made up of corneocytes? Well, these corneocytes are held together by something called the lipid matrix, which is composed of ceramides, cholesterol, and fatty acids. (14) All of these will help get your skin back up and running.

Let’s break them down!

1. Ceramides

cerave baby cream

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Ceramides are the most abundant part of the lamellar sheets present in the intercellular spaces of the stratum corneum. (15) Or more simply put, they are the main part of the protective barrier of skin, accounting for approximately 50% of it, followed by cholesterol at 25%, and free fatty acids at 15%. (16) All of these play a crucial role in hydrating and maintaining healthy skin.

Ceramides, specifically, help regulate cells, repair damaged skin, and prevent transepidermal water loss (TEWL) by creating a waterproof barrier. (171819)

“Ceramides are the main component of the stratum corneum of the epidermis layer of human skin. Together with cholesterol and saturated fatty acids, ceramides creates a water-impermeable, protective organ to prevent excessive water loss due to evaporation as well as a barrier against the entry of microorganisms.” (20)

Fun fact #2: one of the reasons baby skin is super smooth and soft is because of ceramides!

“Newborn infants, especially premature ones, are born with a waxy or cheese-like coating on their skin that prevents them from losing too much moisture. That coating is called the vernix caseosa and it is composed, primarily, of ceramides.” (21)

As you may have guessed, dehydrated skin is lacking in ceramides so it’s a good idea to use products that contain them! Here are a few suggestions:

  • CeraVe Cream (Full review here)
  • CeraVe Baby Cream (the same as CeraVe Cream but without parabens, which makes it a slightly better option because parabens can be sensitizing to select individuals. [22, 23] Moreover, it doesn’t have the same MVE technology that CeraVe Cream does, which mean it’s probably better suited for those who find CeraVe Cream clogs their pores since it won’t penetrate as deeply into the skin. I will write more about this in the future)
  • CeraVe Healing Ointment
  • La Roche Posay Cicaplast Baume B5 (Note: not safe for malassezia)

2. Fatty Acids

I feel like this one is kind of a mixed bag.

Yes, fatty acids are part of the lipid matrix and a few studies have shown that certain types like linoleic and α-linolenic fatty acid can be beneficial for skin, but as you may recall from the malassezia treatment guide, it’s best to avoid fatty acids with carbon chain lengths 11-24 because these can exacerbate certain dermatological symptoms by feeding yeast.

This will be especially true for those suffering from any of the following conditions: adult acne, atopic dermatitis (eczema), dandruff, malassezia folliculitis (fungal acne), psoriasis, seborrheic dermatitis, and tinea versicolor (pityriasis versicolor).

Not only that, one of the ways that acne medications like benzoyl peroxide and azelaic acid work to treat acne is by reducing the free fatty acid content of sebum. (2425) People that are acne-prone tend to have a little too many fatty acids in their skin!

Here is a list of the 11-24 fatty acids that you should be mindful of and possibly avoid, unless you wanna try and experiment with them in your routine:

  • Undecylenic Acid (C11)
  • Lauric / Dodecanoic (C12)
  • Tridecylic (C13)
  • Myristic / Tetradecanoic (C14)
  • Pentadecanoic (C15)
  • Palmitic / Hexadecanoic (C16)
  • Palmitoleic / Hexadecenoic (C16:1)
  • Margaric (C17)
  • Stearic / Octadecanoic (C18)
  • Oleic / Octadecenoic (C18:1)
  • Linoleic (C18:2)
  • α-Linolenic (C18:3) 
  • Nonadecylic (C19)
  • Arachidic / Eicosanoic (C20)
  • Heneicosylic (C21)
  • Behenic / Docosanoic (C22)
  • Tricosylic (C23)
  • Lignoceric / Tetracosanoic (C24)

I bolded the two that might be okay, just make sure to patch test!

Recommendations:

3. Components of the NMF

Besides the lipid matrix, there’s another part of our stratum corneum called the natural moisturizing factor, or NMF for short. This is made up of about 40% amino acids, 12% sodium PCA, 9% glycerol, and 8.5% urea (among other things). (26)

These are all hygroscopic (water-holding) substances, that are essential for maintaining the health, function, and hydration of the stratum corneum. (27)

Just like the lipid matrix, it’s a good idea to look for products that contain these molecules if you want to treat dehyrated skin!

Recommendations: 

4. Urea

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I know I just mentioned urea above because it’s part of the NMF, but it’s importance cannot be overlooked! I’ve written an exhaustively informational post about it, which can be found here. Seriously, check it out!

In short, urea stimulates epidermal gene expression to regulate key components of skin health. And what makes it especially cool, is that it is both repairing, moisturizing, AND exfoliating.

Interestingly, despite its clear keratolytic (i.e. exfoliating) properties, treatment with 10% urea for up to 6 hours did not alter the amount of stratum corneum removed following tape stripping, in contrast to the other known keratolytic agents such as 2% salicylic acid.” (28)

Remember how I said you need to avoid all chemical exfoliation when treating dehydration? Well think of urea as a way to bridge that gap. It gently exfoliates WITHOUT compromising the SC. In fact, it even helps build it up!

To read more about urea go here.

Recommendations:

5. Filaggrin

“Filaggrin is degraded into several free amino acids (histidine, glutamine, arginine), PCA, urocanic acid, ornithine, citrulline, and aspartic acid. These degradation products exhibit functions within the permeability barrier of the SC, including maintenance of hydration, pH (acidity), buffering capacity of the SC, and physiological desquamation, all of which contribute to healthy skin function and appearance….

And the degradation of filaggrin to form major components of NMF are vital to physiological maintenance of SC hydration and the functional integrity of the SC permeability barrier.  Loss-of-function mutations in the filaggrin gene are collectively the strongest and most widely replicated genetic risk factor for developing AD (atopic dermatitis / eczema).” (29)

Okay, cool. Got it! So….

Filaggrin = SUPER IMPORTANT.

But I’ve never actually seen filaggrin in a product before….

“Then why the hell mention it f.c.?”

To prove a point son! Remember how I said urea is important? Well guess what naturally upregulates filaggrin in our skin? BOOM — Urea.

The takeaway: urea is cool.

😎

6. Hyaluronic Acid

Yet another ingredient I’ve written a super duper long article about that you should check out. :p Link here for those interested. 

Like urea and glycerin, this is also a humectant and a component of the NMF. It has the ability to hold 1000 times its own water weight, and hydrates the skin by drawing in moisture from the atmosphere and deeper layers of the epidermis.

There’s a lot more to say about it, like the importance of it’s molecular weight and how that might cause inflammation or help with wound epithelialization, but that’s why that super duper long blog post exists. 😉

Recommendations:

7. Squalane Oil.

Avene extreme tolerance emulsion

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Speaking purely from experience, this is by far the most moisturizing oil I’ve ever tried in my life! I think many others would agree. And it makes sense considering squalene makes up 10-16% of our sebaceous lipid mixture (i.e. the composition of our facial oil). (30)

It absorbs beautifully, is non-irritating up to 100% concentration, and does a great job at preventing TEWL by being slightly occlusive. (3132)

I don’t want to sound like a broken record here, buuuut…. I’ve also written a very long article about squalane too.

Ha ha ha.

100% recommended reading material. You should check it out.

Note: squalane also acts as a penetration enhancer, which means it can turn otherwise non-comedogenic ingredients comedogenic since it allows molecules to freely flow in and out of pores. Just keep this in mind if you plan on pairing it with other skincare products. It’s very unlikey to give you problems when used on it’s own, however.

Recommendations:

  • Avene Extreme Tolerance Emsulsion (Note:  For those of you who are psyched out about moisturizers causing breakouts, this is by far your safest option and VERY well tolerated across a multitude of skin conditions and sensitivities. It only has 6 ingredients with squalane being one of them. I will write a review about this soon enough. The only con is that it isn’t super moisturizing)
  • The Ordinary 100% Squalane Oil
  • Timeless 100% Squalane Oil

8. Niacinamide

Also known as vitamin B3 or nicotinic acid. This is a powerhouse skincare ingredient that does a little bit of everything. It helps brighten skin and treats hyperpigmenation by stopping melanosome transfer, reduces the appearance of wrinkles, and is especially great for stabilizing epidermal barrier function. (33)

In fact, remember those awesome little ceramides we spoke about earlier? Niacinamide actually increases the synthesis of these in our skin naturally!

Oh, and did I mention it also increases collagen production and does comparatively better than antibiotics when treating acne. (343536)

Yup. Quite the useful little fellow. Be on the lookout for him!

Recommendations:

 9. Occlusives.

cerave healing ointment

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And last but not least… occlusives. These are a category of moisturizer that work by forming a barrier over the skin to prevent water loss (similar to dimethicone, which is another ingredient to use). They literally trap in water so it can’t escape, which is the best way to hydrate the daylights out of skin!

The most popular option is vaseline a.k.a. petroleum jelly. It’s cheap, available almost anywhere, and super effective. In fact, it prevents transepidermal water loss (TEWL) by up to 98%! Waaaaaaaaat?

That makes it the most effective occlusive on planet earth, and it’s a time-honored ingredient that’s here to stay. Sometimes simplicity is best. 😉

I know the idea of rubbing some goopy a** vaseline on your face might sound gross, and perhaps scary cause you think it will clog your pores. But rest assured, industry experts from the Journal of Cosmetic Science have shown it is non-comedogenic. (37)

And dude, haven’t you ever noticed how boxers always slather that stuff on in between rounds? I mean, I don’t know, could be the reason boxers have nice skin. 😉 Pffft, definitely not the diet and all the exercise.

Just keep in mind that vaseline and other occlusives trap everything underneath the barrier they form, so it’s very important that you apply them to clean, freshly washed skin at the end of your routine. Otherwise, you risk locking in bacteria and a bunch of other nasties you don’t wanna deal with.

Recommendations:

  • Aquaphor (contains glycerin, lanolin alcohol, panthenol, mineral oil and 41% petroleum)
  • CeraVe Healing Ointment (contains ceramides, cholesterol, hyaluronic acid, dimethicone, panthenol, and 47% petroleum jelly. Despite it’s higher concentration of petroleum jelly it’s a lot thinner than aquaphor!)
  • Vaseline (just straight petroleum jelly!)

 Dehydrated Skin + Acne: How to Treat it.

“In many cases, the iatrogenic subset of exogenous insults to the stratum corneum is easily overlooked or not considered by the clinician, except where clinical relevance has been emphasized academically or is well-recognized in practice (i.e., the early irritant changes secondary to topical retinoid application).” (38)

Note: iatrogenic means illnesses caused by, or related to medical examination / treatment .

It’s no secret that the mostly all treatments used to manage acne cause excessive dryness, peeling, itching etc. all of which can contribute to dehydrated skin. Like we discussed earlier, these should be avoided if you’re dealing with dehydration.

You may be wondering, “is there a way I can manage dehydration AND treat acne at the same time?”

Good question! In my opinion, yes. Let’s go over them.

1. Benzoyl Peroxide….

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I’m sure you’ve heard of benzoyl peroxide (BP). It’s the second most widely prescribed acne medication in the world, (39) and for good reason — it’s super effective and has years of clinical efficacy!

But I already know what you’re thinking….

“What the hell f.c.?!? Have you lost your mind? Use BP when you have dehydrated skin??!? THAT STUFF IS THE SARAHA DESERT INCARNATE.”

True, but hear me out first. Yes, BP can lead to dehydration. That fact is literally mentioned in the research paper I’ve been quoting throughout this article:

“Examples of medications that may adversely affect the SC include topical corticosteroids, topical retinoids, and benzoyl peroxide. However, the extent to which a topical formulation affects the SC permeability barrier may vary somewhat depending on the ingredients used in the vehicle.”

That last sentence is key!

What they’re saying is that the formulation of a skincare product OR HOW IT IS UTILIZED, will dictate how irritating it is. This idea is highlighted by the fact that one study found a 5.3% benzoyl peroxide foam not only treated acne more effectively than 5.0% leave-on gel, but actually INCREASED skin moisture.

SOURCE.

Saaaaay what? Where can I get me some of this foam? For realz.

The takeaway here is that the amazingness of BP comes with how well it can be utilized or formulated.

That’s why I’m always harping on about using benzoyl peroxide “short contact therapy.” In other words, rather than leaving it on the skin, you apply BP for 5 to 10 minutes (aim for shorter durations), then rinse it off completely.

You can think of it as the poor man’s version of that delicious BP foam from the study above. You’re essentially using it in the same way. That is, leaving it on for 5 minutes so it can still kill acne-causing bacteria and work it’s keratolytic magic, but washing it off before it starts to cause ALL KINDZ of dryness.

Another thing you can do is layer BP over moisturizer. One study found that controlled release of benzoyl peroxide through a polymer system significantly reduced it’s irritation without sacrificing efficacy. (40) Putting on moisturizer first provides a similar-type buffer between the skin and BP to slow the absorption.

Fun fact #3: benzoyl peroxide can reduce P. acnes (i.e. acne causing bacteria) by up to 97.5% in just 5 days. (41)

Not sold yet? Need additional convincing that BP might be a good option to treat dehydrated acneic skin?

Well then…. did you know BP is also considered a re-epithelization agent, meaning it helps heal wounds? (4243) Dehydrated skin is basically a wounded stratum corneum.

“Epithelialization is an essential component of wound healing used as a defining parameter of a successful wound closure. A wound cannot be considered healed in the absence of re-epithelialization. The epithelialization process is impaired in all types of chronic wounds.” (44)

Oddly enough, and despite it’s shortcomings, BP was actually used as an epidermal wound healing agent for burns, ulcers, and topical infections for the first 50 years in dermatology. (45)

Just something to consider. And at the risk of sounding like a broken record: MAKE SURE TO DO CONTACT THERAPY. If you don’t, you will be impeding the healing process. Seriously, I cannot stress this enough.

What to know more about Benzoyl Peroxide? Check out this article, or my review of the acne.org system.

Recommendations: 

Note: stick with 2.5% concentration! This is just as effective as 5% and 10% with less irritation. (46)

2. Azelaic Acid.

What can essentially be thought of as a “natural” alternative to benzoyl peroxide. Studies have shown that 15% to 20% azelaic acid has similar efficacy to 5% benzoyl peroxide and 0.5% tretinoin mono-therapy with less irritation.

I won’t say it’s a perfect option for dehydrated skin, but it’s certainly a lot less compromising to the stratum corneum than most other acne medications.

I have personally found azelaic acid to be most effective at treating inflammatory-like acne vs. clogged pores and blackheads.

To learn more about it, check out this related reading: The Ultimate Azelaic Acid Review. EVERYTHING You Need to Know!

Recommendations:

3. Blue and Red Light Therapy!

Truthfully this isn’t something I’ve tried myself, but certain frequencies of light (e.g. 630-633 nanometers) target the bacteria in the oil glands to produce porphyrins which kills acne. (4748)

Laser and light-based therapy is considered a painless way of ameliorating acne with no downtime, and little side effects. It’s works best for whiteheads and inflammatory acne vs. clogged pores and blackheads.

Recommendations:

Like I said, I’ve never tried this so don’t really have any. Sorry haha. :p But Liah Yoo once made a video on this and I think she’s rad AF. She recommended the Neutrogena Light Therapy Mask.

4. Sodium Ascorbyl Phospate.

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Sodium Ascorbyl Phosphate (SAP) is a water-soluble derivative of Vitamin C. There isn’t much research on this ingredient as a whole, but what’s out there is promising.

In terms of treating acne, an in vitro study found that 1% concentration of SAP has strong antimicrobial effects against acne for 8 hours, (49) and that a 5% SAP lotion used for 12 weeks is more effective than 5% benzoyl peroxide monotherapy and 0.1% adapalene with NO SIDE EFFECTS. (505152)

Not only that, for decades scientists have known that lipid peroxidation (i.e. the oxidation of sebum) plays a MAJOR role in the development of acne. In fact, there is evidence that “lipid peroxidation is the driving force behind the progression of comedogenesis and inflammation in acne.” (53)

If lipid peroxidation does not occur, than acne cannot exist. SAP is able to reduce this sebum oxidation by up to 40%! (54)

Recommendations:


Do you feel I missed other options for treating acne while simultaneously dealing with dehydration? Share your thoughts in the comments down below!

Additional Tips.

Just things to think about that will help you on your journey.

Be baby gentle!

scared baby

(click the photo to see why that baby is freaking out 😂)

Treat your skin as gently as possible. None of this scrub-the-sh*t-off your-face stuff! Your hands should be gracefully gliding over your skin at all times. Imagine an infant has been glued to your face and treat it accordingly!

It’s best to think of your skin as an open wound when treating dehydration. That will make a world of difference! To give you an idea of the kind of substantial progress that can be made when you think “wounded soldier” vs. “a f*cking punching bag,” check out this 5 day before and after photo.

Comparing the two pictures, you can literally see how the skin looks “wounded” in the before picture.

Holy heaven oil production!

One of the hardest things about having dehydrated skin is the inevitable over-production of oils you’ll likely experience, which can unfortunately lead to more acne.

It’s one of the reasons people tend to over-wash and exfoliate in the first place! A couple fixes for this:

1. Oil-blotting paper

Unlike cleanser or chemical exfoliation, this is a gentle way of removing excess oils without compromising the SC.

Pro-tip: don’t wanna drop the cash on oil-blotting papers? Steal toilet seat sheet covers from public restrooms. These are made of the same material. :p

2. Use arrowroot powder!

arrowroot powder

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I’m sure you can get the same effect with mattyfing powder, but I’m not lady and don’t wear makeup so I wouldn’t know. :p

(No offense to dudes that wear makeup. Nothing wrong with that!)

Simply use a makeup brush, dip a little bit of it into the powder, and gently stroke away. Imagine your face painting or something nice. 😀 This will help remove excess oils without looking like you have anything on your face.

Stick with it for a month.

It takes approximately 28 days for the skin cell cycle to replace itself. Sometimes longer! This means you HAVE to give yourself at least a month on a barebones routine before adding additional things into the mix. Just trust me on this one. It will make your life a whole lot easier!

And last but not least….

What to Expect, Case Studies, and More Tips.

I’ll leave you with a bunch of random quotes from fellow redditors who have gone through and nipped dehydration in the bud. This will help you get a better feel for what to expect and reassure you that there is a light at the end of the tunnel!

“You need to focus the most on hydration now. Use an occlusive at night to help seal in moisture. My favorite is Vaseline. Surprisingly, it doesn’t clog pores or anything like that. My skin has never felt more hydrated. Quit using all actives. I know your derm suggested to try another topical, but right now, you need to focus on fixing your moisture barrier. Acne can be dealt with later.”—u/srarky

“I can’t believe the difference. My skin feels totally new. Before, the skin next to my nose/cheek would look wrinkled and dry when I pulled it taut. My makeup looked great for an hour and then flaked and went patchy on me. As a westerner who has been conditioned that any shine or oil = BAD!, I reveled in the SQUEAKY clean feeling my skin had after I washed it. I loved using manual and chemical exfoliators and clay masks. I wore thick, full coverage, matte, Instagram makeup every single day. I thought that my skin was just straight up oily for years, but looking back at photos (especially when I was drinking) I can see that dehydration has been an issue off and on for a while. When I finally accepted that my skin was very unhappy, I stopped all of that. Now my face feels “juicy” and supple all f*cking day- no dryness. Super dewy and hydrated and just… happy.”—u/oklettucehead 

“My skin went from very oily to dry/barely any oil.”—u/see-chel

“I’ve killed my barrier a few times (turns out that blackhead removing routine with BHA and a clay mask is not for me) and I have found that layering moisturizers works best for me. This is my go to “OMG my face isn’t working” routine: a moisturizing toner with no acid, a hydrating serum, a light oil, a heavy cream, and an occlusive.”—u/_MasturbationStation (that username though…. haha)

“I discovered that by properly hydrating my skin, my scars are practically unnoticeable! It has also reduced the overall oiliness and given me the healthiest skin I’ve ever had.”—u/Original_LucyS 

“Not using a cleanser in the morning has helped my skin so much! I just wash with water now in the morning and do my normal double cleanse at night to remove sunscreen and make up. My skin used to feel so dry, tight and dull after cleansing in the morning, but since I’ve switched to not using a cleanser in the AM, my skin retains all the moisture put in through the products used in my PM routine, instead of it just being washed away. I think it has helped with oil production a lot – my forehead and chin don’t seem to be getting very oily at all now, and the oiliness on my nose (which has always been the worst for me), has decreased so much. I find myself rarely reaching for blotting powder throughout the day now.”—u/l0l0lol0l0l

“The thing that has ultimately helped me reduce sebaceous filaments / blackheads is hydrating the f*ck out of my face and switching to gentle physical exfoliation 3x a week. I know this is going against the popular opinion that chemical exfoliation is the best way to reduce SFs, but my experience has been the exact opposite. Every time I try to use an AHA or BHA, they end up looking much worse in the long run. I would say try stepping moisturizing up a notch to see if it makes a difference. For me it was pretty dramatic. I would say they’re about half their original size now, and are significantly less dark.”—u/plant_ho

“My skin is easily dehydrated, history of eczema and contact dermatitis. When I stopped using harsh anionic surfactants (sulohates/ olefin sulfonates) my T-zone became less oily and my eczema healed literally the first week. For skin that is fundamentally healthy/ normal but has been badly treated all you need to do is hold in water (eg. petroleum jelly) and the barrier can repair itself. Clinically dry and eczematous skin is deficient in urea and ceramides, it does not have the ability to get back to full normal function. Hyaluronic acid is OK, but is not addressing the underlying issues in dermatological conditions like eczema. The large molecule stuff cannot penetrate, and the small stuff may have adverse effects. I also find the inside-outside approach is important, my skin bounces back pretty fast from being abused or neglected if I am giving it the fatty acids it needs in my diet (oily fish, whole eggs, walnuts, seeds).”—u/Firefox7275

“I started using a konjac sponge along with some cleansing milk in the shower, followed up with a toner, then some essences and a light moisturizer. After about a week or two of diligently following this routine day and night, my dry patches disappeared as did the ridiculous oil beads that would form on my face post-shower. I should also throw in that I make it a point to drink a LOT of water. I actually use an app to remind myself.”—u/didneypurnsess 

In the end, I figured out what works best for me is glycerin and then vaseline at night, and more importantly, minimalism…. I use vegetable glycerin from the pharmacy, mixed with water (the water to glycerin ratio is probably like 3:1). In my experience, it’s not that plain glycerin works significantly better than hydrating serums, but you do have to make sure there’s enough water for your skin to absorb or you’ll just make things worse. But really, if your skin is already dehydrated, a humectant alone isn’t going to do that much. I’d recommend you to find a good occlusive. Vaseline is literally the best one, but I’m sure there are also moisturizers you can use for that purpose during the day that aren’t nearly as icky.”—u/GiveMeYourF*cks (someone give this person a medal! The simplicity is so ballin’ and effective!)

“To those of you who are stubborn like me, hear me out- it isn’t worth it. Don’t abuse the actives. If you’re using actives frequently and your acne only gets worse/shows no improvement, try relaxing on the actives for a while. I don’t regret it at all. My skin feels like skin again and has gone from extremely oily to oily combo/oily.”—u/happuning

“Stopped all actives COLD TURKEY for a month. This was the biggest thing that helped. You cannot fix dehydration IF there is still exfoliation on the table happening. I even stopped using a konjac sponge. Just f*ckin left my face alone, moisturizing and cleansing only for a month. Made a huge difference. My face is now SO much more resilient and I can’t believe all the money and time I was spending on hydrating products that never ‘took hold’ because my skin kept getting knocked back with exfoliation.”—u/lgbtqbbq (a.k.a. Lena from faceonomics.blogspot.com)

“I turned down the heat in my showers. I like to boil myself, like a lobster. This has made the biggest difference in how dry my skin is or isn’t. Sometimes if I really want a hot shower I will cover the parts of me I’m worried about in oil first. Protects the skin for a bit and makes it less likely to freak out after the shower.”—u/ThatOneDruid

“Straight squalane = angel tears.”—u/philosophyofblonde

“Stopping all actives, exfoliation, simplifying my routine, and cutting out foaming cleansers. Also identifying triggers by introducing new products one at a time and paring down when any flare up would occur.”—u/honeybobunny

Now it’s your turn! Share your tips and experiences in the comments below!

Warmly,

f.c.

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