Tips for Choosing the Right Moisturizer.

As the harsh winter approaches, more than half of the patients who visit us are troubled by skin itchiness. Transitional seasons can make the skin particularly sensitive to changes in temperature and humidity levels, ranging from mild itchiness to painful symptoms where one may even feel compelled to scratch the skin. It's crucial to provide proper care when itchiness begins, as it can become more challenging to endure than pain itself.

 

Dry skin symptoms occur in 75% of elderly individuals. With age, the lipid content within the stratum corneum, which maintains the skin barrier, decreases. Additionally, the pH of the epidermis increases, leading to thinning of the epidermis, flattening of the ridges, and increased scaling in the stratum corneum. Consequently, the outermost layer of the skin, the epidermis, shows signs of deteriorating dry skin, itchiness, and increased sensitivity to irritation.

 

Therefore, during transitional seasons, make an effort to adjust your lifestyle pattern differently from the summer to minimize drug intake due to itchiness.

 

The skin's lipids consist primarily of ceramides, cholesterol, and fatty acids. As individuals age, the total amount of these lipids decreases, particularly cholesterol and ceramides. In contrast, in younger skin, these components are mixed in a molar ratio of 3:1:1, promoting skin barrier function.

 

Changes in the skin surface pH are also characteristic of aging skin. Altered pH disrupts the proper function of ceramides, which provide moisture to the skin, resulting in abnormal shedding of the stratum corneum and weakened bonding between corneocytes. Therefore, skin surface pH plays a crucial role. Individuals over 80 years old have reported higher skin surface pH compared to younger individuals. Considering this, using a slightly acidic moisturizer can be beneficial. Research has shown that using skincare products with a pH of 4.0 for four weeks led to enhanced robustness in the stratum corneum. Thus, considering pH when choosing a product is essential for maintaining healthy skin.

 

The skin barrier's role in moisture retention is vital, as well as the role of natural moisturizing factors (NMFs). NMFs, primarily composed of amino acids, act as humectants within corneocytes, crucial for maintaining moisture levels. When humidity is low, NMF production increases over several days, and trans-epidermal water loss becomes active, allowing the stratum corneum to maintain adequate moisture even in dry atmospheres. However, due to repeated use of cleansers or skin aging, NMF levels decrease, necessitating their preservation.

 

When the transitional seasons arrive, many turn to moisturizers to prevent itchiness. However, it's essential to choose a moisturizer suitable for your skin condition. It's recommended to switch to a product that suits the dry weather of autumn and winter, rather than using the moisturizer you used in the summer. Additionally, it's advisable to choose a body cleanser that is appropriate for the winter season.

 

Firstly, choose a product that can replenish damaged skin lipids. As cholesterol synthesis decreases with aging, leading to a reduction in total skin lipids, selecting a cream with sufficient cholesterol is necessary. Additionally, using a cream containing ceramides to replenish the decreased ceramide levels can be helpful. It's advisable to choose a product with a well-balanced mixture of related lipid components such as fatty acids, cholesterol, and ceramides.

 

Secondly, it's necessary to check the pH of both the moisturizer and cleanser. An appropriate moisturizer should effectively maintain skin barrier function and quickly restore a compromised skin barrier. As skin acidity decreases with age, using a slightly acidic moisturizer can be beneficial. If product selection is challenging, choosing a product designated for atopic skin is less likely to fail. This is because it is primarily formulated for atopic dermatitis, one of the most representative skin barrier impairment conditions. Moisturizers designed for atopic skin are likely to contain ingredients that alleviate skin itchiness. It's also recommended to use a slightly acidic cleanser or body cleanser. Using a high pH cleanser can quickly damage the skin barrier function, potentially leading to secondary skin inflammation. Therefore, using a cleanser or body cleanser with a pH of around 4.5-5.5 is recommended, and showering frequency should be minimized as much as possible. Changing the pH of the skin surface, one of the prominent changes in aging skin barrier, to a slightly acidic level is an essential factor.

 

Lastly, supplementation of natural moisturizing factors and moist components is necessary. Moisturizers containing glycerol and urea can be helpful. These not only have moisturizing effects but also contribute to the activation of aquaporin-3 (AQP-3), a critical component in reinforcing the aging skin barrier. Using a moisturizer containing these components is beneficial, as a deficiency in AQP-3 can lead to deficiencies in skin moisture, elasticity, and barrier function. If you want to alleviate itchiness, cream or ointment-type moisturizers may be suitable. However, if you're concerned about stickiness, it's recommended to apply a lotion-type moisturizer thinly several times. Regardless of the effectiveness of a moisturizer, if it's inconvenient for you to use, you may end up not using it. Choosing a product that is easy to use is a priority.

 

Additionally, restoring the antioxidant barrier of the stratum corneum can be another strategy to reduce skin barrier aging. Therefore, selecting moisturizers containing antioxidant ingredients like tocopherol can be helpful. Along with this, regulating underlying conditions such as metabolic syndrome due to aging can help prevent systemic itchiness.

 

Remember that itchiness can be contagious to those around you, much like yawning. If your spouse or family member starts to scratch due to itchiness, even if their skin is normal, you may feel itchy as well. When applying moisturizer, it's crucial to apply it together with your spouse or family, and maintaining the appropriate indoor temperature is necessary. Also, wearing clothes made of cotton can help prevent itchiness if static electricity occurs. Skin aging becomes more noticeable when the seasons change. Therefore, during transitional seasons, make an effort to adjust your lifestyle pattern differently from the summer to minimize drug intake due to itchiness.