How To Fix Dehydrated Skin

Is your skin feeling a little lackluster at the moment? I’m talking dull, uneven skin tone with fine lines that are suddenly more noticeable? It’s possible, and entirely likely, that your skin may be dehydrated!

But what is dehydrated skin? What are the main causes of dehydrated skin? What’s the difference between dry vs dehydrated skin? And what are the main symptoms of dehydrated skin?

Fear not, this article will answer all your questions and show you how to fix dehydrated skin!

What Is Dehydrated Skin?

Dehydrated skin is, basically, skin that is lacking enough water to function optimally. Often referred to as ‘dry skin’, it is a common condition that can result from aging, medical conditions, medications, excessive use of detergents and soaps, sun exposure, as well as exposure to dry and cold weather ^[1].

However, the skin does not have to be dry in order to be dehydrated. In fact, it is relatively common for acne-prone and oily skin types to have dehydrated skin. In this case, it’s usually harder to identify dehydrated skin as an overproduction of oil can mask the usual symptoms of dehydrated skin ^[2].

Skin hydration is controlled by the stratum corneum, the outer most layer of the epidermis (and thus the skin). The stratum corneum maintains the vital barrier function of the skin by keeping water in the skin and keeping irritants out ^[3].

When the stratum corneum barrier is damaged, water is lost from the skin (transepidermal water loss – TEWL) and stratum corneum hydration is reduced.

Dry Vs Dehydrated Skin

There is often confusion between the commonly used term ‘dry skin’, literally meaning without water or moisture, and the physical aspect of rough, brittle, and scaly skin ^[4].

In addition, ‘dry skin’ can be mistakenly considered as the opposite end of the spectrum to ‘oily skin’. This is due to the fact that early scientific investigators believed dry skin to be a result of reduced sebum secretion. However, in many cases of dry skin, sebum secretion remains within normal levels ^[5].

Furthermore, some research suggests that dry skin is not necessarily associated with changes to the level of water within the skin ^[4]. Although, other research demonstrates that the rate of TEWL increases with increasing skin dryness ^[5].

This conflicting evidence may be due, in part, to the fact that there is no clear definition of ‘dry skin’ in the medical literature. Instead, it is referred to in terms of physical characteristics, symptoms, and causes ^[5].

For example, in the medical literature, ‘dry skin’ is used to describe both dermatitis and xerosis (xerosis is the medical term for abnormally dry skin). However, while dermatitis is considered a ‘dry skin’ disorder, it is due to a hypersensitivity reaction and inflammation, rather than a lack of water in the skin.

In the skincare community, however, the accepted distinction between dry vs dehydrated skin is as follows:

• Dry skin lacks water and oil.
• Dehydrated skin lacks water and overproduces oil.

What Are The Main Symptoms Of Dehydrated Skin?

Dehydrated skin generally feels tight and dry, even though there is an excess of oil. However, a key difference between dry and dehydrated skin is that dry skin usually feels persistently tight and dry whereas dehydrated skin alternated between feeling tight and dry, and then overly greasy. Sometimes, it can even feel dry and tight at the same time as feeling greasy.

As dehydrated skin is associated with an overproduction of oil, it is common for individuals with dehydrated skin to also suffer from acne. Furthermore, some common acne treatments can be incredibly drying for skin which can lead to a vicious cycle. For example, the skin overproduces oil and causes breakouts, the treatments used to control the breakout are excessively drying, and the skin overcompensates by producing more oil.

Oily, Acne-Prone, Dehydrated Skin

As mentioned earlier, dehydrated skin is associated with stratum corneum barrier dysfunction. Some evidence suggests that oily acne prone skin is also associated with abnormalities in stratum corneum function. Common acne treatments can then further damage this barrier function by excessively ‘drying’ skin.

One study found that men with mild-to-moderate acne had higher oil secretion, greater TEWL, and decreased stratum corneum hydration compared to acne-free men. The more severe the acne was, the greater the increase in TEWL and decrease in stratum corneum hydration ^[6].

In other words, the skin of acne patients contained too much oil and not enough water/hydration. This highlights that the stratum corneum permeability barrier may be damaged in individuals with acne and that the degree of damage increases as the severity of acne increases ^[7].

However, other research has found that the stratum corneum of individuals with acne had less TEWL, higher water content, and higher skin surface lipid levels than individuals without acne ^[8].

Stratum corneum levels of free sphingosine and total ceramides are also significantly reduced in individuals with acne ^[6]. Evidence also points to an essential fatty acid deficiency, specifically, a deficiency of linoleic acid ^[9].

Altogether, this research provides strong evidence for an impairment in stratum corneum barrier function in individuals with acne which supports the idea that dehydrated skin lacks water but overproduces oil.

Related Reading: The 5 Best Hydrating Products For Acne Prone Skin.

What Are The Main Causes Of Dehydrated Skin?

Skin hydration depends on two major factors:

1. The presence of natural moisturizing factors (NMF)
2. The structure and composition of the lipids in the stratum corneum.

Natural moisturizing factors (NMFs) consist of amino acids and derivatives of amino acids, such as lactic acid, urea, and sugars. These NMFs represent 5-30% of the stratum corneum (dry weight).

The structure and composition of the lipids in the stratum corneum is generally referred to as the lipid matrix. This matrix creates a barrier function via its mixture of ceramides (45-50% of weight), cholesterol (25% of weight), and free fatty acids (10-15% of weight) ^[1].

Both in vitro and in vivo studies have demonstrated that lipids, particularly ceramides, play a vital role in skin hydration by regulating water in and out of the skin ^[10][11]. In fact, it is now well established that a reduction of ceramides within the stratum corneum directly affects the barrier properties and thus the hydration state of the skin ^[1].

Dehydrated skin is therefore caused by reductions in natural moisturizing factors, changes to the ratios of lipids in the stratum corneum, and overall stratum corneum barrier dysfunction.

One of the most common causes of dehydrated skin is the use of products that damage the skin’s barrier. Many cleansers contain surfactants that are responsible for removing oil and debris from the surface of the skin. However, some surfactants can damage stratum corneum proteins ^[12] and decrease skin surface lipids ^[13].

In fact, some of the harsher antibacterial treatments for acne are exceptionally good at reducing sebum, which can cause some dramatic short-term improvements in acne.

However, these treatments also reduce fatty acid levels, disrupt the ratios of skin surface lipids, and disrupt skin barrier function. This perpetuates the cycle of oil overproduction and can make acne worse in the long run.

How To Fix Dehydrated Skin

So now we know what causes it, how can we learn how to fix dehydrated skin?

As dehydrated skin is caused by reductions in natural moisturizing factors, changes to the ratios of lipids in the stratum corneum (particularly ceramides), and overall stratum corneum barrier dysfunction, effective treatments for dehydrated skin would be those that:

1. Increase natural moisturizing factors
2. Balance stratum corneum lipids – particularly ceramides
3. Improve overall skin barrier function

Usually, improvements to A & B also mean improvements in C.

First and foremost, you will want to ensure that you’re not damaging your skins barrier function further by using harsh products or using actives too frequently.

For example, opt for gentler cleansers that don’t leave your skin feeling tight afterward and reduce the frequency of actives to every other day or a couple of times a week.

If your moisture barrier is in a particularly bad state, it is probably best to avoid actives, such as chemical exfoliants, for at least a month. You can then slowly reintroduce them at a later date.

For example, reintroducing retinoids once a week for 3 weeks, then twice a week for 3 weeks, and continuing to gradually increase frequency as your skin builds tolerance. Some people will find that their skin will never tolerate daily use of retinoids, but you can still get really good results from retinoid use every other day or a couple of times a week.

Examples of gentle cleansers that you can introduce: Avene Tolerance Extreme Cleansing Lotion, Hada Labo Tokyo Gentle Hydrating Cleanser.

As discussed earlier, low-molecular-weight NMFs (e.g. urea, lactic acid, carboxylic acid, and amino acids) and lipids (e.g. fatty acids and ceramides) are all components of the stratum corneum. However, they are also ingredients available in over-the-counter (OTC) moisturizers. This means that by applying these ingredients you can replenish the substances that the stratum corneum is lacking, thus improving stratum corneum hydration ^[14].

One of the components of the NMFs, urea, has a lot of research to back up its role in preserving healthy skin hydration levels.

1. Urea

Urea is a polar, hygroscopic (meaning it holds water) molecule produced within the human body and naturally found within human skin. It is a waste product produced by the metabolism of proteins and other organic nitrogen compounds which is then excreted in urine and sweat.

Research has demonstrated that topical urea at concentrations of 10% or less can reduce TEWL and increase skin hydration and water retention. It does this by acting as a humectant. In addition, at higher concentrations, urea works as a keratolytic (meaning it exfoliates the skin) ^[15].

Product recommendations: Hada Labo Tokyo Skin Plumping Gel Cream, Skinceuticals Retexturing Activator Replenishing Serum.

2. Ceramides

Ceramides are essential to maintaining normal stratum corneum barrier function and one way of approaching the repair of the skins barrier function is to replace the depleted lipids and improve skin hydration ^[16].

Topical application of ceramides improves skin barrier function and decreases TEWL, while also having an anti-inflammatory effect on skin ^[17]. In fact, one study found that a topical cream containing fatty acids, ceramides, and cholesterol significantly improved the skin barrier function, as measured by decreased TEWL and increased skin hydration, as quickly as 30 minutes after application^[18].

Product Recommendations: CeraVe Moisturizing Cream, Hada Labo Tokyo Skin Plumping Gel Cream.

3. Niacinamide

Niacinamide is a water-soluble form of vitamin B3 that can improve skin hydration and reduce the amount of water lost through the skin by stabilizing the skins barrier function ^[19]. Some evidence suggests that this may be due to the fact that it increases the levels of ceramides, fatty acids, and cholesterol in the stratum corneum ^[20].

In one study, twice-daily application of a moisturizer containing niacinamide reduced TEWL and increased hydration, thus improving stratum corneum barrier function ^[21].

Product Recommendations: Nia 24 Skin Strengthening Complex, Paula’s Choice BOOST 10% Niacinamide.

4. Hyaluronic Acid

The hyaluronic acid content of the epidermis and dermis helps to regulate the skins moisture levels and barrier function. Hyaluronic acid is widely distributed in the body but is most abundant in the skin. In fact, the skin contains 50% of the total body hyaluronic acid ^[22].

The hydration of the skin is hugely dependent on the amount of hyaluronic acid bound water in the dermis and epidermis. The levels of hyaluronic acid are significantly larger in the dermis than in the epidermis and it is the dermal hyaluronic acid that regulates water balance ^[23].

Hyaluronic acid is able to form a film on the surface of the skin which reduces TEWL and protects the stratum corneum. In addition, it acts as a humectant to draw water into the skin and increase the water content of the epidermis ^[24].

One study that compared the effects of different molecular weights of hyaluronic acid on crow’s feet wrinkles. While low molecular weight hyaluronic acid was associated with improvement in crows feet wrinkles, all topical formulations of 0.1% hyaluronic acid led to significant improvement in skin hydration and elasticity ^[25].

Product Recommendations: CeraVe Moisturizing Cream, Hada Labo Skin Plumping Gel Cream, Skinceuticals Retexturing Activator Replenishing Serum.

How To Fix Dehydrated Skin: An Overview

What Is Dehydrated Skin?

Dehydrated skin is skin that lacks enough water to function optimally.

What Are The Main Causes Of Dehydrated Skin?

Dehydrated skin is a common condition that can result from aging, medical conditions, medications, excessive use of detergents and soaps, sun exposure, as well as exposure to dry and cold weather.  The most common cause is from harsh skincare and cosmetics.

What’s The Difference Between Dry Vs Dehydrated Skin?

Dry skin lacks both water and oil whereas dehydrated skin lacks water but overproduces oil to compensate.

What Are The Main Symptoms Of Dehydrated Skin?

Dehydrated skin generally feels tight and dry, even though there is an excess of oil. This tightness is rarely permanent and tends to come and go. This is in contrast to dry skin that persistently feels tight and dry.

How To Fix Dehydrated Skin:

We can fix dehydrated skin by repairing the damaged stratum corneum barrier. In most cases, this means replacing natural moisturizing factors and lipids (such as ceramides). In addition, we can fix dehydrated skin by using products that draw water into the skin, such as hyaluronic acid.

One important step is to reduce or eradicate the use of overly harsh skincare products until we have fixed our moisture barrier.

References:

1. Tfayli, A., Jamal, D., Vyumvuhore, R., Manfait, M. & Baillet-Guffroy, A. (2013). ‘Hydration effects on the barrier function of stratum corneum lipids: Raman analysis of ceramides 2, III and 5’, Analyst, 138(21), 6582-6588. 
2. Yamamoto, A., Takenouchi, K. & Ito, M. (1995). ‘Impaired water barrier function in acne vulgaris’, Arch Dermatol Res., 287(2), 214-218. 
3. Wickett, R. & Visscher, M. (2006). ‘Structure and function of the epidermal barrier’, J. Infect. Control. 34(10), Supplement, pp. S98-S110. 
4. Pierard, G. (1987). ‘What does “dry skin” mean?’ Int J Dermatol., 26(3), 167-168. 
5. Rawlings, A., Harding, C., Watkinson, A. & Scott, I. (2002).Chapter 6: Dry and xerotic skin conditions, In: J, Leydon & A, Rawlings ‘Skin Moisturization’, Marcel Dekker Inc: New York.
6. Yamamoto, A., Takenouchi, K. & Ito, M. (1995). ‘Impaired water barrier function in acne vulgaris’, Arch Dermatol Res., 287(2), 214-218. 
7. Thiboutot, D. & Del Rosso, J. (2013). ‘Acne Vulgaris and the Epidermal Barrier’, J Clin Aesthet Dermatol. 6(2), 18-24. 
8. Zhou, M., Xie, H., Cheng, L. & Li, J. (2016). ‘Clinical characteristics and epidermal barrier function of papulopustular rosacea: A comparison study with acne vulgaris’, Pak J Med Sci., 32(6), 1344-1348. 
9. Downing, D., Stewart, M., Wertz, P. & Strauss, J. (1986). ‘Essential fatty acids and acne’, J Am Acad Dermatol., 14(2), 221-225. 
10. Golden, G., Guzek, D., Kennedy, A., McKie, J. & Potts, R. (1986). ‘Stratum corneum lipid phase transitions and water barrier properties’, Biochemistry, 26(8), 2382-2388. 
11. Williams, M. & Elias, P. (1987). ‘The extracellular matrix of stratum corneum: the role of lipids in normal and pathological function’, CRC Crit Rev Ther Drug Carrier Syst., 3, 95-122. 
12. Levin, J. & Miller, R. (2011). ‘A guide to the ingredients and potential benefits of over the counter cleansers and moisturizers for rosacea patients’, J Clin Aesthet Dermatol., 4(8), 31-49. 
13. Draelos, Z. (2008). ‘Clinical situations conductive to proactive skin health and anti-aging improvement’, J Invest Dermatol Symp Proc., 13(1), 25-27.
14. Loden, M. (2016). ‘Treatments Improving Skin Barrier Function’, Curr Probl Dermatol., 49, 112-122. 
15. Celleno, L. (2018). ‘Topical Urea in Skincare: A Review’, Dermatologic Therapy.
16. Sahle, F., Gebre-Mariam, T., Dobner, B., Wohlrab, J. & Neubert, R. (2015). ‘Skin diseases associated with the depletion of stratum corneum lipids and stratum corneum lipid substitution therapy’, Skin Pharmacol Physiol, 28(1).
17. Carneiro, R., Salgado, A., Raposo, S., Marto, J., Simoes, S., Urbano, M. & Ribeiro, H. (2011). ‘Topical emulsions containing ceramides: Effects on the skin barrier function and anti-inflammatory properties’, Eur J Lipid Sci., 113(8), 961-966. 
18. Sparavigna, A., Tenconi, B. & De Ponti, I. (2014). ‘Preliminary open-label clinical evaluation of the soothing and reepithelialization properties of a novel topical formulation for rosacea’. Clin Cosmet Investig Dermatol. 7, 275-283.
19. Gehring, W. (2004). ‘Nicotinic acid/niacinamide’. Journal of Cosmetic Dermatology, 3(2), 88-93. 
20. Tanno, O., Ota, Y., Kitamura, N., Katsube, T. & Inoue, S. (2000). ‘Nicotinamide increases biosynthesis of ceramides as well as other stratum corneum lipids to improve the epidermal permeability barrier’, Br J Derm., 143, 524-531. 
21. Draelos, Z., Ertel, K. & Berge, C. (2005). ‘Niacinamide-containing facial moisturizer improves skin barrier and benefits subjects with rosacea’, Therapy Clin., 76, 135-141. 
22. Papakonstantinou, E., Roth, M. & Karakiulakis, G. (2012). ‘Hyaluronic acid: A key molecule in skin aging’, 4(3), pp. 253-258. 
23. Stern, R. & Maibach, H. (2008). ‘Hyaluronan in skin: aspects of aging and its pharmacologic modulation’, Clin Dermatol., 26(2), 106-122. 
24. Olejnik, A., Goscianska, J. & Nowak, I. (2012). ‘Significance of hyaluronic acid in the cosmetic industry and aesthetic medicine’, CHEMIK, 66(2), 129-135. 
25. Pavicic, T., Gauglitz, G., Lersch, P., Schwach-Abdellaoui, K., Malle, B., Korting, H. & Farwick, M. (2011). ‘Efficacy of cream-based novel formulations of hyaluronic acid of different molecular weights in anti-wrinkle treatment’, J Drugs Dermatol., 10(9), 990-1000.