How a disrupted skin barrier leads to inflammation

Published on 07/29/2021 by Dr. med. Christian Gersch
Dr. Gersch is a Kaiserslautern based concierge physican

A very common symptom is a non-specific skin inflammation, an "eczema". This is often treated with cortisone ointments. Most of the time, however, these inflammatory skin changes have a biochemical basis that can be managed quite easily:

<h2>The interplay of soap and skin

<p>Soap has the task of binding fat-soluble substances ("dirt"). Since soap itself is water-soluble, these substances, which were originally only fat-soluble, can be washed off with water. If one wanted to rinse off water-soluble substances directly (tomato ketchup from a plate, for example), then theoretically soap is not needed.

<h2>What it means to wash the skin with soap

<p>The skin has a protective barrier made of fats. When the skin comes into contact with soap (also shower gel, dishwashing detergent), then a good part of these fats are being removed together with any impurities that may be present. The so-called skin barrier actually has the task of making the skin waterproof. If the fat is washed off, the skin becomes permeable to water. The body consists largely of water, but has the desire to remain as "dense" as possible to hold its water. Therefore, it will rebuild the skin barrier as quickly as possible, but often needs about 1 ¹/₂hours. Until then, after washing with soap, the skin is somewhat permeable to water and water-soluble substances.

If there is low humidity in the ambient air, the skin then rapidly loses water to the outside in the absence of a lipid barrier. With high humidity (rainy weather, tropics) this problem hardly occurs. However, if the skin dries out in this way, dry spots form and it becomes vulnerable to harmful substances. Their penetration can trigger inflammatory reactions. This creates the symptoms of dry, inflamed eczema. In fact, these eczema are caused by soap being used to remove fat from the skin.

How to address this problem

Put shea butter or coconut oil on the hands after washing, to replace the washed-off fat (along with the substances to be washed off) again (with good fat). Avoid usage of re-moisturizing cream, just fat, to restore the skin barrier. The body is going to rebuild itself after 90 min and until then the shea butter will protect it against noxae and dehydration.

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