rosacean skin (was Re: Using ice on face)

[Guest guest]

Barry, the protective barrier is compromised in inflamed/flushed

skin -- that applies to any dermatitis, in addition to rosacea.

Inflamed skin is more sensitive to products: more likely to react to

lactic acid (a presumed test for skin sensitivity), and more likely

to develop irritative dermatitis. I don't know but it makes sense

that it's more permeable to water going in -- certainly it's more

likely that water from inside the skin will go out (evaporate),

leaving the skin dry, scaly, tight.

It may be that once skin is inflammed, the acid mantle becomes

secondary to the compromised protective barrier -- or the pH changes

when skin is inflamed, up or down. Or, it may be that we've being

handed a song-and-dance about the face's acid mantle, and products

that are " pH adjusted " are meaningless from a practical perspective.

I just don't know -- do you?

Marjorie

Marjorie Lazoff, MD

>

>

>

>

> That's a good point Marjorie. Do you think the epidermis of

inflamed/flushed

> skin is possibly not as good a barrier as it should be? We have the

layer of

> dead cells, then skin lipids (usually quite water-repellant) then

the

> stratum corneum, then the rest of the epidermis, and only then do

we get to

> the living dermis.

>

> Is it possible that damaged skin in cea is more permeable, and

allows

> the passage of not only water but other materials too?

>

> A lot of moisturising/cleansing products nowadays claim to be

adjusted to

> " skin pH " - usually regarded as around 5.0 - 5.5 (I've seen other

figures!).

> But maybe cea skin has a different " pH " , or as you say needs a

different

> pH in the products used on it. Maybe water with a trace of mild

acid, to

> bring the pH down to about 5, would be better?

>

> Barry

> > Has anyone tried applying " normal saline " to the skin? It's

> > isotonic with blood and body fluids, so I wonder if it might be

> > less stressful to the skin. On the other hand some ceans

might

> > be sensitive to the salt present - 0.9% sodium chloride.

>

> I don't know, but I wouldn't think the irritant nature of water is

> due to its hypotonicity. An intact epidermis is a physical barrier

> protecting the cells underneath; the skin cells on the top are

dead,

> even if there's inflammation, so there are no exposed living cells

> that would require an isotonic environment (are there?) Normal

saline

> is used for wound irrigation because it's isotonic, that's true,

but

> that's because it is exposed directly to living cells.

>

> Something somewhat related that I've been thinking about: the skin

> surface has an acid mantle that helps maintain skin integrity and

> function. I wonder how many of our favorite cleansers and

> moisturizers respect that, by having an appropriately acidic pH. Or

> maybe the pH of a product isn't important? Or maybe chronically

> inflamed and/or flushed skin has different pH needs?

>

> Marjorie

>

> Marjorie Lazoff, MD