Barrier Creams for Atopic Dermatitis: How They Work and Why They Matter
Atopic dermatitis (AD), commonly known as eczema, is a chronic skin condition that causes the skin to become dry, itchy, and inflamed. One of the main issues in atopic dermatitis is the disruption of the skin barrier, which leads to increased water loss and makes the skin more vulnerable to irritants and allergens. To help restore and protect this barrier, one of the most effective tools available is the use of barrier creams. In this article, we will explore what barrier creams are, how they work, and why they are essential in the management of atopic dermatitis.
What Are Barrier Creams?
Barrier creams are specially formulated skincare products designed to protect and restore the skin's natural barrier function. Unlike regular moisturizers, barrier creams contain ingredients that not only hydrate the skin but also form a protective layer on the skin’s surface, preventing moisture loss and shielding the skin from environmental irritants.
Key components of barrier creams include:
Occlusives: These ingredients, like petrolatum and dimethicone, form a protective seal over the skin to prevent water loss.
Humectants: Ingredients like glycerin and hyaluronic acid that draw moisture into the skin from the environment.
Emollients: Substances like ceramides, fatty acids, and cholesterol that help fill in the gaps between skin cells, smoothing and softening the skin.
How Do Barrier Creams Work?
Atopic dermatitis is often associated with a weakened or damaged skin barrier. The skin barrier acts as a shield, preventing water from escaping while blocking harmful irritants and allergens from entering. When this barrier is compromised, it leads to dry, irritated skin that is more prone to flare-ups.
Barrier creams work by:
Replenishing Lipids: People with atopic dermatitis often have lower levels of natural lipids, such as ceramides, in their skin. Barrier creams contain these lipids, helping to restore the skin’s protective barrier. Studies have shown that ceramide-containing creams can significantly improve the skin barrier function in people with eczema.
Reducing Water Loss: By forming a physical barrier on the skin, these creams reduce transepidermal water loss (TEWL). This keeps the skin hydrated and prevents it from becoming dry and flaky.
Protecting Against Irritants: Barrier creams shield the skin from irritants and allergens, such as soaps, detergents, and environmental factors, which can trigger eczema flare-ups. This is especially helpful in people whose work or lifestyle exposes them to harsh substances.
Soothing Inflammation: Many barrier creams contain soothing ingredients like aloe vera, colloidal oatmeal, or licorice root extract, which can help calm the skin and reduce inflammation.
Types of Barrier Creams
There are several types of barrier creams available, each suited to different needs:
Ceramide-Based Creams: These creams contain ceramides, which are naturally occurring lipids in the skin. Ceramide-based creams are particularly effective at restoring the skin barrier in atopic dermatitis.
Petrolatum-Based Creams: Petrolatum, also known as petroleum jelly, is a highly effective occlusive that locks moisture into the skin. It is a common ingredient in barrier creams and is often recommended for people with very dry or cracked skin.
Silicone-Based Creams: Silicone-based barrier creams, such as those containing dimethicone, form a lightweight protective layer on the skin, making them ideal for daily use. They are less greasy than petrolatum-based creams, which some people may prefer.
Prescription Barrier Creams: In some cases, doctors may prescribe specific barrier creams that contain additional ingredients to help with skin repair, such as urea or lactic acid. These are often used for more severe cases of atopic dermatitis.
Effectiveness of Barrier Creams for Atopic Dermatitis
Barrier creams are an essential part of managing atopic dermatitis. Numerous studies have shown their effectiveness in improving the skin barrier and reducing flare-ups. Here are some key benefits:
Reduced Flare-Ups: Regular use of barrier creams helps keep the skin hydrated and protected, which can reduce the frequency and severity of eczema flare-ups.
Less Need for Steroid Creams: By maintaining the skin’s barrier function, barrier creams can help reduce the need for stronger treatments, like topical corticosteroids. This is especially important for long-term management, as overuse of steroid creams can lead to side effects such as skin thinning.
Improved Quality of Life: For people with atopic dermatitis, the use of barrier creams can significantly improve their quality of life by reducing itching, dryness, and discomfort.
How to Use Barrier Creams
To get the most benefit from barrier creams, it’s important to use them correctly:
Apply after Bathing: The best time to apply a barrier cream is right after bathing, when the skin is still damp. This helps lock in moisture.
Use Generously: Don’t be afraid to use a generous amount of cream. Cover all affected areas, especially dry or irritated spots.
Reapply Frequently: For maximum protection, reapply the barrier cream throughout the day, especially if you’re washing your hands or exposed to irritants.
Conclusion
Barrier creams are a vital tool in the management of atopic dermatitis. They help restore the skin’s natural barrier, prevent moisture loss, and protect against irritants and allergens. Whether used alone or alongside other treatments, regular use of barrier creams can significantly improve the symptoms of atopic dermatitis and reduce the need for more aggressive therapies. At Mellinos, we encourage patients to explore their options and consult with a healthcare provider to find the most suitable barrier cream for their specific needs.
References
Cork, M. J., Danby, S. G., Vasilopoulos, Y., Hadgraft, J., Lane, M. E., Moustafa, M., Guy, R. H. (2009). Epidermal barrier dysfunction in atopic dermatitis. Journal of Investigative Dermatology, 129(8), 1892-1908.
Proksch, E., Brandner, J. M., & Jensen, J. M. (2008). The skin: an indispensable barrier. Experimental Dermatology, 17(12), 1063-1072.
Kim, B. E., Leung, D. Y. (2018). Significance of Skin Barrier Dysfunction in Atopic Dermatitis. Allergy, Asthma & Immunology Research, 10(3), 207-215.
Loden, M., & Andersson, A. C. (1996). The barrier recovery effect of different moisturizers assessed by the evaporimeter. Acta Dermato-Venereologica, 76(5), 412-414.
Danby, S. G., Brown, K., Wigley, A. M., & Cork, M. J. (2016). Ceramides in the management of atopic dermatitis in infants. Journal of Dermatological Treatment, 27(6), 573-581.
Author: Dr. Yesser Falk