Understanding the Skin Barrier and Eczema

Our skin is our body's largest organ, and it's here to help protect us from the outside world. It's our first defence against germs and pathogens, allergens, chemicals and other irritants we encounter daily in our external environment. The term' skin barrier' refers to the outermost layer of our skin, known as the epidermis. This physical and functional barrier contains various cells and microbes that respond to external invaders or prevent them from entering the body, where they can cause harm. 

The skin barrier also helps to prevent water loss through the skin - a process called 'epidermal water loss'. 

In people with eczema, the skin barrier doesn't function properly and needs some extra support to address symptoms of dryness, itching and inflammation before they worsen. Eczema symptoms are not just uncomfortable – if left untreated, the skin barrier can become increasingly compromised, leaving it more vulnerable to allergic reactions and infections. This is why creating a consistent, nourishing skincare routine for our little ones who struggle with eczema is essential! Their skin barrier plays an important role in their overall health.

What causes a dysfunctional skin barrier?

If your little one has eczema, they will have some level of skin barrier dysfunction. But what causes this in the first place?

For those with eczema, skin barrier dysfunction can be caused by many different factors, such as:

• A lack of filaggrin protein in the skin. This can be linked with a mutation in the FLG gene, which causes the skin to produce less filaggrin. Filaggrin is a protein crucial to the skin's structural strength, as it helps bind keratin filaments together. Less of this protein means skin cells lose more moisture, shrinking to create tiny 'gaps' in the skin, leading to more dryness and itching, further weakening the skin barrier.
  
  
• An altered composition of lipids (including ceramides, cholesterol or free fatty acids) in the skin, with a lack of ceramides. As ceramides in the skin help it lock in moisture, having less of them can contribute to skin dryness and irritation.
  
  
• An imbalance in the skin microbiome. Our skin is home to many different microorganisms, including bacteria, viruses, fungi and even mites! These are commensal organisms, meaning they live in harmony with the human body. In those with eczema, the skin can become colonised with a bacteria called Staphylococcus Aureus, which is linked to reduced fatty acid production in the skin. This bacteria can cause itching and perpetuate the 'itch-scratch cycle', which can lead to further skin barrier damage.

The skin barrier can also become damaged through external factors like over-washing, exposure to chemicals and other irritants, harsh skincare products, too much exposure to the sun and environments that are too dry or too humid.

What can you do to support a healthy skin barrier?

Doing what we can to support our little one's skin barrier is key to managing their eczema symptoms. A healthy skin barrier helps to protect them from external threats like germs, allergens and chemicals and also protects their body from increased water loss¹.

Here are some ways to support a healthy skin barrier in little ones prone to eczema: 

Staying on top of flare-ups 

When you notice your little one heading into an eczema flare-up, it's crucial to start treating it right away. Early treatment helps to break the itch-scratch cycle that can lead to further damage to the skin barrier. Work with your medical professional to create an eczema management plan with treatments that are effective for your little one, and try to stay consistent with their daily skincare routine to nourish their skin and minimise flare-ups. If you're ever concerned about your little one's skin or eczema, don't delay having it checked by a medical professional. 

Stay consistent with moisturising the skin

Replenishing moisture levels through a consistent moisturising skincare routine is key for supporting a healthy skin barrier and preventing eczema flare-ups. Using a thick ointment like our Eczema Moisturiser can be helpful as it creates a thin film on the skin that acts as a protective barrier to reduce moisture loss.

Regular short, lukewarm baths

Regular baths help to wash away irritants, allergens and dead skin that might be disrupting the skin barrier. Be sure to keep baths short (10 minutes or so is enough) and use lukewarm water, which is gentler on dry skin. Opting for a gentle, soap-free wash that won't agitate the skin can also be helpful. Our Natural Oatmeal Bath Soak is another gentle cleansing alternative, with soothing and moisturising properties thanks to the goodness of colloidal oats. And of course – always apply your little one's moisturiser within 2 minutes of getting them out of the bath to maximise skin hydration.

Avoiding triggers

Exposure to environmental triggers such as dust, pollen, household cleaning chemicals, certain skincare ingredients, itchy or synthetic fabrics and extreme temperatures can cause the skin to become inflamed and further weaken the skin barrier. The weaker the skin barrier becomes, the more it may react to these environmental triggers and become more vulnerable to pathogens – so it's best to do what you can to help your little one avoid exposure to their triggers and other irritants. 

By doing what you can to support your little one's skin barrier, you're not just helping their eczema symptoms and overall health – you're also helping them feel more comfortable and confident to embrace life's adventures with healthier, happier skin.  

This post was brought to you and your baby with love by the Itchy Baby Co. team. X

Disclaimer: Information provided is of a general nature only, and you should always consult your medical professional.

1 Kanwar AJ. Skin barrier function. Indian J Med Res. 2018 Jan;147(1):117–8. doi: 10.4103/0971-5916.232013. PMCID: PMC5967208.