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Treatment of problem skins - an overview

 

If you start out to renovate a building you should begin with the roof. In terms of the problem skin, first priority should be given to the skin barrier. Next step then is the renovation or in other words the recovery of the skin. Which active agents are appropriate in this case? The following article will provide assistance.

 

Except for normal skin any other skin condition poses a challenge when it comes to finding the appropriate skin care. The preparations should protect the skin but the active agents should perfectly arrive at the spot where they are needed. According to the corneotherapeutic theory established by Professor Dr. Albert Kligman, the Gordian knot is untied by transporting the active agents via so-called transport vehicles into the skin and then reclosing the skin barrier with lamellar cream bases without sealing the skin surface. This procedure minimizes the wash out of active agents and skin care components during skin cleansings.

The individual steps

As a matter of fact, the treatment of acne, neurodermatitis & co. pertains to the responsibilities of a physician. However, in addition to the medical treatment, each problem skin also needs appropriate cosmetic care which is every bit as important as the medication. In order to achieve adequate results though, a correct skin analysis and detailed background knowledge on cosmetic active agents are required. The trial and error method here only is time-consuming and annoys the persons affected. The following chart provides some clues on the potential active agents

 

Skin type

Cleansing

Peeling

Toning (lotion)

Masks

Massage

Dry and low-fat skin

Alkyl polyglycosides (gel) or triglycerides (milk)

Jojoba beads; no peelings in case of cracked skin

Phosphatidylcholine, D-panthenol

Skin recovery: Vitamins A, B3, C, E, linoleic acid

Radical scavengers: Oligomeric proanthocyanidins (OPC)

Moisturizers: Amino acids, hyaluronic acid, glycerin, aloe, alginic acids

Astringents (for cracked skin): Gallic acid, tannins, polyphenols

Barrier protection: Phytosterols, ceramides, long-chained fatty acids, hydrogenated phosphatidylcholine, triglycerides, squalane

Wheat germ oil, avocado oil, jojoba oil

Barrier-disordered skin prone to inflammations

Alkyl polyglycosides (gel) or triglycerides (milk)

no

Phosphatidylcholine, D-panthenol; CM-glucan before wet shaving

Anti-inflammatory: α- and γ-linolenic acid, boswellia acids

Anti-itching: Urea, allantoin, fatty amides

Antimicrobial: Betulinic acid

Skin recovery: Vitamins A, B3, C, E, linoleic acid

Moisturizers: Amino acids, hyaluronic acid, glycerin; after laser treatments and shavings also CM-glucan, alginic acid, aloe

Barrier protection: Phytosterols, ceramides, long-chained fatty acids, hydrogenated phosphatidylcholine, triglycerides, squalane

Evening primrose oil, wheat germ oil, avocado oil

Senile skin: horny dry, wrinkled

Alkyl polyglycosides (gel) or triglycerides (milk)

Jojoba beads or enzymes

Phosphatidylcholine, D-panthenol

Skin recovery: Vitamins A, B3, C, E, phytohormones, phosphatidylcholine

Moisturizers: Amino acids, hyaluronic acid, glycerin, alginic acids

Metabolic stimulators: Caffeine, green tea, coenzyme Q10

Radical scavengers: Oligomeric proanthocyanidins (OPC)

Wrinkle reduction: Spilanthol, peptides

Barrier protection: Phytosterols, ceramides, long-chained fatty acids, hydrogenated phosphatidylcholine, triglycerides

Avocado oil, wheat germ oil, jojoba oil

Normal and combination skin

Alkyl polyglycosides (gel) or triglycerides (milk)

Jojoba beads or enzymes

D-Panthenol

Moisturizers: Amino acids, glycerin

Barrier protection: Phytosterols, ceramides, long-chained fatty acids, hydrogenated phosphatidylcholine, triglycerides, squalane

Jojoba oil

Rosacea skin, couperosis skin

 

Alkyl polyglycosides (gel) or phosphatidylcholine, azelaic acid (lotion)

no

D-Panthenol

Anti-inflammatory: α- and γ-linolenic acid, boswellia acids

Skin recovery: Vitamins A, B3, C, E

Moisturizers: Amino acids, glycerin

Radical scavengers: Oligomeric proanthocyanidins (OPC)

Antimicrobial: Azelaic acid, betulinic acid

Vaso-stabilizing: Echinacea, Butcher's broom

Barrier protection: Phytosterols, ceramides, long-chained fatty acids, hydrogenated phosphatidylcholine, triglycerides, squalane

With mask components

Oily skin

Alkyl polyglycosides (gel)

Jojoba beads or enzymes

Phosphatidylcholine, D-panthenol

Skin recovery: Vitamins A, B3, C, E, phosphatidylcholine

In case of dry skin also moisturizers: Amino acids, glycerin

Rose hip seed oil

Blemished skin prone to acne

Alkyl polyglycosides (gel) or phosphatidylcholine, azelaic acid (lotion); in case of dry skin possibly triglycerides (milk)

Enzymes; in case of dry skin also jojoba beads

Phosphatidylcholine, D-panthenol, azelaic acid

Anti-inflammatory: α- and γ-linolenic acid

Skin recovery: Vitamins A, B3, C, E, phosphatidylcholine, linoleic acid, phytohormones

Antimicrobial: Azelaic acid

Moisturizers (in case of dry skin): Amino acids, glycerin

Barrier protection (in case of dry skin): Phytosterols, ceramides, long-chained fatty acids, hydrogenated phosphatidylcholine, triglycerides, squalane

Rose hip seed oil, wheat germ oil

After Sun

Alkyl polyglycosides (gel) or triglycerides (milk)

no

Phosphatidylcholine, D-panthenol, CM-glucan

Anti-inflammatory: α- and γ-linolenic acid, boswellia acids

Skin recovery: Vitamins A, B3, C, E; D-panthenol

Moisturizers: Amino acids, hyaluronic acid, glycerin, alginic acids, aloe

Possibly with mask components

Psoriasis prone skin

Alkyl polyglycosides (gel) or phosphatidylcholine, fumaric acid (lotion)

no

Phosphatidylcholine, D-panthenol, fumaric acid

Anti-inflammatory: α-, γ-linolenic acid and boswellia acids

Antimicrobial: Betulinic acid

Skin recovery: Vitamins A, B3, C, E, fumaric acid

Barrier protection: Phytosterols, ceramides, long-chained fatty acids, hydrogenated phosphatidylcholine, triglycerides, squalane

With mask components

Annotations to the different treatment steps

  • Cleansing: Alkyl polyglycosides are an example for very gentle cleansing components in gels. Triglycerides are typical fat solvents in emulsions (milk); the residues are removed with a little sponge or with water. Liposomal lotions with phosphatidylcholine (PC) are multifunctional, i.e. they cleanse and simultaneously transport PC-bound linoleic acid (anti-inflammatory) and optionally azelaic acid (antimicrobial) into the skin; and in case of psoriasis also fumaric acid.
  • Peeling: Jojoba beads are gentle wax bodies for the mechanical exfoliation.
    There is a large variety of enzyme peelings as for instance in form of powders to be mixed with water and to be left on the skin for some time before they are rinsed off with water.
  • Toning means to prepare the skin for the passage of active agents. This requires components such as PC and D-panthenol since they prepare the skin barrier for the permeation of the active agents of the following mask. Exception: CM-glucan.
  • Mask: The active agents that should pass the skin barrier are applied first. Subsequently, the barrier protective substances are lightly massaged into the skin (Exceptions: oily skin and after sun products). The massage can possibly be intensified by using massage oils.
  • Massage: The pure oils can be applied directly or in combination with the barrier protective substances as indicated for the mask. Convenient in this context are analogously combined massage creams.
  • The products for the skin care at home may contain active agents of the mask and the oils cited in the column "massage".

As the paper shows, the customized application of a relatively small repertoire of active agents already is sufficient in order to provide effective skin care for a multitude of different skin problems. Several agents cited in the chart are representative for other substances with similar efficacy (e.g. radical scavengers). On the other hand, several active agents, such as amino acids, are multifunctional (in this case moisturizers and radical scavengers), even if they are only cited for a specific application.

Dr. Hans Lautenschläger

 
Please note: The publication is based on the state of the art at the publishing date of the specialist journal.

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© Copyright Kosmetik Konzept KOKO GmbH & Co. KG, Leichlingen, www.dermaviduals.de
Revision: 27.05.2021
 
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published in
Kosmetik International
2012 (8), 16-19

 
problem skin - further literature
Cancer – adjuvant skin care
Corneotherapy – Quo vadis?
Problem skin – relapses in skin care and dermatology – how to handle them?
Rosacea: use of skin care boosters – prevention and therapy
Quantum of sun - prevention & recovery of photodamaged skin 
Enzymes - to inhibit or to stimulate?
Microbiome and skin inflammation
Hormones control puberty, pregnancy and menopause - can we control their impact?
Too much radiation? Various causes of photodamages
Skin & hormones
Microorganisms - in and around our body
Chain reaction - skin enzymes and enzyme defects
Contact dermatoses - causes, prevention and professional care of irritated skin
Perioral dermatitis - causes, treatment and differentiation
Acne - the potentials of cosmetic prevention
Overdoing skin care - too much of a good thing
Skin care before and after surgery
Careful with washing! - Gentle skin care for babies and small children
Skin care at strong sweat formation*
Repairing the barrier - on active agents and active agent systems to support the skin regeneration
Protecting the skin barrier - fungal infections and skin care
Shady sides - manifestations of light dermatoses
Landing approach - preparing for the final descent - skincare for pregnant women
Skin - from the outside in
Food intolerance - when food irritates the skin
Treatment of problem skins - an overview
Skin care during cancer therapy
Corneotherapy
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Cellulite from A to Z
Crossing borders - on the boundaries of cosmetic skin care
Corneotherapeutic skin care for the rosacea skin
Hormone cycles - menopause skin care
Skin care for the adolescent skin
Skin care for psoriasis skin - individually adapted
"I cannot tolerate this product" - the influence of medical drugs on skin and skin care
Delicate children skin - criteria for the adequate skin care
Stressed skin - itching & Co. - causes and remedies
Skin reactions - cosmetics and their effects
Scars - cosmetic prevention and skin care
Skin care during radiotherapy - soothing, vitalizing and protecting
Skin elasticity - what can cosmetics achieve?
Dermopharmacy - decorative cosmetics for problem skin
Couperosis - a field for active agent concentrates
Good looks, protection and skin care all inclusive: make-up for the problem skin
Photodamaged skin: sun-bathing and after sun care
"Acne caused by too many different moisturizing factors in creams?"
Irritated skin - skin in a state of turmoil
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Mixed skin - a skin with two different faces
Reddened Skin - what may cause the symptom?
History and current aspects of corneotherapy1)
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Skin barrier disorders - preventive measures
Acne - prevention and care
Essential fatty acids - cosmetic from inside and outside
Psoriasis - the appropriate care
Neurodermatitis - specific prevention