Skin Barrier Repair Serum – TBH Rebound Serum

Rebound is a skin barrier repair serum that can help soothe irritated, damaged skin by strengthening the skin’s natural defences against environmental stressors.

• It contains ceramides to create an effective barrier
• It hastens skin healing and reduces the appearance of fine lines and wrinkles
• Soothes irritated skin
• Reduces redness visibly
• Assists in repairing damaged skin

Valid for all skin types: dry, oily, or sensitive. You won’t have to buy five separate serums to meet your hydration and barrier support needs if you use this one, which contains vital components at the appropriate concentration—designed by the lovely Hannah English, a pharmaceutical and skincare expert, in collaboration with TBH—only $59.

For a free consultation with one of our Doctors, book online or call 07 3350 5447. 

A 1:1:1 Ratio of Skin Lipids is Essential for Skin Barrier Repair.

Your skin barrier is highly sophisticated protection that also assists in maintaining balance in body function. The skin barrier not only protects you from U.V. damage, infections, toxins and other assaults, but it also keeps water in your body.   A damaged skin barrier causes dryness and sensitivity and increases the risk of infection, local redness and inflammation. A less-than-healthy barrier does not look so great, either and has varied presentations and is almost universally present in our clients. The poor skin barrier conditions include dermatitis, acne, eczema, psoriasis, rosacea, skin sensitivity, skin dryness, and skin aging. The causes of disruption can be external, internal or both.

External Factors Impeding Skin Barrier Repair.

• Too much cleansing or exfoliating depletes the skin’s natural lipid barrier and acid mantel.
• exposure to skincare products that have a too alkaline composition (not good for the acid mantel),
• chemicals in personal care products or cleaning products that can set up an inflammatory response
• environmental toxins (ditto)
• secondary to aesthetic procedures – peels,  lasers,  microdermabrasion where the process has been overzealous
• infection
• U.V. damage and exposure.

Internal Factors Stopping Skin Barrier Repair.

•  inflammation related to diet, gut dysbiosis, inflammatory gut disorder,
• genetic predisposition in the case of eczema, which has a defect in the production of ceramides essential for an intact lipid barrier,
• aging (loss of barrier function due to change in cholesterol content in the lipid barrier and impaired skin-tight junction),
• medications you take (e.g. cholesterol-lowering tablets can interfere with the lipid barrier),
• genetic susceptibility (more common in lighter skin types, as the skin of colour has slightly more acid skin which is associated with a more substantial skin barrier)

What makes up your skin barrier?

Your skin barrier is not one thing but consists of several elements: physical, chemical, and immune, and it includes our resident skin microbiome. Therefore, to consider how you accomplish skin barrier repair, it is best to look at the barrier functions.

They prevent water loss and skin barrier repair!

One of the essential functions of our skin is preventing water loss. It may seem simplistic, but this is integral to our survival, and why, when this is damaged, our skin appears dry. The super lipid barrier of the stratum corneum provides this waterproofing. The outmost layers of skin cells are enveloped in multiple lipids (fats), preventing water loss (because the fat will not allow water to pass through). This lipid barrier is created by epidermal cells called keratinocytes.

This lipid barrier consists of 3 essential fats or lipids– cholesterol, ceramides, and free fatty acids, forming an intact barrier. For normal barrier function, there must be approximately equal numbers of each molecule, creating a 1:1:1 ratio. Remember this ratio 1:1:1, which is essential for barrier function and repair. When the skin barrier is disrupted, repair only occurs when the lipids in the skincare product are presented in a 1:1:1 ratio. 

This lipid barrier not only prevents water loss (trans-epidermal water loss or T.E.W.L.), but it is also essential in preventing harmful bacteria and toxins from entering, helps in U.V. protection and keeps our resident skin microbes. Happy!

The key player in the skin moisture barrier is the outer layer of skin called the stratum corneum. Multiple layers of fatty (lipid) membranes surround multiple layers of ‘mature’ skin cells.

The skin has tight junctions, as well as the gut.

In addition to the lipid barrier, a second tight junction skin barrier was discovered not long ago. Lying in the second-most outer layer of your skin (stratum granulosum) is similar to the impenetrable barriers in your gut lining. Tight junctions form the main barrier in the gut lining (disruption of this causes a leaky gut). Like the tight junction in the gut, it is controlled by proteins that act like locks, latches and springs to prevent the flow of what gets into our bodies selectively. Less is known about the purpose of the skin-tight junction barrier. However, recently, it has been understood that we can also have ‘leaky skin’ when the tight junctions are disturbed; things that shouldn’t enter the body via the skin do! And this may play a role in developing food allergies.

The barrier to infection and entry of bad bacteria and other bugs. There are several components at play to protect against bad bugs from entering and causing infection.

The acid mantel – ‘it makes our skin sour.’

The acid mantel is not a physical layer on the skin. Instead, it is an acid gradient – as you get closer to the skin’s surface, it gets more acidic (or sour). (At the skin surface, the ph is about 5, whereas, inside the body, it is more neutral -7.4)

This plays an essential role in keeping out nasty bugs – like Staphylococcal aureus, which does not like acid environments and encouraging the friendly skin bugs that thrive in its sourness. The acids creating the acid mantel are produced as the lipid barrier is formed. When the acid mantel is disrupted, the skin barrier is disrupted – ( so be careful what products you put on your skin), and infection can occur.

Immune function of our skin barrier repair.

Our skin’s innate and acquired immune function is very sophisticated, which stops any nasty bugs from invading to prevent them from causing infection.

1. Anti-microbial peptides form part of the innate immune system – The epidermis cells form the super barrier and secret molecules that fight against nasty bugs. (Anti-microbial peptides also occur in the gut)

These peptides are a defence response from our innate immune system. They recognise potentially harmful bugs, secret molecules which can kill them and activate other immune cells to come and eliminate them – this is true!

2. Immune cells – an interplay between immune cells in our skin. For example, the Langerhans cells are specialised in the skin and responsible for recognising anything invading, and they talk to our adaptive immune cells to get rid of the invader. Many other cells are involved in immune function, like mast cells, macrophages, t cells, all of which have a protective role.

 3. Sebum produced in the oil glands also plays a role in anti-microbial protection. Secreted on the surface, mixed with the metabolites produced by the helpful bacteria that reside inside,  this oily secretion’s acidity is also believed to be defending against harmful bacteria.

The Skin Microbiome: the good bugs and the not-so-good.

We know a lot about the diversity of microorganisms in our gut. Still, much less attention has focussed on the skin microbiome – until now, as modern techniques reveal the variety of our skin’s normal flora.   Most of these organisms do not live in the gut (as the skin has ph- 5 instead of the ph inside – 7.4, and they do not survive in acid environments).

Healthy skin – is all a matter of balance.

We know the normal skin microbiome helps protect us against colonising bugs that cause infections like impetigo or cellulitis. But normal skin bugs can contribute to skin problems when an overgrowth of a particular organism occurs. The resulting imbalance (dysbiosis) causes problems. (in acne, eczema, and even rosacea). Like the gut microbiome, healthy skin depends on the diversity and balance of the organisms.

The skin super lipid barrier and the anti-microbial barrier are closely related. If you disturb the skin barrier, you upset the microbiome and vice versa. Fixing the skin barrier allows the skin microbiome to come back into balance. This is because the (epidermal cells) keratinocytes (as well as producing the lipids for the super layer) also make the anti-microbial peptides, determine the skin’s acidity that fosters the growth of good bacteria and inhibits the growth of bad ones. So when the keratinocytes deliver the lipids to waterproof the skin, they also provide the anti-microbial peptides.

Sebum –the final layer for skin barrier repair.

Though the lipids produced by the keratinocytes fill the spaces between the stratum corneum barrier cells, they do not form the majority of fats on the skin. Instead, the sebum secreted onto the surface and hair coats all skin. Sebaceous lipids’ composition is unique and consists of a mix of triglycerides, wax esters and squalene. Omega-3 and omega-six fatty acids are essential for the formation of sebaceous lipids.

Sebum has an additional protective role; it provides a store of fatty acids that can be absorbed back into the epidermis to be used by keratinocytes for recycling into the lipid bilayer,

• it possesses antibacterial properties
• confer anti-oxidant protection through vitamin E.
• It also provides food for bacteria which usually are commensal.
• It provides additional protection against skin dehydration and repelling of water.

Skin Barrier Repair – the first task in cosmetic medicine.

A damaged skin barrier increases trans-epidermal water loss (T.E.W.L.), resulting in dry skin interfering with the protective mechanisms- chemical, physical, acid mantel and anti-microbial defence mechanisms. The disrupted barrier allows allergens, microbes, and irritants to penetrate, resulting in inflammation.

In nature, skin barrier repair is the first task is restoring an intact epidermal barrier. Therefore, we consider converting the skin barrier as our first task in cosmetic medicine.

Signs and causes of impaired skin barrier include:

1. 1. Sensitive skin is perceived as stinging, burning, irritation, or itching when using skincare products. A large study found up to 60% of the average population to have sensitive skin. This occurs in men and women and increases with age. https://pubmed.ncbi.nlm.nih.gov/30206954/ This highlights the importance of skincare formulation in protecting the skin barrier.
   2. All inflammatory skin conditions have, by definition, a disturbed barrier function—acne, psoriasis, rosacea and eczema.
   3. A damaged skin barrier is evident in aging skin. Over the age of 50, changes to skin barrier function occurred due to decreased cholesterol, changes to the skin-tight junction barrier and increased inflammation ‘inflammaging”. This inflammation arises from a dual source, the gut and the skin microbiome action on your immune cells.
   4. Blonde hair and red hair predispose to more sensitive skin. This is because the melanin in “skin of colour” confers a slightly more acid property to the skin surface, resulting in a more robust barrier function.
   5. Impaired barriers occur during psychological or physical stress, as witnessed by stress-precipitated outbreaks of acne, eczema, rosacea, and psoriasis.
   6. Using medications such as oral steroids impairs the skin barrier, and takes cholesterol-lowering medicines called statins.