“Dr. Williams, I need help. I have dry skin. I’ve used every moisturizer out there including the Chanel moisturizer made with vanilla beans from Madasgar, and NOTHING is working. To top it off, my skin is now drier and more wrinkled than ever!”
I’ve heard similar stories to this a thousand times.
If you listen to advertisements on the tv or the beauty consultant at the department store counter, you’d think that the secret is that you haven’t been using the “right” moisturizer.
Let me tell you right now and here: moisturizers are over-hyped and oversold. But why?
We have lost sight as a society of the length and breadth of schooling and education that doctors endure.
Let’s take a walk down medical board lane. As a Board Certified Plastic Surgeon who completed 9 years of post-graduate training, I have taken my share of tests and board exams. That process has afforded me certain expertise. Because of my licensing process, the FDA and DEA award me certain rights as a clinician…one being the ability to recommend what my patient needs in order to achieve their goal, not simply what will put a dollar in my pocket. As a result of my training, I have numerous tools (including he ability to prescribe treatments) in my bag to give you the very best recommendations and treatments. Moisturizers are not my only tool.
Let’s think of it another way. If you are a manufacturer of a moisturizer, that is the extent of your “solution” to skin problems. You don’t have a medical license. You simply do not have the tools to recommend or prescribe anything else. So, what do you do to increase profits and satiate your investors? You’re going to make another moisturizer so I can capture more of the market. Since I began practicing Plastic Surgery, this is troubled me as a clinician.
Before we go any further, I would like you to read my blog on Melanocytes to get a good understanding of the skin structure.
Assuming you’ve read that, let’s move on. The epidermis (stratum corneum) is the outermost layer of 15-20 layers of dead skin cells which are void of nuclei or cellular function. Naturally, as you would assume, you need to slough these cells off over time. This sloughing process (exfoliation) is what occurs every time you towel off after a shower, use a scrub brush, etc.
The primary purpose of moisturizers is to moisten the skin. When you apply a moisturizer, it sits on top of the dead skin cells of the epidermis. This in turn makes the epidermal cells adhere more to the underlying cells which in turn makes them harder to exfoliate. As the cell layers of the epidermis build up, wrinkles start to look deeper. In addition, the added moisture from the moisturizer signals the sebaceous glands which are housed in the deeper dermis to slow down production because they think they have enough moisture. This down-regulation causes rebound dryness.