Skin is the largest organ in the body and is often overlooked when it comes to caring for it. It has a very important job. Amongst other functions, it protects our bodies and other organs all day long every day.

To keep it functioning properly, it needs to be cared for every day consistently just like any other organ, like the heart. Therefore the importance of good skin care habits should not be underestimated.

With the right routine and right products, you can keep the skin functioning optimally, feeling healthy and looking youthful for years to come.

What is the structure of the skin?

The skin consists of 3 layers, epidermis (outer layer), dermis (middle layer), and fat (innermost layer) (1, 2). The epidermis is further divided into 5 layers, stratum basale (innermost layer), stratum spinosum, stratum granulosum, stratum lucidum, and stratum corneum (outermost layer). Each layer performs different functions specific to that layer.

What is the function of the skin?

The skin is an important organ and vital to your body. It performs many important functions (3). If you do not care for it properly, it will not function properly.

1. Protection

Each layer of the skin contributes to protecting the body from the external environment.

The innermost fat layer serves to cushion the body and protect it from trauma.

The outermost layer (stratum corneum), also referred to as the acid mantle, serves as a barrier to the outside world. It protects the skin from dehydration by locking in moisture and keeping out microbes that can cause infection.

The bottom layers of the epidermis produce pigment which protects our body from UV radiation emitted by the sun. The middle layer or dermis contains collagen and elastin which gives our skin strength and flexibility.  This is also where oil glands (sebaceous glands) are located. They secrete oil which prevents dehydration of the skin.

2. Temperature regulation

The skin helps to keep our body temperature consistently at 98.6 F no matter what the environmental conditions are. It does so by different mechanisms. When you are hot, you will perspire and this moisture that is produced will evaporate and cool the skin. Your capillaries also dilate to radiate or release heat. When you are cold. The fat layer serves to insulate the body.

3. Secretion

The sweat glands in the skin secrete sweat, which is basically waste products. There are 2 types: apocrine and eccrine. The apocrine glands are found in the axilla and genital areas. The eccrine glands are found all over the body.

4. Excretion

The sebaceous glands, or oil glands, excrete oil which is also called sebum. They are found all over the body but especially in the face. They serve to lubricate, hydrate, and protect the skin.

5. Sensation

The nerves in the skin allow us to feel different sensations, such as heat, cold, pain, pressure, and itch. These sensations are carried by different nerve fibers. Pain fibers are closest to the surface, so it is easier to feel this sensation. Pressure is deeper and not as easily felt.

6. Absorption

This is the basis for the whole cosmeceutical and topical pharmaceutical industry. This allows us the apply different products topically on the surface of the skin, such as retinoids or vitamin C, so they can be absorbed and reap the benefits. This is a very easy delivery system for medications as well. Also, in addition to your diet, this is one of the ways we get vitamin D into our bodies.

7. Shedding skin cells

The top layer of the skin, the stratum corneum, sheds its skin cells regularly, if the skin is not functioning properly, the cells do not shed when they should. When they do not shed, they get stuck in your pores and clog them up leading to blackheads and acne.

Why is skin care important?

If you want your skin to work optimally, you need to take care of it. This is the same for any organ. If you do not take care of your heart, by eating right and exercising, then you will get heart problems, such as high blood pressure or heart failure. Skin is the same. The purpose and advantage of skin care is to keep the skin healthy so it can perform the functions listed above.

Also, by taking care of your skin now, it will prevent problems later on which are time-consuming and expensive to fix. For example, proper use of sunscreen will prevent wrinkles and skin cancers in the future. It is easier to prevent them than to treat these problems later.

If you get wrinkles, it will require surgical, laser, or injections in the future to improve them. Skin cancers require surgery to cure them, which will leave a scar. The old adage is true: an ounce of prevention is worth a pound of cure. Good skin care benefits your skin now and in the future.

Our appearance for many is tied to our self-confidence. If our skin is not cared for properly, then it will not look good. It will get dull, rough, sag, and look wrinkled. This gives the skin an aged appearance. For many, if you do not look good, you will not feel good.

Proper care of your skin, will lead to proper care of the rest of your body. You will want to eat right, drink plenty of water, eat food rich in anti-oxidants, get plenty of sleep, and avoid smoking and alcohol (1, 2, 4). These habits will help your skin and your body as a whole. A healthy lifestyle will give your entire body longevity for years to come.

How do I care for my skin?

There are some basic steps to skin care that everyone must perform and then some advanced ones that everyone should do. Each step is important for the health and maintenance of your skin.

Here are some examples of skin care routines:

Basic skin care routine

Morning:

1. 1. Cleanser
   2. Moisturizer
   3. Sunscreen

Evening:

1. 1. Cleanser
   2. Moisturizer

Advanced skin care routine

Morning:

1. 1. Cleanser
   2. Toner
   3. Serum
   4. Eye cream
   5. Moisturizer
   6. Sunscreen

Evening:

1. 1. Cleanser
   2. Toner
   3. Acne treatment or retinoid/retinol or exfoliator
   4. Serum
   5. Eye cream
   6. Night cream/moisturizer

Why do I need to cleanse my skin twice a day?

It is important to cleanse your skin twice a day every day. Cleansing in the morning removes the dirt and oil that accumulate overnight. If you do not remove the dirt and oil, it can lead to acne or even infections. Cleansing at night removes dirt, oil, makeup, toxins, and dead skin cells that have accumulated throughout the day.

Some use cleansers with glycolic acid to help with anti-aging (1). Glycolic acid helps stimulate collagen production to help erase fine lines and wrinkles, help exfoliate dead skin cells, and help remove dark sunspots.

There are also cleansers with extra hydration for dry skin or anti-inflammatories to calm and soothe sensitive skin, like sunflower oil or jojoba oil (5-9).

It is also important to select a pH-balanced cleanser. If the pH of your skin does not remain slightly acidic, it will not function properly to keep moisture in and microbes out (10,11).

It is also important to cleanse your skin the proper way. Avoid using harsh cloths or brushes, hot water, and dirty implements. You can use clean fingers to gently massage the cleanser into your skin, then rinse with lukewarm water, and pat dry with a clean towel. Scrubbing or rubbing will not clean your skin any better, it will just lead to irritation.

What is the importance of toner?

Toners are not just for oily skin anymore. Everyone can benefit from a toner. They serve to ensure a clean pH balanced palette upon which you apply your other products. pH balance is important for your skin to function properly and prevent dehydration and the entrance of microbes (10, 11). Our skin is slightly acidic, so we want to select products that are slightly acidic as well. In addition, some toners even hydrate dry skin, calm inflamed skin, or help with anti-aging.

Toners are applied usually with a clean cotton ball, which is wiped over the entire face. Wipe it gently, there is no need to be rough and scrub your skin. That will just serve to irritate your skin and inflamed it.

What is a serum?

There are many types of serums. These are liquid products that are full of highly concentrated ingredients. The most common serums are full of antioxidants that help prevent aging (1, 2). Anti-oxidants help to neutralize free radicals in the environment that can attack and destroy your skin.

Free radicals are emitted from various sources, such as the sun, and have unpaired electrons, so they constantly searching for another electron. They steal these electrons from your collagen, which ultimately destroys the collagen and leads to wrinkles.

Anti-oxidants will donate their electron to stabilize the free radicals and protect your collagen. The most popular and most effective ones are vitamin C and E (1, 12-14). They not only scavenge free radicals, but vitamin C also helps stimulate collagen production and lighten dark spots.

The anti-oxidant vitamin E also helps with the hydration of the skin. Our body produces some antioxidants, but with time or excess exposure to free radicals, your skin cannot keep up with the demand and that leads to damage.

You can even use different serums during the day and at night if you want to target different problems, such as antioxidants during the day and extra hydration at night.

Since these serums are very concentrated, all you need is a few drops that will easily spread over your face. They can be applied with clean fingertips and gently massaged into your skin. Wait for it to be absorbed before you move on to the next step. If it does not absorb, it will not work properly.

Why do I need an eye cream?

Many do not understand the importance of eye creams. They believe that their moisturizer is enough. This is true if you are in your teens and perhaps early 20’s. After that point, you really need to use one.

In your 20’s, your production of collagen begins to decrease and the skin around your eyes is most vulnerable because it is so thin and delicate (1). Eye creams are specially designed for this specific area to give it extra nutrients and protection from the harsh environment.

Eyes creams can deliver many important ingredients in higher concentrations to help specific problems associated with just the eye area, such as dark circles or puffiness. They can also address wrinkles, dehydration, or inflammation.

Eye creams can be applied with clean fingertips in a tapping motion all around the eye area. It is important to be very gentle in this area because it is so delicate and easy to irritate. You do not need to rub the cream into this area, it is absorbed quickly. Eye creams need to be used twice a day because your skin needs hydration twice a day.

Why do I need 2 different moisturizers?

To really take optimal care of your skin, you need 2 different moisturizers, one for the morning and one for the evening. This is because they perform different functions not just hydration of your skin. Your morning moisturizer will hydrate your skin but should be lightweight and not heavy, otherwise, your face will appear greasy and your makeup will not be easy to apply. The sole purpose of daytime moisturizers is to hydrate your skin for the day.

Your night moisturizer will be thicker and more nourishing. It will hydrate but also give your skin growth factors or peptides it needs to keep it functioning properly. Some have anti-oxidants or anti-inflammatories in them as well.

Growth factors and peptides help your skin produce collagen and elastin to keep it looking good as well as healthy (1, 15-19). Collagen and elastin give your skin strength and elasticity so they can optimally protect your body.

They can be applied with clean fingertips and gently massaged into your skin with a circular upward motion. It does not absorb any better if you are rough with your skin.

Do I need sunscreen every day?

You must wear sunscreen every day. In fact, it needs to be reapplied throughout the day depending on your activities. If you are getting sun exposure, then you need to reapply every 1-2 hours depending on how much you are sweating.

Many do not realize that when you are sitting in the car, you are getting sun exposure. The UV goes through the glass in cars and even in windows in the house.

Also, make sure you are using enough of it. Depending on your size, you need approximately one ounce (shot glass size) to cover your entire body and a nickel size to cover your face. If you do not use enough of it, you will not get the benefits of sunscreen.

Choose a broad-spectrum sunscreen that protects against UVA and UVB rays with an SPF of about 50 (1, 2). An SPF of 50 will block out about 98% of the sun’s rays. Both UVA and UVB can cause skin cancers.

There are physical and chemical sunscreens, which work differently. Physical, or mineral, sunscreens work as soon as you apply them and act as a physical barrier to prevent UV from penetrating the skin. These can be applied after your moisturizer.

They consist of ingredients with titanium dioxide and zinc oxide. Chemical sunscreens cause a chemical reaction to take place in your skin to convert the UV rays into harmless heat, so they need 20 minutes to be absorbed into your skin. If you are using a chemical sunscreen, you may want to apply it before your moisturizer so it can be adequately absorbed into your skin. They consist of ingredients, such as avobenzone and octinoxate.

Are retinoids necessary?

Retinoids perform several important functions (1, 2, 20). They decrease oil production and help exfoliate dead skin cells which can help with acne. They also help stimulate collagen production to give you anti-aging benefits.

Retinoids will help decrease fine lines and wrinkles while improving the texture and tone of your skin. Improving your collagen helps to strengthen your skin’s protective abilities. They will also help remove dark sunspots.

Retinoids can cause some peeling and irritation especially in people with sensitive skin. They should only be used at bedtime. Start out using it twice a week for 2 weeks, and if well tolerated, increase to 3 times a week for 2 weeks.

If you are still tolerating, then increase to every night. Start with over-the-counter retinoids before using prescription ones that are stronger. You may need to use more moisturizer to counteract the drying effects. Also, they cannot be used if you are pregnant, planning on becoming pregnant, or nursing.

How often should I exfoliate?

Exfoliation is important to get rid of dead skin cells, otherwise, they can lead to clogged pores and acne (1, 2). However, if you use them too often and over-exfoliate, it can lead to problems. Usually, twice a week is sufficient if you have oily skin. People with dry or sensitive skin may only be able to tolerate exfoliating once a week.

There are 2 types of exfoliators: chemical and physical. Chemical exfoliators consist of enzymes to break up the bond between the dead cells so they can be easily rinsed off your face. These tend to be easier to use for beginners.

Physical exfoliators consist of beads or brushes that physically remove the dead skin cells. These are very user-dependent and can be easily misused. If the beads are jagged or large, or if you overuse them, they can abrade your skin. If they abrade or cut your skin, this can lead to infections and scarring.

Does skin type matter when I select products?

I cannot stress the importance of a skin care routine that consists of the right products for your skin type. If you choose the wrong ones, that can do more harm to your skin than doing nothing at all. When you set out on this skin care journey, you will need to check product labels to determine if the product is right for your skin type.

For example, if you have oily, acne-prone skin and you select a moisturizer that is not oil-free, you will worsen your oily skin and lead to more breakouts. This guide should help you determine what your skin type is.

Skin types

Dry skin

• Looks flaky and dull
• Feels rough, tight, or stinging

Sensitive skin

• Looks flaky, red, and irritated
• Feels itchy or burning

Oily skin

• Looks shiny with blackheads and acne
• Feels greasy

Normal skin

• Does not look dry or oily
• Does not feel dry or oily

Combination Skin

• Looks and feels oily in the T zone (forehead, nose chin)
• Looks and feels dry on the rest of the face

How do I know what products are good?

Not only is it important to use the proper skin products for your skin type, but you also need to use quality products. Now that does not mean to use only expensive products. Price does not guarantee quality.

Many inexpensive products work just as well or better than expensive ones. You need to do your research. Check labels, check reviews, check reputation, and check with your dermatologist. The importance of skin care using quality products is paramount.

Using bad products is worse than using no products at all. The purpose of skincare products is to help your skin. Good products in, good results out. You do not want to waste your time or money on bad products that do not work. Also, some bad products have impurities that can cause allergic reactions or bacteria that can cause infections.

What ingredients should I avoid?

There are some ingredients that could harm your skin and should be avoided. Many of them should be avoided based on skin type since they may not harm everyone.

1. Mineral oil and petrolatum – These can clog your pores and lead to more acne breakouts on the face, especially if you have oily, acne-prone skin.
2. Parabens – These can be irritating especially to those people with dry or sensitive skin. It is also thought that they could disrupt female hormones leading to an increased risk of breast cancer. Parabens can worsen UV damage as well.
3. Sulfates – These can be irritating especially to those with sensitive skin and may even lead to acne breakouts in acne-prone skin. Some people can be allergic to these ingredients.
4. Silicones – These ingredients are occlusive and can trap dirt and oil causing worsening of your acne. Also, they act as a barrier to inhibit other ingredients from penetrating.
5. Dyes and fragrances – These can be irritating to all skin types, but especially if you have dry or sensitive skin types. Some may even be allergic to these ingredients. Beware of unscented products, as they have extra scents added to them to cover up the natural odors of the ingredients.
6. Alcohol – This can be drying to your skin especially if you already have dry or sensitive skin types.
7. Propylene glycol – This is a humectant moisturizer but it is also used as a preservative. It may irritate those with sensitive skin or even cause allergic reactions.
8. Lanolin – This is an occlusive moisturizer that is made from the secretions of sheep’s skin, which is similar to our sebum. However, it can also irritate sensitive skin or cause allergic reactions.
9. Formaldehyde releasers – These have caused irritation and allergic reactions especially in people with sensitive or dry skin. These function as preservatives and disinfectants.

What are some quality products that I can use?

There are many quality products out there, but it can often be confusing to select one that is right for you. This is just a brief list of quality products to choose from. If you are having a hard time finding products, always consult with your dermatologist.

Cleanser

• Oily skin – Boscia Detoxifying Black Charcoal Cleanser
• Normal skin – Zelen Life Cleanser
• Dry or sensitive skin – Cetaphil gentle cleanser

Toner

• Oily skin – Effaclar Astringent Toner for Oily skin
• Normal skin – Zelen Life Toner
• Dry or sensitive skin – Avene Gentle Toning Lotion

Serum

• CE Ferulic by Skinceuticals
• Phloretin by Skinceuticals

Eye cream

• Dark circles – L’Oreal Revitalift Triple Power Eye Cream
• Puffiness – La Roche Posay Pigmentclar Eye Cream
• Dry skin – Skinceuticals Hydrating B5 gel (oily skin) or Eye Balm (dry skin)
• Wrinkles – La Roche Posay Redermic Retinoid Eye Cream

Moisturizer for day

• Oily skin – Skinceuticals Hydrating B5 Gel
• Normal skin – Zelen Life Moisturizer
• Dry skin – La Roche Posay Toleriane Ultra Moisturizing Cream

Sunscreen

• Oily skin – La Roche Posay Clear Skin Oil-Free Sunscreen SPF 60
• All skin types – La Roche Posay Anthelios Melt In Sunscreen Milk SPF 60
• Sensitive skin – La Roche Posay Mineral Sunscreen SPF 50

Night cream

• Hydration – Skinceuticals Triple Lipid Restore Cream
• Growth factors – TNS Essential Serum by Skin Medical
• Peptides – TNS Advanced Serum by Skin Medical
• Glycolic acid – Skinceuticals Glycolic 10 Renewal Cream

Retinoid

• Over the counter products
  • Differin gel 0.1%
  • Effaclar Adapalene Gel by La Roche Posay
• Prescription
  • Adapalene gel 0.3% (Differin)
  • Tretinoin (Retin A)
  • Tazarotene (Tazorac)

Exfoliator

• Chemical
  • Clarifying Exfoliating Cleanser by Skinceuticals
• Physical
  • Ultra Fine Face Scrub by La Roche Posay

Conclusion

Caring for your skin is just as important as caring for any other organ in your body. The importance of the skin is often overlooked or taken for granted. However, the skin performs vitally important jobs for the body every day.

It regulates body temperature, protects your body from infections and dehydration, absorbs nutrients, and can build your self-confidence. Proper care with quality products for your skin type will ensure the longevity, health, and youthfulness of your skin for the future.

It is also a good starting point for proper care of your entire body. A healthy lifestyle can benefit your whole body and keep you in shape for the rest of your life.

References

1. Baumann L (ed) 2015. Cosmeceuticals and Cosmetic Ingredients. McGraw-Hill Education, NY.

2. Draelos ZD (ed) 2005. Cosmeceuticals. Elsevier Inc, NY.

3. Montagna W, Parakkal P. 1974. Structure and Function of the Skin. Elsevier Inc, NY.

4. Addor FAS. Beyond photoaging: additional factors involved in the process of skin aging. Clin Cosmet Investig Dermatol. 2018 Sep 20;11:437-443. doi: 10.2147/CCID.S177448. PMID: 30288075; PMCID: PMC6159789.

5. Lin TK, et al. Anti-inflammatory and skin barrier repair effects of topical application of some plant oils. Int J Molecular Sci. 2018; 19:70.

6. Danby SG, et al. Effect of olive and sunflower seed oil on adult skin barrier. Pediatr Dermatol. 2013; 30: 42-50.

7. Calgary S, et al. The effect of sunflower seed and almond seed oil on preterm infant skin. Adv Skin Wound Care. 2020; 33: 1-6.

8. Pazyar N, et al. Jojoba in dermatology. G Ital Dermatol Venereol. 2013; 148: 687-91.

9. Meier L, et al. Clay jojoba facial mask for lesioned skin and mild acne. Forsch Komplementmed. 2012; 19: 75-9.

10. 10. Surber C, Humbert P, Abeis C, Maibach H. The Acid Mantle: A Myth or an Essential Part of the Skin. Curr Probl Dermatol. 2018; 54: 1-10.

11. 11. Lambers H, Piessens S, Bloem A, Pronk H, Finkel P. Natural Skin Surface pH is on Average Below 5, Which Is Beneficial for Its Resident F Int J Cosmet Sci. 2006 Oct;28(5):359-70.
12. Farris PK. Topical vitamin C: a useful agent for treating photoaging and other dermatologic conditions. Dermatol Surg. 2005 Jul;31(7 Pt 2):814-7; discussion 818.

13. Thiele JJ, Hsieh SN, Ekanayake-Mudiyanselage S. Vitamin E: critical review of its current use in cosmetic and clinical dermatology. Dermatol Surg. 2005 Jul;31(7 Pt 2):805-13; discussion 813.

14. Masaki H. Role of antioxidants in the skin: anti-aging effects. J Dermatol Sci. 2010 May;58(2):85-90.

15. Creely JJ, DiMari SJ, Howe AM, Hyde CP, Haralson MA. Effects of epidermal growth factor on collagen synthesis by an epithelioid cell line derived from normal rat kidney. Am J Pathol. 1990 Jun;136(6):1247-57.

16. Kim, D., Kim, S. Y., Mun, S. K., Rhee, S., Kim, B. J.”Epidermal growth factor improves the migration and contractility of aged fibroblasts cultured on 3D collagen matrices”. International Journal of Molecular Medicine 35, no. 4 (2015): 1017-1025.

17. Kähäri, Veli-Matti & Niinikoski, J & Vuorio, Eero. (1987). Epidermal growth factor increases collagen production in granulation tissue by stimulation of fibroblast proliferation and not by activation of procollagen genes. The Biochemical journal. 247. 385-8. 10.1042/bj2470385.

18. Aldag C, Nogueira Teixeira D, Leventhal PS. Skin rejuvenation using cosmetic products containing growth factors, cytokines, and matrikines: a review of the literature. Clin Cosmet Investig Dermatol. 2016;9:411-419

19. de Araújo R, Lôbo M, Trindade K, Silva D, F, Pereira N: Fibroblast Growth Factors: A Controlling Mechanism of Skin Aging. Skin Pharmacol Physiol 2019;4:275-282.

20. Riahi RR, Bush AE, Cohen PR. Topical Retinoids: Therapeutic Mechanisms in the Treatment of Photodamaged Skin. Am J Clin Dermatol. 2016 Jun;17(3):265-76.