As the body’s largest organ, it makes sense that the skin should be kept healthy and clean. Plus, vanity is a strong motivator—humans may have evolved to analyze others’ skin to determine their health (and attractiveness).
It makes for a booming business. The skincare industry was worth $133.9 billion in 2018, and is projected to reach $200.25 billion by 2026.
With an ever-growing list of skincare products boasting a litany of buzzy ingredients, it can be hard to sort out what we actually need to take care of our skin.
Experts explain how our skin protects us, how to keep it intact, and what’s nice (but not strictly necessary) to add to your routine.
The biology of the skin
The “skin barrier” is made up of skin cells and the linked system of proteins and lipids that surround and connect them. This wall serves as the first line of defense against outside threats, whether those are irritants like toxic chemicals or infectious agents like bacteria.
“The bricks are the skin cells and the mortar is the skin barrier made of proteins and lipids,” says Mona Gohara, an assistant clinical professor of dermatology at Yale School of Medicine.
The skin barrier does more than just keeping undesirables out––it also is crucial for keeping certain essentials, like water, in. If the skin barrier doesn’t have enough water, it dries out, damaging the lipid links that connect skin cells. This can allow unwelcome material to get in, and cause skin conditions like dermatitis and psoriasis.
Should you supplement your diet or water intake for healthy skin?
An average person’s water intake and diet are enough to keep the skin healthy.
Supplements like biotin are marketed to help protect your skin, but Devina Mehta, a dermatology resident at Cornell Universitysays most people don’t need them—a well-rounded diet that supports your mental and physical health will support your skin health too.
You don’t need to chug water all day, either—you just need enough to not be dehydrated.
“I do not advise any amount of water for strong skin,” says Jules Lipoff, adjunct associate professor at Lewis Katz School of Medicine’s department of dermatology. “You would have to be super dehydrated for it to really affect the skin.”
What skin products do you actually need?
The only thing that average people without any skin problems actually need to do is to keep the skin barrier intact. This can usually be accomplished through the use of three products: cleanser, moisturizer, and sunscreen.
“We do have mechanisms in our skin that are self moisturizing and self-exfoliating and protective,” Gohara says. “But you still have to take care of it. It’s not something that’s going to happen by itself. You have to make a proactive effort to maintain the natural mechanisms in the skin that already exist.”
Gohara recommends a gentle non-soap cleanse, which gets rid of irritants like dirt without the harshness of normal soap. As she explains, soaps have a high pH that can weaken the skin barrier, allowing irritants in and causing inflammation. Non soap cleansers are often labeled with things like “non-soap,” “soap-free,” “sulfate-free,” or “pH neutral”.
To feel clean, individuals may be inclined to scrub every inch of their body while in the shower, but that can do more harm than good. “Letting the water flow is sufficient,” Lipoff says. “You don’t need to exfoliate. Exfoliation happens by itself, it doesn’t need to be helped along.”
Moisturizing is also a key part of keeping the skin barrier intact, as it limits water loss. The skin has ways of naturally maintaining moisture, but when we dry it out with a hot shower or exposure to cold and dry weather, we need to help it out, Gohara explains. Lipoff advises his patients to apply moisturizer to wet skin to strengthen its effectiveness.
You should also use sunscreen, as unprotected exposure to UV light can dry out the skin and increase the risk of skin cancer. By using sunscreen, “you’re going to minimize a lot of damage in a lot of ways to your skin,” Gohara says. It’s a low hanging fruit.”
Dermatologists acknowledged that not everyone’s skin is created equally, and some people may have skin barrier impairments like acne, eczema, or rosacea. “Oftentimes people who suffer from them will need additional therapies or products to help them with that,” Angelo Landriscina, a board-certified dermatologist in New York, says.
Some topical treatments, such as those containing benzoyl peroxide targeted for acne, can irritate the skin further—requiring an even more heavy duty moisturizer to restore and strengthen the barrier, says Gohara.
What are helpful additions to your skincare routine?
Once the skin barrier is intact and protected, secondary concerns like anti-aging can be addressed.
Hyaluronic acid, for example, is a valuable but nonessential ingredient to look out for. It helps hold onto water and make the skin look more plump. “It’s an ingredient I really like and it’s buzzy for good reason,” Landriscina says. “It’s just a nice-to-have sort of ingredient.”
People often seek anti-aging products once their skin shows wrinkles or dark spots. But the most effective anti-aging practices start before damage occurs, especially with protection from the sun, says Landriscina.
Outside sunscreen and other sun protection, retinol (vitamin A) and retinoids (derivatives of the same vitamin) are also helpful additions for discoloration or wrinkles. “They’ve been at the forefront of the skin care zeitgeist for a long time because they’re very effective and very well studied,” he says. “But it is by no means necessary.”
For those looking to reduce the effects of sun damage, Mehta recommends vitamin C serum in the morning and retinol at night. “These products serve to help brighten the skin, lighten dark spots and boost collagen production,” she says.
Though beneficial, these ingredients can also cause damage if not used appropriately. Mehta encourages speaking to a dermatologist to see if the products are right for you.
“You don’t want to just go out buy something because it’s new or buzzy or because your friend likes it or you heard about it on social media,” Landriscina advises. “You should constantly be taking inventory of your skin and what you’re doing for it, and the changes and choices you make should be based on the result you’re trying to achieve.”