7 SKIN FLOODING HACKS: DERMATOLOGIST SKINCARE ROUTINE STEPS
Did you hear about skin flooding recently? How does that relate to skin barrier function? For healthy, beautiful skin, we must begin with understanding the skin barrier.
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1. Focus on skin barrier repair, not trends
In 2023, TikTok looks set to become an arbiter of skincare trends. It started with the 2022 trend of skin cycling, which really was nothing new. The idea of cycling retinoids, acids and moisturiser therapy has been around for as long as retinoids have been. Skin flooding though, is a new take on something age-old. Wet occlusion therapy—that’s what dermatologists prescribe for eczema, especially in severe cases. Erythroderma is also known as red man syndrome, an extreme case of skin barrier dysfunction in eczema or other forms of dermatitis. In pediatric dermatology, we call this type of treatment as wet pajamas therapy. Referring to a child who quite literally wears wet pyjamas to bed over moisturisers applied on damp skin.
2. Skin flooding based on the brick wall model of skin
The integrity of the skin barrier depends primarily on the cohesiveness of the top layer of skin cells. The corneocytes, specifically that are linked to one another via bits of “cement” a la the brick wall model of the skin barrier perform the key role of preventing moisture loss to the environment. Skin flooding is quite literally the “flooding of skin” with moisture—a series of steps that include various active ingredients that work on different levels of skin to keep maximum moisture in. The skin barrier isn’t just water though, the superficial skin cells— the corneocytes are precisely replenishing lipids that help to keep the cells together. These lipids are known as ceramides which directly repair the skin barrier. And that is how dermatologists explain the science of skin flooding to treat barrier dysfunction.
3. Skin flooding is about a healthy skin barrier that’s working
An intact skin barrier is also essential for regulating the skin microclimate—what is known as skin ecology comprises the unique interactions of cells that “talk” to one another via chemical signals known as cytokines and chemokines. More than that, it also provides the ideal environment for healthy bacteria to thrive—a concept known as the skin microbiome. In essence, a healthy skin barrier effectively fulfils the following functions:
- Physical barrier between the environment and the body’s cells
- Regulate surface temperature i.e. sweating.
- Adjust moisture levels according to environmental humidity via trans-epidermal water loss
- Hosts a diverse flora of microorganisms
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4. Learn skin flooding for skin problems like eczema, dermatitis and sensitive skin
Recognise signs of skin barrier dysfunction and learn skin flooding the right way.
When the skin barrier is defective, it can present in the following ways:
- Broken skin, wounds
- Redness, flaking
- Stinging, sensitivity, pain
- Swelling, skin thickening
What has been described as sensitive or reactive skin really is a failure of skin to regulate environmental changes. Hence “reacting” to perceived triggers like a drop in humidity or temperatures. This could also apply to using certain skincare products—usually because of concentration of cleansing agents and potential irritating skincare actives. Laureth sulfates in cleansers damage the skin barrier with repeated usage, or in the case of already dry skin—it dries it out further causing a flare-up of dermatitis.
Dermatitis is synonymous with eczema and refers to a state of barrier dysregulation. One presenting with any of the above constellation of symptoms can be presumed to have a form of dermatitis. The precise subtypes—eczema, allergic and irritant contact dermatitis, perioral dermatitis etc. do take specialised knowledge in dermatology and clinical acumen for correct diagnosis and is beyond the scope of this article.
5. Skin flooding is about developing skin resilience
Skin resilience isn’t a medical term but is a useful concept that encapsulates our discussion of the skin microclimate. The best way to think of resilient skin is as skin that quite literally—bounces back. Environmental damage from UV and airborne pollutants are only one part of the story.
The reason why biological aging plays a key role in this boils down to how our cells repair damaged DNA. DNA damage directly leads to cancer cell formation and our bodies are actually designed to actively combat cancers with a physiological reaction known as apoptosis—referring to the death of cancer cells. That’s why children and young adults do not develop signs of skin aging despite being exposed to the same environmental assaults as older adults. The question here is also the role of cumulative damage—frequent sunburns for instance in childhood are a direct risk factor for skin cancer development in one’s lifetime. This also is the reason why dermatologists view skin flooding as key to developing skin resilience.
6. Skin flooding for the lips—a dermatologist’s top tip
The lips are the most neglected part of skincare routines. That’s a huge mistake because mucosal skin is the most fragile—it’s also equally susceptible to sun damage. I wouldn’t recommend applying sunscreen to lips—sunscreen really shouldn’t be ingested. There are some lip products with SPF but that doesn’t guarantee protection either—I’d stick with sun avoidance and using physical measures such as a broad rimmed sun hat. The other factor to consider is the increased absorption at mucosal areas such as the lips—this is why regular moisturisers aren’t the most suitable for the lip area. Besides, it is cosmetically rather unacceptable to have opaque creams on the lip area. Read more about the lip care ritual I recommend to for skin flooding the lip area.
7. Skin flooding is good, but feeling stressed about your skincare routine or life in general isn’t!
Guess what? Stress damages the skin. This isn’t a myth, psychological stress sets off the neuroendocrine axis which involves the brain sending a bunch of bad signals to the rest of the body—and skin is one of the most vulnerable organs. Simply because it is visible and also, intricately linked to our immune system—which is also why conditions like acne and eczema flare up during periods of stress. But on a more serious note, if you are feeling stressed about your skincare routine (too many steps for example), we really recommend ditching whatever you are doing. Seriously.
Here’s a 2 step method to skin flooding effectively and easily like a dermatologist would
A good skincare regimen can flood your skin with moisture in as little as 3 steps in your skincare routine. And it isn’t the typical cleanse-tone-moisturise preached by the nineties beauty brands.
This is recommended for those with dry skin on a daily basis and up to three times a week for those with combination skin.
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1. Use a milk cleanser to cleanse and hydrate in 1 step
It’s more an emulsion (oil in water) rather than a milk per se. But these cleansers look milky and are preferred over micellar formulations.
2. Moisturise immediately without drying your skin
Applying moisturiser to damp, wet skin enhances absorption a la the wet pajamas therapy described above. Use a palm-sized amount of moisturiser if you have dry skin—rather than the smaller amounts you are used to. If you are heading out, wait for it to absorb over half an hour or so and massage the excess onto your hands and rest of your body like your neck area.
How to skin flood if you have combination skin?
1. Double cleanse if you wear makeup
The first step should be an emulsion-based moisturiser, the second a hydrating foaming cleanser. Choose honey or soy as natural emulsifiers.
2. Apply moisturiser on wet skin
Leave on a larger amount of moisturiser over areas that tend to be dry like the cheeks.
How to skin flood for oily skin types?
1. Double cleanse with a hydrodermabrasion or microdermabrasion tool
Here’s how I carry out skin flooding for myself:
First, I wet my face, apply a pea-sized amount of cleanser Then, I use home skincare device with a microcrystalline copper oxide tip for gentle microdermabrasion. It works with vacuum technology and the microcrystalline tip exfoliates skin on a microscopic level, similar to what a chemical peel does.
The science behind this is that skin dullness is not just caused by retention of dead skin cells, but also because of surface oxidative stress caused by pollution. Thorough cleansing itself removes the pollutants and instantly restores the glow. The key is to cleanse effectively with the help of technology, I prefer microdermabrasion or hydrodermabrasion over sonic cleansing but you would do well to use both really.
2. Moisturise with hydrating face mists and a sleeping mask at night
Creams aren’t comfortable on oily skin especially in summer or tropical weather like where I practice in Singapore. So if you have super greasy skin I won’t blame you for disliking cream moisturisers. Instead, I advise my patients to use a facial mist that contains polyglutamic acid, hyaluronic acid and glycerin. These are lightweight water soluble humectants that help to keep the skin micro-climate healthy. The mist is to be frequently used throughout the day to maintain a state of balance, also known as homeostasis. With time, the skin environment should begin to harmonise.
It is a myth that oily skin doesn’t need moisture. In fact, it needs even more moisture than dry skin does—in a sense. Because oily skin is caused by dysregulated oil production. It could be parched on the surface yet secreting a tonne of oil underneath. This is where inflammation begins, in the pilosebaceous follicle. I always recommend a good skin hydrating regimen for my acne patients, in order to regulate the skin environment.
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