Proper skin cleansing and moisturization are the two basic processes that must work in harmony to maintain overall skin health and epidermal barrier integrity (1,2). The role of
skin cleansing is to remove external debris, cutaneous secretions, and microorganisms. In addition, the integrity of the epidermal barrier must be consistently maintained to allow for cutaneous homeostasis as the presence of proper skin water content is mandatory for enzymatic functions required for lipid synthesis and barrier restoration. Therefore, moisturization is a vital component of “routine maintenance” of the outer skin barrier. This is especially true in conditions where epidermal barrier dysfunction and reduced epidermal water content are present. Examples of such conditions include low ambient humidity, xerotic skin disorders such as atopic dermatitis, genedermatoses such as ichthyosis vulgaris, underlying systemic disease states such as hypothyroidism and diabetes mellitus, use of skin care products that produce significant epidermal barrier damage such as harsh soaps and cleansers or astringents, and some topical medications such as topical retinoids (3-5).
The plethora of cleanser and moisturizer products available make it difficult for both professionals and consumers when faced with the question, “Which products should be used?” The bottom line is to maintain a “simplest is best approach,” especially as many product claims, special ingredients, and heavily promoted “designer” products are substantiated by little to no scientific evidence supporting their purported benefits and high expense (1,2,5,6).