In today’s article I’m going to answer questions about what are ceramides in skin care products, the technicalities behind ceramides in moisturizers, what is the right combination of ceramides in products, do we even need them in our products.
What is a ceramide?
A ceramide is a lipid and along with other lipids, like free fatty acids and cholesterol, lipids are really important in our skin integrity and our.skin barrier function.
Think about stratum corneum or the outer layer of cells as cells that have glue between them, holding them together and making a nice, tight seal, keeping the skin hydrated and healthy.
The ceramides, the cholesterol and the free fatty acids are really part of the glue that holds it all together.
Ceramides are the most abundant lipid in that glue. They come comprise 50% of the lipid component of the skin barrier.
There are nine different classes of ceramides that we have identified, classes 1 through 9.
In people who have a skin condition called atopic dermatitis, which is commonly referred to as eczema, we have learned that those people actually have a deficiency in expression of ceramides 1 and 3.
Those people have a tendency to lose water from the skin very easily, suffer skin irritation and have impaired barrier function. They have more transepidermal water loss and dryness.
We also have learned that with age, our body stops making these ceramides as well. As we get older, or wiser as I’d like to say, we have more of a tendency to have dry skin and when we have dry skin that means that water is being pulled out of our skin.
We’re more prone to irritation and that can flare a lot of skin conditions like acne, rosacea, perioral dermatitis, eczema.
Ceramides are something that our skin actually makes by itself, but as I said with age and with certain skin conditions some ceramides can become deficient.
Here in comes the application of ceramides to the skin in a moisturizer. Actually there is quite a bit of compelling evidence to suggest that using a moisturizer formulated with ceramides can help the body begin to make more of its own ceramides and restore skin barrier function and integrity.
There was a study looking at children with atopic dermatitis who were given a ceramide rich emollient to use in place of their normal moisturizer that did not have ceramides. That study shows that as early as 3 weeks the children with eczema had improvement in barrier function and transepidermal water loss using the ceramide containing moisturizer.
We also have a body of evidence suggesting that using ceramide containing products in patients with acne helps them in coping with the dryness and irritation that comes alongside many acne medications.
In other words ceramide containing moisturizers are useful in the management of acne because it helps to make the acne treatments more tolerable and as a result, for the patient to comply with it better and to get better control of their disease.
There are even prescriptions ceramide containing moisturizers. They have been formulated to contain a mixture of ceramides and have actually been shown in studies to improve skin barrier function. They are medication that requires a prescription.
After these came out, some people have looked at how do these expensive prescription ceramide containing creams compared to the over-the-counter stuff and they’re the exact same.
To answer your question, applying ceramides to your skin in a moisturizer can help in restoring skin barrier integrity and improve measures of transepidermal water loss, dryness and irritation.
We have actual data to support that claim and so they are very useful ingredients in moisturizers.
For your next question, do I need ceramides in my moisturizer, do I need a moisturizer with ceramides, the answer is no.
There are other ingredients that also help the body to remember to make ceramides and improve skin barrier function.
These include urea, lactic acid and moisturizers that contain those ingredients have been shown to do the same thing as ceramide containing moisturizer.
You don’t have to worry about getting a moisturizer that has ceramides. Yes they can be helpful but not essential.
The next question is what about the type of ceramide and the ratio of ceramide in the product. Does that matter?
That’s a myth actually that the ratio of ceramides in your products matters. The reason it’s a myth is because we have zero studies looking at the ratios of ceramides and the different types of ceramides in moisturizers as far as their impact on outcomes of measures of transepidermal water loss, dryness, irritation and the overall function of the moisturizer.
We really don’t have any studies. Furthermore we don’t even know what the right mix and the right amounts of ceramides are in normal skin or how to correct that issue in people with disease states like eczema.
At the beginning the article I pointed out that people with eczema or atopic dermatitis have been shown to have deficiency in ceramide 1 and 3. It’s not surprising that a lot of moisturizers will have some synthetic ceramide 1 or ceramide 3 and that probably piggy backs off of that finding.
These ingredients were put into moisturizers with people with eczema in mind and that’s what some of the studies were done. We’re looking at people with eczema. So that’s probably why a lot of moisturizers have ceramide 1 and 3.
It’s not that they are magic, it’s not that you need the right mix of them. It’s really just built on the observation that people with eczema have deficiencies in ceramide 1 & 3, but it doesn’t necessarily mean that those are the secret to everlasting skin barrier integrity.
Many of you also ask what about not only the type of ceramide but the mix of ceramides plus some of the other lipid components that are part of our skin, like cholesterol and free fatty acids. Is there a mixture of those three things in moisturizers that is ideal for helping the skin barrier.
The answer is no.
We really don’t know that either. We do not know how much ceramide to cholesterol to free fatty acid is needed to go into a moisturizer to get it to do its thing.
It likely doesn’t matter based on what we know about just using a moisturizer that it can help skin barrier function. It likely does not matter but it may matter, we just don’t know that.
It may matter in a specific setting, such as certain disease states. They may benefit from a certain balance of these ingredients versus other disease states or just normal dry winter skin. We really don’t have that level of information.
A long story short – the amount and the type of ceramides in your moisturizers is not something that you should worry about and you also shouldn’t kill yourself to find a moisturizer that has a ceramide in it.
If you have a moisturizer that’s working for you and doesn’t have ceramides, you don’t have to feel like you’re missing out, you’re not.
It’s not something you have to chase after, but it is a good ingredient with evidence to back its inclusion in products.
The last question is can ceramides and skincare products cause problems or is there any reason why somebody shouldn’t use ceramides in their products.
The answer is no.
To be frank, any ingredient can potentially cause issues for people, but there are no conditions or disease states or situations in which ceramide in moisturizer is contraindicated.
It’s more important to avoid other ingredients in the product that are known irritants, known allergens and known to be problematic, things like fragrance and essential oils. That can ruin a moisturizer, whether it has ceramides in the right balance.
That’s really important to avoid. Avoid fragrance in your ceramide containing moisturizer. Don’t chase after ceramides and accidentally end up with glorified perfume on your skin.
Rebecca is a licensed aesthetician and certified laser technician with almost 15 years experience in the dermatology. Her life-long passion is making people look good and happy.