The Power of Cleansing: Achieving Radiant Skin

The practice of cleansing has evolved significantly from simply removing dirt from the skin. Historically, cleansing has been an integral part of religious ceremonies and healthy living, and in modern times it is considered a way to enhance the health and appearance of the skin. However, it is crucial to strike a balance between cleansing the skin and preserving its natural functions.

The earliest form of cleansing involved using a hard object to scrape the skin, and olive oil was often used in conjunction with this process to help loosen dirt. Throughout history, various civilizations have utilized plant materials and water for cleansing. Soap-making can be traced back to Sumerian clay tablets from 2000 BC, and the Phoenicians used tree ash and animal fat to make soap by 600 BC. The importance of soap as a cleansing agent was recognized in the first century AD, and the Greek physician Galen was the first to write about its use. In 1884, the English developed the first wrapped soap bar. The soap industry continued to grow, and the development of synthetic detergents during World War II was a major breakthrough. Today, synthetic detergents form the basis of many skin-cleansing products.

Many environmental pollutants and cosmetic products are not water-soluble, so washing with water alone is not enough to remove them. Cleansers, being detergents or soaps, have the ability to attract both fat and water. They are surface-active substances that remove impurities in an emulsified form while retaining the skin's moisture.

Composition of Cleansers: Surfactants are the key ingredients in most cleansers. The type and amount of surfactant used in a cleansing agent directly impact its potential for skin dryness and irritation. Soap is the most commonly used surfactant in skin cleansers, but it can often lead to skin dryness and irritation.

Types of Cleansers

1. Soaps: Made up of long-chain fatty-acid alkali salts with a pH between 9.0 and 12.0. These include:

• Glycerine bars: contains glycerine to counteract the drying effects of soap.
• Super-fatted soaps: contain more fats like lanolin, which forms a protective film on the skin.
• Deodorant or antibacterial soaps: contain antibacterial agents such as triclosan to control odour by inhibiting the growth of bacteria.
• Synthetic Detergent Bars of Soap: These soaps use a non-soap synthetic surfactant as the main ingredient. Unlike soap, synthetic surfactants are not made by saponification and have a neutral or slightly acidic pH, making them less irritating to the skin and less likely to form a foamy layer. Microscopy has shown that skin washed with synthetic detergents has well-preserved lipids and proteins, unlike skin washed with soap, which experiences significant damage. The increased content of free-fatty acids in synthetic detergents provides a moisturizing benefit that helps maintain skin hydration.
• Lipid-free Cleansing Lotions: These lotions contain fatty alcohols and are suitable for people with sensitive or dry skin. They can be wiped off without water, resulting in less facial residue and a higher evaporation rate. The fatty alcohols in these lotions also help counter the irritancy or drying potential of the surfactant, and the agents may contain emollients (e.g., fatty alcohols) and/or humectants (e.g., propylene glycol).
• Liquid Body Washes: These are more hygienic and convenient than traditional bar soap. These use lighter concentrations of surfactants and increased emollients to prevent dehydrating skin as much as soaps.

 

The skin acts as a barrier to protect the body from external factors, but the use of harsh soaps can result in damage to the skin's barrier, causing skin irritation, erythema, and itching. Allergic contact dermatitis can also occur from the presence of fragrances, preservatives, or dyes in some soaps. Furthermore, the rapid evaporation of water from the skin surface can result in a tight feeling after washing. Cleansers that contain fat solvents such as alcohol, and even non-ionic surfactants, can lead to skin dryness, scaling, and roughness, which can also cause long-term environmental damage to the skin.

Factors that Contribute to the Irritating and Drying Potential of Cleansers include:

• The type of surfactant used in a cleanser plays a crucial role in its drying and irritating potential. Surfactants, when they bind to keratin, cause protein denaturation, leading to damage in the cell membrane of keratinocytes and adverse cutaneous responses.
• The length of time a cleanser is left on the skin also affects its irritancy potential, as the longer it is left on the skin, the greater the irritancy potential.
• The pH of a cleansing agent is another critical factor, as maintaining the skin surface at its physiological pH (5.5) during cleansing prevents overgrowth of certain microorganisms, like Propionibacterium acnes, and helps to avoid damage to the lipid bilayer of the stratum corneum. Soaps with an alkaline pH can cause damage to the lipid bilayer, leading to dryness of the skin and long-term environmental damage. Synthetic detergents, on the other hand, have a neutral or slightly acidic pH, which closely matches the skin's pH.

 

1. Atopic Dermatitis

Atopic dermatitis (AD) is a complex interplay between environmental, immunologic, genetic, and pharmacologic factors, and various triggers such as irritants (soap and detergents, occupational irritants, and disinfectants), microorganisms (Staphylococcus aureus, viruses, and dermatophytes), aeroallergens, seasonal changes, and psychogenic factors may worsen the disease. Washing twice daily with a classic alkaline soap (pH 10.2) has been shown to increase suffering from atopic dermatitis and can cause damage to the skin barrier function, leading to increased colonization of gram-positive bacteria.

In these cases, using a synthetic washing bar, is recommended. This type of cleanser is known for its mildness and ability to maintain proper hydration of the stratum corneum, making it a good choice for atopic dry skin.

2. Cleansing in Acne

For individuals with acne or acne-prone skin, the goal of cleansing is to gently remove surface dirt, sweat, and excessive skin lipids without irritating or drying the skin. The ideal cleanser for acne skin should be non-comedogenic, non-acnegenic, non-irritating, and non-allergenic.

A common misconception about acne is that scrubbing the skin with soap and water several times a day will reduce oiliness. However, this approach only leads to an aggravation of acne and can sometimes even cause acne. For acne-prone skin, a fragrance-free liquid cleanser with good rinsability is recommended.

3. Cleansing with Rosacea

Rosacea is a skin condition that affects the face and causes redness, flushing, and visible blood vessels. People with rosacea have extremely sensitive skin and are susceptible to chemical irritants, making proper cleansing important. Classic soaps, cleansers containing alcohol, astringents, and abrasives should be avoided in people with rosacea. Gentle cleansing is recommended, using only very mild cleansing agents that are free of harsh chemicals.

Therapeutic skin cleansers, containing sulfacetamide 10% and sulphur 5% in addition to a synthetic detergent, are approved for the treatment of rosacea. These gentle cleansing agents are specifically formulated to help soothe and hydrate the skin, reducing the risk of further irritation. For best results, it is recommended to use a cleanser specifically formulated for people with rosacea. It is specifically designed to soothe and hydrate the skin, helping to reduce the redness, flushing, and visible blood vessels associated with rosacea.