What is Corneotherapy?

As a certifiable skin nerd, I spend most of my time learning about skin. It’s an amazing part of our bodies and a microcosm of functions and activity. It’s the organ that we see every day, shows our emotions, is a window to our health, alerts us to dangers we touch or ingest, protects us from the environment and keeps our insides inside!

It is this constant learning that sent me on a path to becoming a Corneotherapist. A path to learning as much as I can about skin histology; to learn how it functions on a cellular level which means that I can now work with your skin to heal & repair it so that you can have beautiful, healthy skin that behaves itself. It’s now my mission in life to unlock skin health for everyone. At every age and every stage.

To put it simply; Corneotherapy is a scientifically holistic approach to skinCARE that works to care for, protect, rebuild, and honor your skin’s barrier defense systems allowing your skin to flourish.

The outermost layer of your skin is called the Stratum Corneum or horny layer (ok, ok, grow up!) and this is where the term Corneotherapy comes from. It was first coined by Dr Albert Kligman (this is the guy that is considered the father of modern dermatology, he also created Retin-A). In the 1950s Dr Kligman observed, “Whenever you see inflamed skin, regardless of cause, the stratum corneum is leaky and permeable. But, if you repair the stratum corneum, that tells the underlying tissues that they don’t have to keep reacting like there’s danger in the environment.” and used the term Corneotherapy to describe this outside-in approach to skinCARE.

The structures of the skin are many and I’m not going to go through all of them here but I am going to talk a little more in-depth about your skin’s barriers - it’s a defense system.

The First Line of Defense - Your Acid Mantle & Microbiome

The acid mantle is a thin film that covers your skin. It is made up of your natural oil (sebum), water from your sweat & the fats within your skin (lipids). This magical film is acidic (approx. pH 5.5) and is the perfect environment to host your microbiome - the colony of good bacteria that live on your skin and a hostile environment for bacteria that don’t belong there. It keeps your skin lubricated and feeling comfortable. It also helps to reduce water loss so is the first place we want to repair if your skin is dehydrated. 

Bottom Line: An impaired Acid Mantle leaves your skin vulnerable to bad bacteria and water loss.

The Second Line of Defense - Your Corneocytes

These are your skin cells that live in your Stratum Corneum, remember, that’s the outermost layer of skin cells. Think of these like bricks in a wall or roof tiles. Your corneocytes are mature keratinocytes (what we commonly think of as skin cells, however, they’re only one kind of skin cell albeit the most abundant). Unfortunately, in basic skin anatomy and physiology class at beauty school, our baby aestheticians are told that these cells are dead and that’s what you, in turn, also get told. It’s always about getting rid of the “dead” skin cells - exfoliation, peels, microdermabrasion, HydraFacial, dermaplaning; which I now hear as damage, damage, damage and I want you to as well.

What if I told you that they weren’t dead? What if I told you that they’re the mature cells - the adult cells. What if I told you that they have a very important protective function; that they communicate to the teen cells and they communicate to the baby cells and finally to the mother cells ALL about the environment?? It sounds a wee bit like what Dr Kligman observed all those years ago, doesn’t it?

Well, it’s heartbreakingly true. Your corneocytes provide your skin with its second line of defense and we’re all on a mission to remove them before they're ready to shed - a constant mission to seek the elusive “GLOW” at the absolute detriment to your skin’s barrier function.

This constant exfoliation is the reason that we feel like we need to exfoliate - it’s a self-perpetuating cycle. When your “adult” cells are removed, the “teen” cells get put in charge of communicating about the environment, which they are not ready to do and can’t do correctly, they’re also still soft and not tough enough to protect the rest of your skin. More importantly, they don’t know how to communicate adequately - You’re basically leaving the teens in charge, and they’re just not ready for this level of responsibility! Sorry teens!

This, therefore, interrupts the part of the skin cell’s journey where the keratinocyte becomes a corneocyte so you’re left with improperly formed corneocytes, with poorly formed hardcovers (cornification of the cell envelope) that don’t compact properly, meaning that they’re not smooth and locked in together neatly with solid mortar (multilamellar lipids) but are rough and gappy and full of leaks. Just like a damaged roof. So your skin, in turn, slows its natural shedding, trying to hold on to as many cells as possible to protect itself with these poorly formed, sad old cells. Making your skin look dull, dry and flakey. Which the clever beauty marketers and poorly informed aestheticians tell you need to be exfoliated, buffed, and scraped away to reveal that bloody “glow”. And the cycle continues. Ugh! 

Bottom Line: The only dead skin cell is the one that has detached naturally. When your second line of defense is compromised, skin looks dull, dry, flakey and needs a good dose of TLC, the Corneotherapy method - not exfoliation.

The Third Line of Defence - Multilamellar Lipids (the fatty mortar between the bricks)

Before your keratinocytes become corneocytes the cell membrane needs to change from a soft, permeable outer layer to a hardened layer, then create a lipid (fat) layer to fill in the gaps between the cells and, finally, to form your skin’s Natural Moisturizing Factor (NMF - components of this are hydrophilic - they absorb water from the atmosphere. It helps keep water in the layers of the skin and why extended contact with water will dry your skin out). 

Basically, the membranes of your cells harden and, in very simplified terms, the juices from inside migrate to the outside to form a protective layer of lipids and hydration (a lipid bilayer if you will), filling the gaps, and allowing the newly formed corneocytes to form an even, tightly packed, smoothe outer layer to protect you from UV damage, water loss & damage. Much of this process needs various vitamins and minerals to correctly form each of these lines of defense and, without all three, your barrier is compromised and a cascade of issues will continue triggering your innate immune system and causing cellular inflammation.

Bottom Line: Poorly formed multilamellar lipids mean a leaky and permeable barrier which causes cellular inflammation. 

There’s a lot going on in this process so I have tried to simplify it as much as possible but these are all of the things that I am thinking about and considering when I treat your skin. ALL of these processes need to be considered when repairing a barrier disrupted skin and it’s not always a fast process. Every skin is different and so the approach is always unique to you and your skin.

My skin analysis and consultation, The Skinquisition allows me to find out as much as I can about you and your skin. I get to measure your surface hydration and lipids as well as how red your skin is (often an indication of inflammation) as well as the pigment in various areas. It’s how I put together a game plan for you, not just for treatments but also for your homecare and I may even give you some tips on diet, movement, gut health, sleep, and stress. Yes, I’m nosey but it’s for a very good reason - your skin health!

Next week we’re going to dive into the other principles of Corneotherapy because I think this was quite long enough!