Doctor's Forum > a) Why Comprehensive Treatment Today? + b) Tear Gland Physiology
c) pH and Gland Dysfunction + d) Optimizing Periocular Skin + e) Lid Hygiene. A Summary
f) Why Igiene Cleanser & Conditioner?+ g) Igiene C2 vs Baby Shampoo + h) Directions and Compliance

Keys: Corneum Stratum, epidermal water barrier, kinetics, lipid content

The reason for the importance of optimizing. The ability of desiccating bacteria to penetrate skin is directly related to the condition of the Stratum Corneum, rather than the type, or indeed even the amount of bacteria. ( See also The importance of lid cleansing). Optimizing the periocular dermis is paramount in maintaining an optimum environment for the lipid producing glands.

The Stratum Corneum. It is important to note that the epithelium of the cornea is quite different that that of the periocular skin, which is composed of vertically stacked polytherdral corneocytes surrounded by lipid-enriched membranes. This corneocyte originates as a ‘plumb’ cell in the basal layer (the immortal cell, located between the dermis and the epidermis) and as is moves upwards it flattens, loses its moisture, changes function and ultimately helps form the skin barrier. Finally, hardened and dried, it helps the body dispose of toxins as part of the stratum Corneum.

A healthy Stratum Corneum responds to outside insults with a rapid epidermal metabolic reaction including an acceleration of formation, secretion of lamellar bodies and an increase in lipid synthesis.

Kinetics. In ‘regular’ skin the process whereby all the Corneum stratum cells are fully replaced takes place in approximately 2 weeks. In peri ocular skin however this process of removing the waste and toxins accumulated ultimately in the outer cells takes place every 5-7 days. (Clearly an accumulation of this type of debris should be removed daily, see also The importance of lid cleansing). Thus a much more immature skin fulfills the critical function of protection increasing the urgency, but also the need to treat this mantle with the utmost caution.

Evaporative water loss. Ironically, the primary function of the Corneum Stratum is to retard evaporative water loss from inside the body, the aqueous deeper layers of the epidermis and dermis. Only through an optimization of the primary function can the Stratum Corneum facilitate its other function of defending the body against ingress by microorganisms and foreign contaminants and being the firs line of defense against ultra violet light

Water barrier: While the mechanism is not fully understood, a soft, supple skin needs a constant amount of water in the outer layer. To illustrate, envision a dry leaf in the autumn. Bending it will result in cracking its proteins. The health of the undulating water barrier that lies just below the outside of the Corneum stratum is critical. To optimize this conditioning the skin will aid in any dry, stressful environment. (It should be noted that it is not possible to ‘moisturize from the outside in’ as many brands would like you to believe. Does one become a bloated sponge while swimming? Of course not!). Conditioning the Corneum stratum to prevent interior water loss is the only true method.

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