Skin - preventing wrinkles, itchy skin Update 
By Walter Sorochan Emeritus Professor San Diego State University

Posted September 30, 2014; Updated November 27, 2021.  Disclaimer The information presented here is for informative and educational purposes only and is not intended as curative or prescriptive advice.

Skin is the largest organ in the body and covers body tissues. Wiki: Skin  It  plays a key role in protecting the body against pathogens, excessive water loss, excretes toxic wastes, has about 500,000 sweat glands and can produce more than a pint of sweat a day, regulates temperature, acts as an insulator, is sensitive to heat and cold, touch, pressure and vibration, absorbs oxygen and nitrogen, stores fat and water and produces fat-soluble vitamin D. Since the skin contains a lot of fat, it thereby also absorbs and stores many substances and dangerous chemicals that are also fat soluble. It acts as a monitoring system to protect you from harm.  Wiki: Skin

Although there is much that we know about the skin, there is also a lot that we do not know.  This disparity of knowledge about the skin …. how it works, the interpretation of the symptoms and causes, what it is made of and treatment modalities …. all contribute to much disagreement and controversy among the medical experts and general public about human skin. 

This article summarizes what is known about the skin and how we may maintain skin health.  New research discoveries shed a light on the three key ingredients of skin health.

 Update on itchy skin: At one time or another, we all have itchy skin. But some of us have itchy skin that can be painful, last a long time and often it occurs as we get older.  Itchy skin can cause pain, inflammation and make you feel sick.  How do you get rid of it?  Well you don't, for it is your body telling you that something is wrong with your body. 

Usually it is difficult to sooth the skin and stop itchiness.  But here is one way to minimize it and prevent it most of the time, without taking medication: 

This author tries to use the body's natural ways of getting rid of the toxins. Itchiness is the body's way of telling you that there is something wrong with your body. If the body does not get rid of toxins, oxidants or free radicals and other chemical poisons, then these can pile up in lymph nodes in joints and cause irritation, pain, and inflammation.  This is a natural body reaction to poisons in the body.  You can relieve itchy skin by getting rid of the build-up of toxins.  All you have to do is exercise like jumping up and down or skip rope, or use the body's own detoxification system. Yes, you can walk or run, but this is a very slow way to detoxify. 

The concept of natural detox is to use the muscles surrounding the lymphatic vessels to contract, squeeze the lymph fluid and toxins out of the lymph vessels into the red blood cells circulatory system and then eliminate these poisonous toxins as urine.  Although the red blood circulating system has a heart to pump the blood around, the lymphatic system does not have a pump.  So the body uses muscles surrounding the lymph vessels to do the pumping. But you need to contract the muscles to activate the natural pump. 

A simple exercise that you can do standing, sitting or lying down is to use isometric muscle contraction.  Without moving the body, tense up the muscles in the feet, ankles, thighs and hip area for about 2 to 3 seconds and then relax. Repeat about three times and rest.  Then do the same for the upper body muscles, tensing or contracting the fingers, arms, and upper body muscles for 2 to 3 seconds and relax.  Repeat morning, noon and evening each day or as often as needed.  After doing this isometric exercise, you will still feel itchiness for about 15 to twenty minutes and then all of a sudden, the itchiness dwindles away.  It will be gone for about 3 hours before you begin to feel some itchiness again.  When the itchiness begins again, then it is time to do this non-movement exercise again. And you take no pain killers as a prescription!  This is how mother nature made your body to heal and work. 

Eventually, relieving itchiness this way will minimize the severity of itchy skin in disabled or older persons who cannot do physical activity.  Doctors in hospitals use vibrating machines with patients who are in bed for long periods of time.  The vibration contracts the muscles to move toxic poison buildup in the body. 

There is general agreement about the following:

1. Skin is a barometer of the health of the rest of the body. When the skin functions properly it has aesthetically pleasing properties, giving skin a healthful appearance and feel and the body is healthy. On the other hand, a less attractive skin reflects unhealthy biological conditions.

2. Skin ages and loses its elasticity and ability to regenerate.

3. Skin has the ability to heal itself and is virtually indestructible.

4. Skin has multiple functions.

5. Skin is an major detoxifier.

6. Skin damage can include: laxity, discoloration, wrinkling, thickening, changes in skin texture, abnormal skin growths, and impaired wound healing are also possible. 

7. Most commercial skin supplementations and creams and lotions do not work.

8. Skin aging is a normal process and is difficult to distinguish chronological age from other effects.

9. Cumulative effects of decades of skin wear cannot be reversed, although the effects on skin appearance may be temporarily masked.

10. Skin damage usually causes inflammation, discomfort and pain.   Oregon State University: skin damage

11. Skin health is linked to large colon health.   Probiotics and a balanced diet may be important to balance the microbes in the large gut.

12. Skin can synthesize up to 10,000IU of vitamin D in half an hour or less of sun exposure on about 40 % of body. Skin prevents the disease rickets.

Symptoms of unhealthy skin and body: Dry skin, itchy skin, rashes, inflammation and pain are symptoms.  Interpreting the symptoms and how to relieve the symptoms is where there is disagreement and controversy. 

Abnormalities that appear on the skin are usually a sign of metabolic and other glandular disorders in the body. Article by Yilmaz: skin mirroors health is no longer active. 

The architecture of the skin can help us understand our skin.  The skin is composed of several different functioning and interdependent layers. 

skin big

Illustration above shows the skin layers where the three most important ingredients for skin health are located:

Epidermis: This is the outer most skin layer and is about the thickness of a page.   There are nine different ceramides or fatty lipoids [ green color in illustration ] located mostly in the very top epidermis layer known as stratum corneum. The stratum corneum (SC) acts as a protective barrier, keeping moisture in and irritants and infection out. However, the SC is often compromised, allowing the skin to become very dry and itchy. Ceramides help protect collagen.  Collagen, yellow in the illustration, makes up 70 % of our skin and is found in stratum corneum and the dermis. It is the glue that holds tissues and cells together and acts as a skin filler, preventing wrinkles.  Hyaluronic acid [HA], blue in the illustration, is found in the epidermis and dermis and every cell in the body; although 50 % of all HA in the body is found in the skin.  HA absorbs water, preserves moisture in the skin and helps in healing the body. It also works with collagen and acts as a filler and cushions the skin. 

Dermis is about ten times thicker than the epidermis and contains the blood vessels that feed the skin, nerves, sebaceous glands, and hair follicles.

Hypodermis: The final 'fatty tissue' layer in the diagram, also referred to as the subcutaneous layer, contains sweat glands, some hair follicles, blood vessels and fat tissue. The hypodermis is used mainly for fat storage.

Maintaining healthy skin:  There are three ways to keep your skin healthy:

1.  by eating a whole food complex diet that provides the natural essential nutrients from within the body.

2. by covering the skin with a lotion/cream that has the ability to transport ceramides, hyaluronic acid and collagen to the skin without plugging up skin pores.  Most skin cream/lotions cannot do this. 

3. by taking nutritional supplements.  Eating a good diet may be difficult to do today and one may need to supplement with nutritional supplements. 

Which nutrients are essential for good skin health?  The best way to answer this question is to unravel the biochemistry of how ceramides, hyaluronic acid and collagen are synthesized by the body:

Ceramides:  are synthesized by the body from fatty lipid compounds, phosporus and amino acids [proteins]; help maintain the water retention in the stratum corneum and help regulate apoptasis or programmed cell death.  Failure to properly regulate apoptosis can have catastrophic consequences, Rivas: ceramides cause muscle loss 2012  and can result in many disease states including cancer, diabetes, neuropathies, Alzheimer's disease, Parkinson's disease, and atherosclerosis.  AOCS: Ceramides   Ceramides are naturally-occurring in many foods. Sphingoiipids, which contain Ceramides, are found in large amounts in dairy products, eggs and soybeans. Ceramides are also found in rice, millet, and spinach. Walker: plant derived ceramides

Collagen: is synthesized by the body from vitamin C, silica and elastin. Skin deteriorates when collagen breaks down.  Silica is essential for maintaining the health of connective tissues due to its interaction with hyaluronic acid.  Collagen makes up more than 70 percent of our skin.  Ceramides help protect collagen.

Hyaluronic acid: Hyaluronic Acid is synthesized by the body from iron, zinc, magnesium, calcium, selenium, protein amino acids and vitamins A and C.  Vitamin D, iodine, chlorophyll, and silica should not be discounted! Sorochan: Hyaluronic acid 2014  The HA molecule acts like a cellular sponge.  Article by Manasa: Review HA is no longer active.    Brown: HA skin absortion 1999   Collagen gives the skin its firmness but it is HA that nourishes and hydrates the collagen. HA acts as a space-filler in dermal layers between skin cells on a long term basis; enhancing soft, smooth and elastic skin.  Sorochan: Hyaluronic acid 2014

Hyaluronic Acid [HA] has dual functions: excess amount causes inflammation when repairing injury while lesser amounts suppress inflammation after healing.  There is no direct research to support claims that food contains hyaluronic acid; except for trace amounts in meat.  Hyaluronic Acid (HA) is not in the diet in any appreciable amounts. Article by Manasa: Review HA is no longer active.   However, there is a link between HA, magnesium, zinc, vitamins A and C and diseases and health.  Sorochan: Hyaluronic acid 2014  Liguori Double-blind study HA 1997

Nutrients for healthy skin:  Most of the skin health comes from nutrients: Minerals magnesium, copper, selenium, zinc, iron and phosphorus; silica; Vitamins A, B5, C, E, D, K2, niacin; Amino Acids methionine, cysteine, praline and glycine; Arachidonic acid [fat], Linoleic acid (LA), essential fatty acids (EFA); and essential factors that cannot be synthesized by humans that include omega-6 fatty acid, alpha-linolenic acid (ALA), and omega-3 fatty acid. Fallon Weston Price: skin nutrition 2010  Morell: Nutrition for skin 2010  Vesper: ceramides in food 2002  Kresser: skin nutrition  Michaels: nutrition & skin health 2011  Ongoing research has linked bacteria in the large intestine or colon with skin health and disorders. Such bacteria are often referred to as probiotics. 

Probiotics: The inner lying of the large intestine, or gut, is a special type of skin.  It is lined with a film made up of billions of beneficial bacteria, just as healthy skin is home to a variety of bacteria, most of which are beneficial. Essential bacteria found in the large intestine are also perceived as essential to the health of the skin and the human body as a whole. Article by Bowe: Probiotics & skin health is no longer active. Article by Goldin: Probioitics & disease is no longer active.  Sorochan: Probiotics   

There are billions of good and bad bacteria in the gut. The balance between good [80%] and bad bacteria [20%] is essential for good health.   When this balance is compromised, then we can experience a host of health disorders, including lower immunity, diseases and skin disorders. Sorochan: Probiotics  Probiotics, a food supplement, can restore the bacterial balance and comes in many forms, including foods such as yogurt, capsules, powders, and liquids. Restoring the proper intestinal flora through probiotics can rescue your gut health and, in turn, your skin health.  

All three ingredients [ collagen, HA, ceramides ] work together to make skin healthy. The body works wonders in synthesizing all three of these skin ingredients to work together.  But when one or more of these essential ingredients are missing, then we have skin problems like itchy dry skin, psoriasis, eczema and so on.  Cosmetic companies have been trying, for over a century with very little success, to provide topical lotions and creams to fix these problems. 

Skin disorders: A few disorders are summarized in the article skin disorders.

Accumulation of hyaluronic acid in the intestine is linked to numerous diseases and dysfunction in various organs. Kresser: skin nutrition Bowe: Probiotics & skin health 2014  Sorochan: Probiotics

Excessive exposure to sunlight UVA causes free radicals to form, decreasing the skin's ability to produce HA naturally. This is because free radicals trigger the activity of an enzyme called hyaluronidase.  This enzyme breaks down HA in your skin cells as well as in joints, causing less moisture in the skin and thereby contributing to inflammation, pain and itchy skin. 

Dry skin can be caused by many factors; most often from water lost to the environment, chemical exposures, or from complex nutritional deficiencies.  However, the skin has the ability to heal itself and is virtually indestructible.  Michaels: nutrition & skin health 2011  Most of intrinsic skin aging cannot be avoided. The cumulative effects of decades of skin wear cannot be reversed, although the effects on skin appearance may be temporarily masked.  Michaels: nutrition & skin health 2011

Research:  The majority of the research that has been reported on anti-aging ingredients and skin cosmetics has been done by or been sponsored by major cosmetic companies; with a vested conflict of interest in selling their cosmetic products. US patent 20070077292 A1  Most research studies use the single subject approach, that is, only one factor in isolation.  Article by Bernhard: vitamin truth is no longer active.   Sorochan: supplements update 2013 Although this may be a good approach when studying the nature of a drug in isolation by itself, such an approach ignores how a drug or nutrient can commingle with other natural body factors as co-factors or helping each other function in the human body.  The human body does not work in isolation!  This issue is reflected in how the medical profession prefers to relieve the symptoms and ignore the cause of health problems.  The sick person’s problems persist in spite of relieving symptoms.  This may also be true with skin disorders. Such as dry skin. 

Skin creams and lotions:  Most commercial skin products on the market today do not restore HA or ceramides to the skin.  The lack of restoration has been inability to transport topical applications into the skin itself. But a new microvesicular emulsion technology claims to provide a novel and cosmetically acceptable delivery system, which contributes to epidermal barrier repair. Bikowski: MVE delivery system 2006  Gatto: designing topical skin products

CeraVe skin lotion: Valeant Pharmaceuticals North America Company [ vested interest company ] claims that microvesicular emulsion technology is their skin lotion and that it is a "true breakthrough in skin care." It is a blend of skin nourishing ingredients [ collagen, hyaluronic acid and ceramides ] blended with a patented Multivesicular Emulsion [MVE] delivery technology that delivers the ingredients slowly, throughout the day, into the skin and repairs the top skin layer.   CeraVe Moisturizing Lotion is touted as noncomedogenic [ does not cause pimples or acne by clogging pores ] and is non-irritating and fragrance-free. Although clinical research trials are lacking, the science is good and this product has promise.  Buyer-user should be aware that this cosmetic cream/lotion lacks independent research to validate the company claims! 


AOCS Lipid Library, "CERAMIDES - CHEMISTRY, OCCURRENCE, BIOLOGY and ANALYSIS,"  Article by AOCS: Ceramides is no longer active. [ AOCS = American Oil Chemists' Society ]

Balough Lajos, Andras Polyak, Domokos Mathe, Reka Kiraly, Juliana Thuroczy, Marian Terez, Gyozo Janoki, Yaoting Ting, Luke R. Bucci and Alexander G. Schauss, "Absorption, Uptake and Tissue Affinity of High-Molecular-Weight Hyaluronan after Oral Administration in Rats and Dogs," J. Agric. Food Chem. 2008, 56, 10582–10593.   Balogh: Hi HA oral intake 2008

"This report presents the first evidence for uptake and distribution to connective tissues of orally administered, high-molecular weight HA.  Most HA being ingested by consumers is in a high-molecular-weight form around 1 million daltons (1 MDa). The labeling process for HA that yielded the highest efficiency was as follows: 9 mg of HA in 900 μL of distilled water, 30 μL of 10-3 M calcium glucoheptonate, 1.1 mL of 2.2 GBq 99mTcpertechnetate solution, and 100 μL of 1 mg/mL SnCl2 in 1.0 M HCl, pH 4.0. This mixture was incubated at 50 °C for 90 min with gentle stirring."

Barel André O., Marc Paye and Howard I. Maibach, Handbook of Cosmetic Science and Technology, Third Edition, # 2009 by Informa Healthcare USA, Inc.  Article by Barel: Book cosmetic science is no longer active.   [ Information is good but many chapter authors have vested interests in cosmetic companies ]

Barnes L., et al, "Inhibition of Putative Hyalurosome Platform in Keratinocytes as a Mechanism for Corticosteroid-Induced Epidermal Atrophy," J Invest Dermatol. December 6, 2012, doi: 10.1038/jid.2012.439.  Article by Barnes: HA Affect skin is no longer active.   "The molecular size of HA fragments of intermediary size (HAFi) appeared essential for its biological activity in the epidermis. According to our in vivo and in vitro mouse models, the suitable size for such a biological activity in epidermis ranges between 50 and 400 kDa."

Bernhard Mark, "The WHOLE Truth About Vitamins," 2012.   Article by Bernhard: vitamin truth is no longer active.

Berra, B. et al., "Dietary SphinPolipids in Colorectal Cancer Prevention," Eur. J. of Cancer Prev., April, 2002 Vol. 11, pp. 193- 197.  Berra: ceramides prevent cancer 2002 

Bikman Benjamin T. and Scott A. Summers, "Ceramides as modulators of cellular and whole-body metabolism," J Clin Invest. 2011;121(11):4222–4230.  Bikman: ceramides modulate 2011 [ Ceramides regulate many metabolic processes in the body and dysfunction may cause diseases like obesity and diabetes ]

Bikowski J., Shroot B., "Multivesicular emulsion: a novel, controlled-release delivery system for topical dermatological agents," J Drugs Dermatol. ov-Dec, 2006 N;5(10):942-6.   Bikowski: MVE delivery system 2006  ["Multivesicular emulsion {MVE] systems are a new patented technology for topical delivery of pharmaceutical and over-the-counter actives."]

Bowe Whitney P., "Could probiotics be the next big thing in acne and rosacea treatments?" AMERICAN ACADEMY OF DERMATOLOGY, Feb. 3, 2014.  Article by Bowe: Probiotics & skin health is no longer active.

Brind'Amour Katherine, "Get the Skinny on Skin Disorders," HealthLine, August 20, 2012.  Brind'Amour: images of fungi 2012

Brown Tracey J., Daine Alcorn and J Robert E Fraser, "Absorption of Hyaluronan Applied to the Surface of Intact Skin," Journal of Investigative Dermatology, 1999, 113, 740–746; doi:10.1046/j.1523-1747.1999.00745.   Article by Brown: HA skin absortion is no longer active.   [ Hyaluronan is absorbed from the surface of the skin and passes rapidly through epidermis. Hyaluronan absorption demonstrated by the recovery of polymers of molecular size 360–400 kDa from both blood and skin. "This study establishes that hyaluronan is absorbed from the surface of the skin and passes rapidly through epidermis, which may allow associated drugs to be carried in relatively high concentration at least as far as the deeper layers of the dermis." ]

Compositions and methods for improved skin care, published April 5, 2007; US patent 20070077292 A1 files by Mark Pinsky in 2005 & 2006: CTFA [Cosmetic Ingredient Handbook 1992]   describes a wide variety of nonlimiting cosmetic and pharmaceutical ingredients commonly used in the skin care industry: 

"Examples of  ingredient classes include: abrasives, absorbents, aesthetic components such as fragrances, pigments, colorings/colorants, essential oils, skin sensates, astringents, etc. (e.g., clove oil, menthol, camphor, eucalyptus oil, eugenol, menthyl lactate, witch hazel distillate), anti-acne agents, anti-caking agents, antifoaming agents, antimicrobial agents (e.g., iodopropyl butylcarbamate), antioxidants, binders, biological additives, buffering agents, bulking agents, chelating agents, chemical additives, colorants, cosmetic astringents, cosmetic biocides, denaturants, drug astringents, external analgesics, film formers or materials, e.g., polymers, for aiding the film-forming properties and substantivity of the composition (e.g., copolymer of eicosene and vinyl pyrrolidone), opacifying agents, pH adjusters, propellants, reducing agents, sequestrants, skin bleaching and lightening agents (e.g., hydroquinone, kojic acid, ascorbic acid, magnesium ascorbyl phosphate, ascorbyl glucosamine), skin-conditioning agents (e.g., humectants, including miscellaneous and occlusive), skin soothing and/or healing agents (e.g., panthenol and derivatives (e.g., ethyl panthenol), aloe vera, pantothenic acid and its derivatives, allantoin, bisabolol, and dipotassium glycyrrhizinate), skin treating agents, thickeners, and vitamins and derivatives thereof. "

Fallon orell Sally, “Skin deep - Nutrition for the skin,” The Weston A. Price Foundation,  September 24, 2010.   Fallon Weston Price: skin nutrition 2010

Gatto H. & C.A. Rème, "Designing a new range of topical products: the Allermylo story," VIRBAC Laboratories, Medical Department, Carros, France. Gatto: designing topical skin products   [ Original studies conducted on dogs diagnosed with confirmed atopic dermatitis, successful therapy that helped create new understanding of skin functions in humans and creating new therapy products. ]

Goldin B. R. and S. L. Gorbach, "Clinical Indications for Probiotics: An Overview," Clin Infect Disease, 2008, 46 (Supplement 2): S96-S100..   Article by Goldin: Probioitics & disease is no longer active.

Kresser Chris, "Nutrition for Healthy Skin: Silica, Niacin, Vitamin K2, and Probiotics," Chris Kresser Let's take back your health, [ practicing integrated medicine ]   Kresser: skin nutrition

Liguori V., and others, "Double-blind, randomized clinical study comparing hyaluronic acid cream to placebo in patients treated with radio-therapy, Radiother Oncol, 1997, 42(2) 155-161. Liguori Double-blind study HA 1997 ["CONCLUSION: The prophylactic use of a cream with hyaluronic acid is shown to reduce the incidence of high grade radio-epithelitis, suggesting an interesting role of the hyaluronic acid cream as supportive treatment to improve compliance and quality of life in patients undergoing radiation therapy."]

Manasa M, Sridevi V., Chandana Lakshmi M.V.V, and Dedeepya J., “ A Review on Hyaluronic Acid,” Int. J. Res. Chem. Environ. Vol.2 Issue 4 Oct. 2012(6-11).   Article by Manasa: Review HA is no longer active.   This paper reviews on properties, production, routes of injection, sources and applications of hyaluronic acid. When applied to the skin HA can penetrate the skin surface and replenish the natural levels already present. Like hyaluronic acid produced in the body, hyaluronic acid used in this form moisturizes from the dermis to the epidermis from deeper layers of the skin to the outer layer.

Morell Fallon Sally, “Skin deep - Nutrition for the skin,” The Weston A. Price Foundation,  September 24, 2010. Morell: Nutrition for skin 2010

Michels Alexander J., “Micronutrients and Skin Health,” Linus Pauling Institute, Oregon State University September 2011.    Michaels: nutrition & skin health 2011

Papakonstantinou Eleni, Michael Roth, and George Karakiulakis, "Hyaluronic acid: A key molecule in skin aging," Dermatoendocrinol. July 1, 2012; 4(3): 253–258.  Papakonstantinou: HA skin aging 2013  [ This review presents in brief recent knowledge in HA biology and function and focuses on its involvement in skin aging. "The size of HA appears to be of critical importance for its various functions. HA of high molecular size, usually in excess of 1,000 kDa, is present in intact tissues and is antiangiogenic and immunosuppressive, whereas smaller polymers of HA are distress signals and potent inducers of inflammation and angiogenesis." ]

Rivas D. A., E. P. Morris, P. H. Haran, E. P. Pasha, M. d. S. Morais, G. G. Dolnikowski, E. M. Phillips, R. A. Fielding, "Increased ceramide content and NF B signaling may contribute to the attenuation of anabolic signaling after resistance exercise in aged males," Journal of Applied Physiology, 2012; DOI:  Rivas: ceramides cause muscle loss 2012 [ a build-up of a fat molecule known as ceramide might play a leading role in muscle deterioration in older adults. Tufts University School of Medicine ]

Saranraj P. and M.A. Naidu, "Hyaluronic Acid Production and its Applications - A Review," International Journal of Pharmaceutical & Biological Archives, 2013; 4(5): 853 - 859.   Article by Saranraj: HA review is no longer active.   {"There is also a lot of interest in using hyaluronic acid to prevent the effects of aging. In fact, hyaluronic acid has been promoted as a "fountain of youth." However, there is no evidence to support the claim that taking it by mouth or applying it to the skin can prevent changes associated with aging."]

Sorochan Walter, " Hyaluronic acid - Another Magic Health Bullet,", September 18, 2014.  Sorochan: Hyaluronic acid 2014

Sorochan Walter, "Probiotics,",  Sorochan: Probiotics

Sorochan Walter, "Vitamin-mineral supplement update,", October 01, 2013.  Sorochan: supplements update 2013

Vesper, H. et al. "Sphingolipids in Food and the Emerging Importance of Sphingolipids to Nutrition," J. of Nutrition, 2002, Vol. 129: pp. 1239-1250, 1999   Vesper: ceramides in food 2002

Walker Susan, "Phyto-dervived ceramides," Soft Gel Technologies, Inc., March 26, 2004. [submitted by Ronald G. Udell, President]  Walker: plant derived ceramides   [a vested interest article]

Yilmaz Irfan, "It's me Peter, your Skin!" The Fountain, November - December 2009 Issue 72   Article by Yilmaz: skin mirroors health is no longer active.