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Atopic Eczema: Skin Barrier Strengthening and pH
Blog January 19, 2025

Atopic Eczema: Skin Barrier Strengthening and pH

Dr. Yeonseung Choe
Dr. Yeonseung Choe
Chief Director

Skin is not just a dead layer. In the previous post, I discussed skin barrier function and pH conditioning. In this post, we will delve deeper into the role of pH in the skin barrier.

Since various enzymes have different optimal pH levels for proper function, it can be understood that pH can partially act as an on/off switch for various functions.
Source: Fluhr, J. W., & Darlenski, R. (2018). Skin Surface pH in Newborns: Origin and Consequences. Current Problems in Dermatology, 26–32. doi:10.1159/000489515

The epidermis exhibits a biphasic pH gradient structure. These pH changes partially explain the functional differentiation within each layer.

Skin pH precisely regulates various functions. Next, it would be meaningful to examine what supports this pH. You can find relevant information by searching for "skin acidification."

Factors Contributing to Skin Acidity

Factors that contribute to skin acidity are broadly categorized into endogenous and exogenous factors.

  • Exogenous Factors: sebum-derived free fatty acids (FFAs), bacterial metabolites, eccrine gland-derived lactic acid
  • Endogenous Factors: sPLA2, NHE-1, histidine-derived components
The process of FFAs being supplied from phospholipids also seems to be one of the important topics discussed in relation to pH.
Source: Generation of Free Fatty Acids from Phospholipids Regulates Stratum Corneum Acidi®cation and Integrity

In summary, skin acidity is very precisely regulated, and the factors supplying skin acidity can be understood as multifactorial.

Source: Fluhr, J. W., Darlenski, R., Lachmann, N., Baudouin, C., Msika, P., De Belilovsky, C., & Hachem, J.-P. (2012). Infant epidermal skin physiology: adaptation after birth. British Journal of Dermatology, 166(3), 483–490. doi:10.1111/j.1365-2133.2011.10659.x

Since the process of skin pH acidification is highly multifactorial, it would be difficult to condition this intricate process by applying acids externally. The reason why mildly acidic cleansers are considered important is that conventional alkaline soaps or cleansers act as factors that disrupt the already precisely adjusted pH gradient.

We will discuss skin pH in more detail later if necessary, and conclude here for now.

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Dr. Yeonseung Choe

Dr. Yeonseung Choe Chief Director

I have met many patients who came after visiting multiple medical institutions and departments for persistent or recurrent conditions. Symptoms normally handled by different specialties—such as abdominal pain, headaches, palpitations, dizziness, and insomnia—may overlap in one person. Sometimes there is no clear improvement despite taking medication for each symptom, and being unwell gradually becomes part of daily life. In these cases, I look beyond individual diagnoses and examine how the symptoms connect and change together. Asking only about the most uncomfortable symptom today does not reveal the full course. I look at when the body first began to change and what happened after illness, surgery, childbirth, or starting and stopping medication. I also review changes in weight, diet, and sleep, then trace which symptoms improved with previous treatment and which remained. Test results, diagnoses, and the course of previous treatment are important for understanding the current condition. Clinical research in modern Korean medicine, physiological and pathological research in modern medicine, and observations recorded in classical Korean medicine texts offer different perspectives on the same body. Rather than fitting a patient into one perspective, I consider what each can and cannot explain and look for clues that connect symptoms and treatment histories that were previously considered separately.

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