By Dr Naomi Mackle, Dermatology Specialist and Medical Director, Adare Dermatology Clinics
If your skin stings when you apply moisturiser, feels tight within an hour of washing, or flares with every change in the weather, there is a good chance your skin barrier is struggling. Walk down any skincare aisle and one ingredient promises to fix it: ceramides. They appear on everything from budget moisturisers to luxury serums, usually with bold claims about “rebuilding” the skin.
So what are ceramides, and do they actually repair the barrier? The honest answer is more nuanced than the marketing suggests. Ceramides are essential to healthy skin, and there is genuine science behind them. But applying them from a jar is only one way to restore barrier function, and it is not always the most effective one.
In this article, I explain what ceramides are, what the research really shows, who benefits most, and why REFORM Skincare has deliberately chosen a different route to barrier repair.
What are ceramides?
The outermost layer of your skin, the stratum corneum, is often described as a brick wall. The “bricks” are flattened skin cells called corneocytes. The “mortar” holding them together is a highly organised mix of lipids, and ceramides make up roughly half of it by weight, alongside cholesterol and free fatty acids.
This lipid mortar has two jobs. It stops water escaping from the skin (known as transepidermal water loss, or TEWL), and it keeps irritants, allergens and microbes out. When ceramide levels fall or the lipid balance is disturbed, gaps appear in the wall. Water leaks out, irritants get in, and the skin becomes dry, rough, reactive and inflamed.
Your skin makes its own ceramides in the living layers of the epidermis, and there are many different subclasses. Production naturally slows with age and is further disrupted by harsh cleansers, over-exfoliation, low humidity, sun exposure and inflammatory skin disease.
The ceramides in skincare are usually synthetic, “skin-identical” versions designed to mimic those found naturally in the skin. On an ingredient list you will see names such as ceramide NP, ceramide AP or ceramide EOP.
What the evidence actually shows
The link between ceramides and barrier health is well established. Research dating back to the early 1990s showed that people with atopic eczema have reduced ceramide levels in their skin, even in areas that look normal, and that this is associated with increased water loss and greater sensitivity to irritants.
Where the picture becomes more complicated is in what happens when ceramides are applied to the skin. Three points are worth knowing.
The lipid ratio matters. Laboratory studies on barrier recovery found that applying a single barrier lipid on its own can actually slow repair. Recovery was best when ceramides, cholesterol and free fatty acids were applied together in a physiological ratio. Many products list ceramides without the supporting lipids in meaningful amounts.
Concentration is often unclear. Ceramides are costly raw materials, and manufacturers are not required to disclose percentages. A ceramide appearing near the end of an ingredient list may be present at a very low level.
Clinical benefits are real but modest. Well-formulated, ceramide-dominant emollients have been shown to improve dryness, itch and water loss in eczema, and one small trial in children with moderate eczema found a prescription ceramide emulsion performed comparably to a mid-potency topical steroid cream. However, there is limited evidence that ceramide creams outperform other well-formulated barrier moisturisers in head-to-head comparisons.
The bottom line: ceramides are a legitimate, well-tolerated barrier ingredient, but they are one tool among several, and the overall formulation matters as much as any single ingredient.
Who ceramides suit, and who should be cautious
Ceramides are among the gentlest ingredients in skincare and suit most skin types. They are particularly helpful for:
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dry, dehydrated or mature skin;
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sensitive and eczema-prone skin;
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skin irritated by retinoids, exfoliating acids or acne treatments;
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skin that has been over-exfoliated or over-cleansed.
Genuine cautions are few, but worth noting. Rich ceramide creams can feel heavy on oily or acne-prone skin, and some are formulated in occlusive bases that may not suit breakout-prone complexions. Reactions to ceramides themselves are rare, but fragrance, preservatives and plant extracts in the same product can still irritate sensitive skin, so always read the full ingredient list.
Most importantly, if your barrier problems are driven by eczema, psoriasis, rosacea or inflammatory acne, no moisturiser, ceramide or otherwise, should replace a proper medical assessment. Persistent redness, cracking, scaling or itch deserves a diagnosis.
Why REFORM doesn’t use ceramides
You won’t find ceramides in any REFORM product, and that is a deliberate choice rather than an oversight. Instead of supplying barrier lipids from the outside, our approach focuses on hydrating, calming inflammation and supporting the skin to repair itself, using ingredients with strong evidence in the conditions we treat every day at Adare Dermatology Clinics.
Two of those ingredients work closely with the skin’s own ceramide system. Niacinamide has been shown in research to increase the skin’s natural ceramide production and reduce water loss. Urea, at the right concentration, draws water into the skin, softens scale and has been shown to support the activity of genes involved in building a healthy barrier. In other words, rather than patching the wall, these ingredients help the skin lay its own bricks and mortar.
For patients with inflammatory skin disease, we also believe calming the inflammation is just as important as replacing lipids. A barrier cannot recover while the skin beneath it is inflamed.
REFORM products that restore the skin barrier
REFORM Vitamin B5 Gel
Panthenol (pro-vitamin B5) is a humectant that the skin converts into pantothenic acid. It helps attract and hold moisture, supports barrier recovery and soothes irritation, making it an excellent lightweight first step for stressed, reactive or post-procedure skin.
REFORM Phytobotanical Gel
This gel combines thyme extract with alpha arbutin and kojic acid. Thyme extract is very soothing for inflamed skin, making the gel well suited to rosacea, very inflamed acne, eczema and psoriasis, while alpha arbutin and kojic acid help address the uneven tone that inflammation often leaves behind.
REFORM Intensive Moisturiser
We pair our gels with the Intensive Moisturiser, which combines hyaluronic acid for deep hydration with niacinamide to calm redness and support the skin’s own ceramide production. Together, they form a simple, effective daily barrier routine.
REFORM Skin Barrier Repair Cream
For more severely compromised skin, our Skin Barrier Repair Cream contains a high 10% concentration of urea with lactic acid. It is designed for patients with eczema and psoriasis, where dryness, scaling and thickened skin make treatment harder.
At ADC, we routinely recommend applying it before topical steroids or calcineurin inhibitors such as Protopic (tacrolimus) or Elidel (pimecrolimus), because restoring the barrier helps these treatments penetrate more effectively. In some patients, repairing the barrier alone brings a noticeable improvement in the inflammatory condition itself.
Because urea and lactic acid can sting on cracked or broken skin, we advise applying it to intact areas first and seeking advice if your skin is very raw.
The takeaway
Ceramides are a genuinely useful ingredient, and a good ceramide cream can help many people. But barrier repair is not about a single hero ingredient. It is about hydration, calming inflammation and helping the skin rebuild itself, which is exactly how the REFORM barrier range has been designed.
If your skin is persistently dry, reactive or inflamed, book a consultation at Adare Dermatology Clinics in Dublin, Limerick or London for a personalised assessment and barrier plan.
