When Skin Isn’t Responding, Look Here First!

You can’t out-treat a compromised barrier. You can apply every active, run every setting, and layer like a textbook but if the skin’s first lines of defence aren’t functioning properly, the results will always fall short, or worse, trigger a response the skin wasn’t ready for.

Lia Trebilcock, Director of Skin Education International, has spent years teaching skin therapists why barrier repair isn’t a step to rush through on the way to advanced results. It’s the foundation everything else is built on because when a client’s barrier is already compromised, whether by lifestyle, products, or too many treatments too soon, the skin doesn’t have the resilience to meet your efforts halfway.

As Lia puts it, “you’re essentially asking it to run a marathon on a broken foot.”

Barrier Dysfunction Isn’t Always Obvious

We tend to think of barrier dysfunction as red, flaky, reactive skin, and yes, sometimes it is that obvious, but often, it starts quietly, and by the time it shows up in a more visibly severe way, the dominoes have been falling for a while.

Lia frequently uses the domino analogy in her training.

“The skin’s barrier defence systems, the microbiome, acid mantle and stratum corneum, are the first domino. If they stay standing, everything else does too but when the first domino tips, the rest start to fall.”

She maps it out like this: early barrier disruption might manifest as dryness, flaking, dullness, or breakouts. Leave it unaddressed, and it could progress to acne, rosacea, eczema or melasma. It’s not about fear-mongering. It’s about pattern recognition.

“We have to see barrier repair as preventative,” she says. “It’s the work that keeps skin resilient so it can handle the fun stuff later.”

Really Breaking The Barrier

So, what knocks that first domino?

Over-exfoliation, poor product choices, and aggressive treatments are common culprits, but Lia shares that it’s also the everyday habits clients would never connect to their skin.

“Clients might be using a beautiful cleanser, then removing it with micellar water or wipes. That undoes the benefits,” Lia explains. “Even things like antibacterial sprays, fragranced fabric softener, or heavy home cleaning chemicals can cause disruption without anyone realising.”

Internally, essential fatty acid deficiency is one of the most underacknowledged contributors. Without adequate EFAs, the skin struggles to retain hydration, maintain lipid integrity, or repair itself after trauma, and this becomes critical when high-level treatments are introduced.

Results Start With Repair

Lia is clear on this: advanced modalities require a functioning skin. Not a skin “coping well enough,” but one that’s genuinely ready.

“If the barrier’s not stable, the client is on the back foot before they even walk into the room,” she says. “Needling, peels — these all rely on the skin’s ability to heal well. If that function is compromised, you’re not going to get the results you’re hoping for.”

She doesn’t say this to scare therapists. It’s an invitation to slow down and reframe how we measure readiness.

“It’s like surgery,” she explains. “You wouldn’t operate on someone whose body isn’t strong enough to recover. The same principle applies here.”

Skipping this prep work isn’t just a risk to outcomes, it’s a risk to trust. “Clients today are looking for integrity. They respect when you educate them, prepare their skin, and take the long view. They’re not here for quick fixes that cause long-term issues.”

The Sultana Vs Grape Analogy Every Therapist Needs

Still, we all know that some clients want results yesterday. They’ve booked in, paid the deposit, and don’t understand why you’re talking about home care instead of jumping straight into the action.

This is where Lia brings out one of her most-loved teaching analogies.

“In skin needling training, we talk about how new cells are formed during the healing process. If your client’s stem cells have genetic damage, those new cells will carry that same damage. If they’re dehydrated or lacking EFAs, those cells won’t hold water or form healthy membranes.”

Then comes the visual.

“I tell them: imagine your new cells are brain-damaged sultanas. If we don’t prep, that’s what you’re getting, but if we support the skin properly beforehand with SPF, vitamin A, hydration, essential fatty acid supplementation, your skin regenerates with healthy, juicy grapes.”

And then she asks the question: “Would you rather spend $600 on sultanas or grapes?”

You guessed it. No one ever picks sultanas.

It’s a visual that makes skin physiology click — taking the science out of the textbook and into the mind of a client who’s investing in their skin and expecting results. It’s also something every therapist can take into the consultation room to shift the conversation from rushing to lasting clinical outcomes.

Bringing Lifestyle Into The Skin Conversation

The skin doesn’t exist in isolation. It’s the body’s largest organ and arguably the most underestimated. Most clients don’t realise how deeply it reflects what’s happening internally.

Lia says lifestyle factors are often the missing piece in achieving long-term skin results, and that therapists can absolutely initiate those conversations in a supportive way.

“It comes back to what the client wants help with, and how we can best support that. If there’s a lifestyle tweak that will help, explain it. Help them understand the why and the how.”

She uses acne as an example. Sebum should be thin and fluid, but internal imbalances can cause it to become thick and sticky, resembling custard or cottage cheese. That change drives congestion and breakouts.

“Explaining how fish oil helps restore normal sebum consistency makes it really logical for the client. Once they understand, it’s not a hard conversation. It’s just part of the solution.”

The Real Work Isn’t Always Flashy

In a results-driven industry, it’s easy to feel like you have to go harder, faster, and more advanced, but Lia is quick to remind us that the mark of a skilled therapist isn’t how quickly you can needle or peel, it’s how well you can build strong, resilient skin in the first place.

“You don’t have to prove yourself with advanced modalities,” she says. “You prove yourself by knowing when to pause and protect the barrier.”

Barrier repair is often the work that goes unnoticed. It doesn’t photograph like a post-peel glow and it’s not likely to go viral on TikTok. However, it lays the groundwork for every result that follows — better healing, improved function, healthier skin and ultimately, a lifetime client.

“Barrier work isn’t what you do before the real treatment. It is the real treatment. Without it, nothing else holds,” she says.

Clients might not always understand that upfront. That’s why therapists need to because what you’re doing isn’t basic, it’s foundational.

And there’s nothing small about building skin that can handle anything.

@liatrebilcock @skin_education_international_