"Sensitive skin" is not a medical diagnosis that we use as dermatologists. Read more...
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Can you briefly explain what it means to have "sensitive skin"?
The term “sensitive skin” is something that I hear from patients routinely but often means different things to different people. "Sensitive skin" is not a medical diagnosis that we use as dermatologists. Usually, when people say they have sensitive skin they are implying that their skin gets irritated really easily. This can be from several different causes or triggers.
What causes sensitive skin in the first place?
The most common causes of sensitive skin are:
Allergic contact dermatitis: I have had many patients find that when they use various products their skin can get itchy, sensitive, and even swell or become irritated. In these cases, when it’s hard to pinpoint the actual culprit, a type of allergy testing called patch testing is extremely helpful. One of the most common forms of patch testing is where I place 3 sticker panels that test for 35 of the most common preservatives, metals, dyes, and other products. There are no needles or skin pricks. It is always fascinating to see what comes up as reactive on these tests and it is so helpful to know what to look for and avoid on ingredient labels. Takes away the guessing game or trial and error.
Irritant contact dermatitis: These days so many products have ingredients that are meant to make our skin look more youthful by slightly swelling our skin to make the wrinkles look less apparent. Sometimes products have concentrated extracts or other ingredients such as fragrances that can directly irritate the skin just by the concentration in the product that leads to skin breakdown.
Rosacea: Think of rosacea as a tendency to flush or blush given a variety of triggers. Many patients with rosacea will often find that “less is more” when it comes to skincare as their skin tends to be sensitive to many products.
Seborrheic dermatitis: This condition is common and can be thought of as a sensitivity to yeast that normally lives on our body. Our skin becomes overly sensitive to its presence given certain conditions such as heat, sweating, temperature changes, and stress. Products on our skin will often sting or burn when first applied- not from an allergic reaction, just our skin being very sensitive at baseline.
Sun damage. As we age our skin becomes thinner and is also more prone to precancerous spots called actinic keratoses and even early skin cancers. I often see patients that tell me that their skin is exquisitely sensitive in certain spots or areas. Products can really sting or burn when applied.
What are some steps for caring for sensitive skin?
When it comes to understanding your skin and how to manage it best if you think you have ‘sensitive skin’ it is really important to see your dermatologist and find out why. I cannot tell you how often the trigger can be pinpointed and avoided when it comes to allergic and irritant contact dermatitis. For patients with rosacea or seborrhea, these underlying conditions can be effectively managed separately allowing you to resume a skincare routine. For patients with many precancerous spots, these can be treated directly with liquid nitrogen or field therapy can be performed to treat entire areas with a prescription cream or photodynamic therapy.
Choose products without fragrance. Be careful when looking at labels. Just because a product says it's “unscented” does not mean there is no fragrance added. The term unscented only means that you will not be able to discern a scent from the product. However, there are often masking scents or fragrances added to these to mask the scents of the actual ingredients.
If your skin is very ‘sensitive’ do not just focus on your makeup and skincare routine as possible causes. When I perform allergy patch testing on patients I often find the trigger to even be shampoos, conditioners, and hair products.
Watch out for buzzwords on your skin care products: ageless, age-defying, anti-aging… These can contain ingredients such as alpha hydroxy acids that are intended to make your skin irritated a bit to make it look more “youthful”. If you are not looking for this effect you may just get the irritation from these products to deal with.
Make sure moisturizer is a part of your routine to add back turgor and hydration to the skin as well as protect it from the environment.
Add a humidifier to your nighttime routine. It can help add moisture to our skin to make it less susceptible to sensitivities.
Wash with cooler water. Hot water from showers can increase the sensitivity of our sin.
Don’t forget to review your makeup products and applicators. I have even had patients come back as allergic to their makeup applicators when patch tested!
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