Everything You Need to Know for Identifying and Treating Sensitive Skin

Allure posted "Everything You Need to Know for Identifying and Treating Sensitive Skin" The article includes Visha Skincare founder, Dr. Purvisha Patel's expert commentary on how to recognize and treat sensitive skin.

In the world of skin care, there are a few core skin type terms that get thrown around pretty frequently — oily, combination, dry, acne-prone, and sensitive skin. That last one, sensitive skin, is one of those concerns that you hear about all the time. Maybe you might even think you have it. But you're probably not sure what causes sensitive skin in the first place, or how to properly care for it. Is sensitive skin something you're born with, or can it happen to anyone? Are there different types or degrees of sensitive skin? Can skin become more or less sensitive over time? What common skin-care ingredients should someone with sensitive skin try to avoid?

To find out the answers to all of these questions, we enlisted a cadre of board-certified dermatologists. Here, the experts help set the record straight on sensitive skin.

What is sensitive skin, and how can you tell if you have it?

"[Sensitive skin] is not a medical diagnosis, but more of a finding or complaint," says Tennessee-based board-certified dermatologist Purvisha Patel, M.D. For that reason, she says, "it can sometimes be difficult to know if you have sensitive skin or not." She boils the definition down to: "Sensitive skin is characterized by skin that is not able to tolerate harsh conditions, chemicals, environments or even [some] diets."

"Sensitive skin is skin that is more reactive than usual," elaborates Illinois board-certtifed dermatologist Jessie Cheung, M.D. "It is easily irritated by the elements — wind, sun, heat, or cold — or by topical products." Other potential triggers can include hormones, lack of sleep, and even air pollution. When exposed to one of these triggering elements, sensitive skin may burn or sting, turn red, or otherwise feel very uncomfortable.

"Sensitive skin is caused by nerve endings in the top layer of skin becoming irritated," says Amy B. Lewis, M.D., a board-certified dermatologist in New York City. "The irritation of nerve endings occurs when the skin's natural barrier is weakened or broken down by triggers."

Another potential trigger: skin-care products. Those with sensitive skin are generally more reactive to soaps, detergents, dyes, and fragrances in topical products. Using the wrong ones can result in itchiness, dryness, and reddening. This is why your skin-care routine is probably the most telling factor in whether or not you truly have sensitive skin.

"If you're cautious with trying new skin products or find that you're frequently battling red, flaky, itchy, or bumpy skin, then you probably have sensitive skin," Dr. Cheung says.

And even if you haven't dealt with sensitive skin before, it's possible that your skin type can become sensitive over time. "We can sometimes develop skin conditions, skin sensitivities, or allergies," says New York City-based board-certified dermatologist Anthony Rossi, M.D. "Sometimes sensitivities and allergies can be 'induced' by repeated exposures to irritants or ingredients that are known allergens." So if your sensitive skin appeared around the same time as you started using a vitamin C serum or wearing a new type of face mask, it's worth speaking to your dermatologist.

Heightened skin sensitivity isn't just annoying and uncomfortable, it could also signal an underlying skin condition, such as eczema or rosacea, or an allergy, all three experts say. For this reason alone, if you suspect that you have sensitive skin of any degree, you should book an appointment with a board-certified dermatologist who can help rule out any larger underlying conditions. According to Dr. Patel, 60 percent of men and women report having sensitive skin — so if you think you may fall into this broad category, speak to your board-certified dermatologist.

Are there different types of sensitivity?

Just like there are varying degrees of severity for oiliness, dryness, and acne, there are also different levels of sensitive skin. "For example, there are some people where we can isolate one ingredient or environmental factor — like sweat or hot water — that bothers them," says New York City-based board-certified dermatologist Morgan Rabach, M.D. "Then there are some people where most skin-care products and environmental factors bother their skin."

According to Dr. Lewis, sensitive skin can generally be divided up into four main types: naturally sensitive, environmentally sensitive, reactive, and thin.

  • Naturally sensitive skin: This one is genetic, according to Dr. Lewis, and it can be linked to inflammatory skin conditions like eczema, rosacea, and psoriasis.
  • Environmentally sensitive skin: As its name implies, this type of sensitivity is triggered by your environment. Sun exposure, cigarette smoke, air pollution — anything your skin comes into contact with might send it into a stinging, irritating frenzy.
  • Reactive skin: "This type of skin becomes red and inflamed by skin-care products, resulting in very red, warm, and irritated skin," Dr. Lewis says. "Often patients will notice papules or pustules forming where the irritant was placed."
  • Thin skin: As we age, our skin naturally becomes thinner, and thinner skin is easier to irritate.

Could pandemic stress be causing your sensitive skin?

In a word: Yes. According to Dr. Patel, lifestyle changes can cause the development of sensitive skin, even if your skin was previously dry, oily, or anywhere in between. Have you changed your diet? Have you changed your lifestyle? Have you had increased stress lately? For the majority of us the answer to all of the above — at least at some point over the past few pandemic-ridden years — is yes. Those changes can track in the skin.  

Which ingredients should sensitive skin types use?

"[Look for] products that maintain and nourish your skin barrier," Dr. Cheung says. "Glycerin, hyaluronic acid, and shea butter are humectants and emollients that draw and seal in moisture, and ceramides and fatty acids will replenish your lipid bilayer."

Dr. Patel recommends her patients seek out products that contain the skin barrier-nourishing niacinamide — otherwise known as vitamin B3 — or, even better for those with sensitive skin, look for pure-niacinamide products, which she says can be used up to twice daily. "Ceramides and occlusive moisturizers (such as Vaseline and Aquaphor) help repair the tiny cracks in the skin to help repair the barrier," she says.

Lastly, she recommends natural ingredients that can help "coat and soothe skin" — licorice, rosehip oil, algae, and colloidal oatmeal.

OK, then which skin-care ingredients should sensitive skin types avoid?

Since there are varying degrees and causes of sensitive skin, everyone is different. A dermatologist is your best bet for figuring out your own individual trigger. However, generally speaking, those with sensitive skin would be wise to avoid using personal-care products that contain fragrances and dyes. 

The same rules apply to the skin on your body — even using laundry detergent that is heavily scented or contains dye can cause a reaction, so Dr. Rabach recommends choosing detergents that are formulated specifically for sensitive skin.

Regarding skin care specifically, Dr. Lewis advises her sensitive-skinned patients to steer clear of sulfates, exfoliants such as glycolic, salicylic acid, and retinoids, and creams with multiple ingredients. Isopropyl alcohol and chemical sunscreens are also common irritants.

Another potential trigger is the way you go about your skin-care routine — specifically, the cleansing step. "Do not rub or scrub," Dr. Lewis says. "Washing too often will irritate sensitive skin and cause excessive dryness." Instead, stick with mild, gentle cleansers, not soaps or scrubs.

Wearing makeup isn't necessarily a total no-go, as long as you choose cosmetics that won't provoke irritation. Dr. Lewis recommends seeking out mineral makeup and silicone-based foundation and generally choosing cosmetics with fewer preservatives and shorter ingredient lists. 

"Do not use waterproof cosmetics," she says. "You need a special cleanser to remove them." For the rest of your eye makeup, use pencils instead liquid eyeliners; the latter can contain latex, which can cause allergic reactions.

One last cosmetics tip: Toss out any and all products that have been sitting around for too long. The longer they sit in your medicine cabinet, the more likely they can become spoiled or contaminated.

Do I have to give up testing skin-care products?

Don't worry, having sensitive skin doesn't necessarily mean you need to put aside a love for all things new and exciting in skin care. What it does mean is that you may have to be a bit more thoughtful before slathering on your latest purchase. Dr. Rossi recommends testing the product on a small patch of skin on your inner forearm before loading it onto the face.

"You can repeat applications daily for 48 to 72 hours to see if you would get an early response or irritation," he says. He also recommends avoiding trying multiple new products at once, so if you do notice sensitivity or a breakout, you'll know exactly what the culprit is.

Remember, if your skin becomes red, uncomfortable, dry, tight, or generally uncomfortable when exposed to any of the aforementioned triggers, don't just brush it off — go see a board-certified dermatologist. They will most likely give you a patch test that can help determine the exact ingredients that exacerbate your symptoms, and they'll be the best equipped to advise you on how to take care of your sensitive skin.

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