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DEVELOPING A SKINCARE ROUTINE IF YOU HAVE SENSITIVE SKIN
MANY DIFFERENT CAUSES OF SENSITIVE SKIN
There are different causes for sensitive skin. For some people, genetics play a role. Some people have a skin barrier that doesn't function as well, whether that's due to genetics or skin conditions such as eczema (atopic dermatitis). If you have sensitive skin, you may be more likely to develop symptoms of itching, irritation, or stinging after applying certain skin care products.
Sensitive skin can also be a temporary state. If you're handwashing frequently, you can start to strip away the natural oils from the skin barrier. That can contribute to an impaired skin barrier, which can lead to sensitive skin. Along the same lines, over-exfoliating, or using harsh products on the skin, can also lead to impairment of the skin barrier.
Sometimes other skin conditions can contribute to sensitive skin as well. For example, many rosacea patients find that their skin is sensitive to different skin care products.
Melanocytes are the cells in your body that help produce melanin, and they're found throughout your skin. Melanin is the pigment in your skin that helps determine your skin tone, and it’s usually distributed pretty evenly over the surface of your skin.
The key factors in determining how much skin pigment you have in your skin are:
The activity of your melanocytes
The type of melanin in your skin
Where that melanin is distributed in your skin
Too much melanin concentrated in one area can produce solar lentigos, also known as sun-induced freckles or dark spots. It can also produce post-inflammatory hyperpigmentation (PIH) after an injury or an insult to the skin in one area. Too much melanin can also produce dark patches over certain areas of the face due to hormone fluctuations, known as melasma.
THE APPROACH TO SENSITIVE SKIN
Regardless of the cause, approaching a skin care routine when you have sensitive skin boils down to two main things.
Avoiding products that cause irritation
Choosing products that help build up and strengthen the skin barrier
INGREDIENTS THAT CAUSE IRRITATION
Certain ingredients may work well in treating certain concerns, but at the same time may cause irritation. If you have sensitive skin, you need to be careful when using ingredients such as (note that this is not a complete list):
While you may be able to use some version of these ingredients, you'll need to be really careful.
Some people with sensitive skin can still use these active ingredients if they
Choose a lower concentration
Choose a vehicle that is more moisturizing/less irritating
Use the ingredient less frequently
Adjust the other components of their skin care routine
For example, retinoids are known to have powerful effects when it comes to skin renewal/anti-aging benefits. For somebody with sensitive skin, a dermatologist would recommend a retinoid that comes in a lower concentration, and that is formulated in a moisturizing base. And instead of using it every night, you might need to use it every third night instead.
Also, you would want to make sure that the other products in your skin care regimen were not irritating. That means choosing cleansers that are hydrating instead of foaming, and possibly choosing thicker moisturizers.
AVOIDING VEHICLES THAT CAUSE IRRITATION
While certain active ingredients can cause irritation, the vehicles in which they travel are just as important.
There are a number of different vehicles, ranging from lotions to creams to gels to toners and more.
Vehicles that are alcohol-based can definitely cause stinging and drying of the skin. For some people with sensitive skin, other ingredients in their products can also cause symptoms, although this varies a lot from person to person. For example, some of my patients have noted stinging and irritation when using products with propylene glycol, while others handle it just fine.
CHOOSING PRODUCTS TO PROTECT AND STRENGTHEN THE SKIN BARRIER
In general, moisturizing properly will help strengthen the skin barrier.
Choose skin care products that are thicker
Apply moisturizers on top of damp skin to help lock in moisture: In other words, step out of the shower, towel off partially, and while your skin is still damp, apply moisturizer on top of damp skin
Creams and ointments are the most effective at locking moisture into the skin when applied on top of damp skin
Creams and ointments typically come in tubs or tubes, and have a higher oil/lipid content. This higher lipid content means that they can lock moisture into the skin more effectively
Lotions usually come in pump bottles, and they have a higher water content, so they don’t hold moisture into the skin as well
As with so much else in medicine, though, everybody’s different. Some people find that a heavier moisturizer actually irritates their skin more. For these individuals, a lighter lotion formulation may actually be less irritating.
ALSO BE CAREFUL OF ALLERGIC REACTIONS OF THE SKIN
Sometimes “sensitive“ skin is actually inflamed skin, and if that inflammation is due to allergic reactions to your skin care products, then you may need to do some detective work or undergo testing.
I specialize in allergic contact dermatitis. In this type of allergic reaction, a substance or product applied to the skin can trigger an allergic reaction. Unlike other types of allergy, though, this one can be very delayed. It can take, on average, 2 to 3 days for the reaction to appear. In some cases, it can take as long as one week.
In other words, if you’re allergic to your moisturizer, you won’t experience burning when you first apply it. Instead, 2 to 3 days later, you’ll notice a rash at the area where you applied the moisturizer. And this rash, once it shows up, can take up to eight weeks to go away, even if you never reapply that moisturizer again.
AVOID THESE INGREDIENTS IN YOUR SKIN CARE PRODUCTS
The most common triggers for allergic skin reactions to skin care products are fragrance additives and preservatives. Avoiding products that contain natural fragrances, synthetic fragrances, formaldehyde preservatives, and methylisothiazolinone is helpful for those with either sensitive skin or with suspected allergic reactions of the skin. This handout is updated yearly, and links to products that do not contain these common triggers of allergic reactions.