What is Sensitive Skin? We hear about “sensitive skin” so often that it is almost difficult to define what it is. Indeed, there is no good concensus among experts on what defines “sensitive skin” – and while people with certain skin conditions such as eczema are affected, the problem affects many others with no pathological skin condition as well.

To me, the most important definition of sensitive skin is a practical one. You have Sensitive Skin if your skin:

• reacts negatively (e.g.rashes, redness) to cosmetic topical products, or
• has an exaggerated reaction (i.e more than what we would expect compared to the normal population) cosmetic treatments such as laser resurfacing

Who it Affects

In a phone survey of 994 individuals in America, 45% of respondents self-identify themselves has having sensitive skin. And while this number seems alarmingly high – it is not far from the truth. In my practice, almost half of the patients would already have had a previous bad experience with a cream or a cosmetic treatment.

The problem represents a whole spectrum – from a mild tingling sensation when applying creams, to a severe rash outbreak with a particular topical ingredient.

 The condition affects women more: 51% of women compared to 38% of men in the above-mentioned survey. This is reflected in my clinical practice as well – for the following reasons:

• women have thinner skin compared to men
• women tend to try on more cosmetic products, and undergo more cosmetic treatments
• men tend to under-report the problem of sensitive skin simply because they do not notice.

People of all races are affected equally, while younger children tend to have more sensitive skin.

People with conditions which affect the skin’s barrier function – such as eczema and ichthyosis vulgaris, will have sensitive skin.

What Causes it or Makes it Worse?

Biologically, the cause of sensitive skin is similar to eczema – impairment of the epidermis’ barrier function. This results in increased water loss, and allows more chemicals to penetrate deeper and faster into the skin, resulting in irritation and inflammation.

The triggers for sensitive skin are far and wide – and often difficult to pin point. It can be environmental factors like the sun, cold/hot weather, or more commonly, in my practice: creams and lasers.

There are often concerns that lasers will cause the skin to become more sensitive – unfortunately, there is some truth to this. Lasers, especially resurfacing lasers (e.g. Smartxide2 Carbon Dioxide Laser Resurfacing) burn off a portion of the skin surface- immediately after. We are deliberately disrupting the skin surface to allow new collagen to grow. Hence, great care is needed to make sure you are gentle to your skin after the treatment, as it will be very sensitive for a week. Even after, your skin will experience some degree of increased sensitivity for up to 3 months. Proper follow up care and information from your doctor is crucial to ensure you do not run into any problems, and reap the most benefits out of your treatment.

Caring For Sensitive Skin

Products for Sensitive Skin

Sensitive skin requires more TLC then normal skin, to strengthen and repair the skin’s barrier function.

A good moisturizer is important. Look for one with skin repair properties. Emollient ingredients such as Ceramides, Natural Moisturizing Factor, Hyaluronic Acid are great for enhancing the barrier, and restoring the balance of the skin. Sensitive skin tends to be dryer, so choose a thicker moisturizer (e.g. cream rather than lotion) if your skin feels dry, especially when you are travelling to temperate areas.

Avoid cleaners which are harsh. Those which make you feel squeaky clean are a no-no. Choose a cleanser with a lower pH – this is more compatible with the skin’s natural pH (4.5-5.5).

Unfortunately, “Hypoallergenic” products do not guarantee that you will not develop a skin reaction to them. There are no fixed standards which must be met before a manufacturer can label a product “hypoallergenic”, so I advise you to take those claims with a pinch of salt.

If you have sensitive skin, the best test is still to try the product out to test for a reaction. Try a new products out on an inconspicuous area of the face (e.g. behind the ear) before using it in the rest of the face, to be sure.

Aesthetic Treatments for Sensitive Skin

Medical treatments on the skin can irritate sensitive skin. While many medical treatments cause some degree of redness after, people with sensitive skin can develop exaggerated symptoms which last longer than expected, such as:

• Prolonged redness
• Swelling
• Itching
• Rash
• Blisters/ oozing of fluid

Treatments which deliver energy, or ablate the skin surface often cause more problems in people with sensitive skin, such as:

• Fractional laser resurfacing
• Pigment lasers (e.g. Q-switched Nd-Yag Lasers)
• Carbon Laser Peels
• Chemical Peels
• Microdermabrasion

Have a conversation with your doctor before embarking on any treatment, to learn more about the expected side effects, so that you know when to call him/her for help if a problem occurs. But do not worry, the reactions are usually temporary, and can be treated without any long-term problems.