Does your skin turn bright red, itch, or even break out in hives when you switch laundry detergent? Have you resigned yourself to not being able to enjoy all those great smelling lotions your friends and family gifts you during the holidays? Do you constantly check the clock to make sure you don’t wear that nickel-plated necklace one minute longer than you should before it turns your skin bright green? You may just be dealing with sensitive skin. According to Dr. Kathleen Ellison of U.S. Dermatology Partners in Fairfax, Virginia, “Sensitive skin can present in a lot of different ways and for many different reasons, but the long and short of it is – certain people have ‘reactive’ skin. Fluctuations in temperature, new skincare products, shifting hormone levels, and other changes can all lead to a flareup. When you partner with a dermatologist, you can better understand your specific triggers and ways that your skin reacts to them, so you can improve your overall skin health.” In this blog, Dr. Ellison walks through some basic information about sensitive skin and how we can help you improve your symptoms and avoid unnecessary discomfort.
What is Sensitive Skin?
Sensitive skin is not actually a specific diagnosis. Instead, it’s a general name applied to a group of skin conditions. Dr. Ellison says, “When we talk about sensitive skin, we’re really saying that your skin is more likely to react to stimulus. Whether it’s an actual allergen like poison oak or just a new body wash, you might find yourself dealing with a greater-than-proportionate level of skin irritation.” The good news is that, apart from a few more serious conditions that may cause sensitive skin, this condition is easy to treat by making some simple changes to your daily routine.
What are the Warning Signs I Have Sensitive Skin?
When you tell your dermatologist that you have sensitive skin, they will want to know exactly what that looks like for you. In order to ensure you don’t have a more serious skin condition, your dermatologist will want you to describe your symptoms, frequency of occurrence, and other details. Some of the most common symptoms of sensitive skin are:
- Flushing & Blushing – your skin feels warm and turns red either for a disproportionately long time compared with the activity or with no known cause.
- Irritated skin – you often have bumps, rashes, hives, dry patches, or skin discoloration with little or no outside cause.
- New products hurt – changing your skincare, cosmetics, or cleaning products can cause your skin to burn, tingle, or breakout.
- Dry skin – you often have dry, itchy, or tight feeling skin.
- Sunburn – you may experience more severe sunburn than others even with minimal exposure to the sun.
- Broken capillaries – blood vessels may be visible below the skin around the eyes, nose, cheeks.
- Breakouts – in response to your skin’s lack of moisture, your body may attempt to compensate by overproducing sebum (oil) that can clog pores and lead to breakouts.
What Causes Sensitive Skin?
There are numerous causes of skin sensitivity. Sensitive skin is usually a two-fold issue. First, the skin is more easily irritated by outside stimuli. Second, once irritation occurs, the body’s immune response is too dramatic for the situation, leading to longer-lasting or more severe symptoms than a person with non-sensitive skin may experience. Some of the common causes of skin sensitivity include the following:
Everyone’s skin is made up of several layers. The outer layers of skin protect the body from external irritants and damage. Just below the epidermis, the very top layer of skin, is a lipid (fat) barrier that helps the body retain moisture. For many people with sensitive skin, a thin lipid barrier leads to excessive skin dryness, which in turn further irritates the skin.
Regular Contact with Allergens & Irritants
Exposure to allergens, chemicals, and other irritants can lead to breakouts, rashes, itching, and other symptoms. For those who already have sensitive skin, very minimal exposure can lead to more dramatic symptom flareups than seems reasonable. In some cases, this may be due to one of the following conditions:
- Allergic contact dermatitis – an irritation of the skin that occurs when the body is exposed to allergens repeatedly.
- Irritant contact dermatitis – an irritation of the skin that occurs when the body is exposed to an irritant (chemicals, abrasive materials, harsh weather, friction, etc.) repeatedly.
- Contact urticaria – like contact dermatitis, this is a type of irritation that occurs when the body is exposed to certain agents. Rather than rashes, inflammation, itching, and other common symptoms of dermatitis, contact urticaria leads to hives, swelling, and redness.
- Physical urticaria – this condition causes hives to appear on the skin due to a physical event like exposure to extreme heat or cold, pressure, or vibration.
- Dermographia – literally translates to mean “written on the skin.” Dermographia is simply skin that becomes red, puffy, or raised even when only lighted scratched.
- Aquagenic pruritis – a rare condition that causes irritation when the skin is exposed to water. It does not typically have any visible signs, but the skin itches, tingles, or even burns immediately following exposure.
Photodermatoses is a skin condition that causes an abnormal reaction to sunlight. Those with skin sensitivity to sunlight may notice that they burn more easily than others, or they may have more serious responses like developing blisters, rashes, hives, or tingling sensations due to sun exposure. While prolonged exposure to UV rays can damage anyone’s skin, those with photodermatoses may notice very dramatic symptoms after minimal sun exposure.
We’ve already talked about how skin sensitivity is related to the protective outer skin layers. The skin is strengthened by lipid (fat) cells that form between the outer layers of skin cells. These lipid barriers protect the body from irritants, keep in moisture, and generally promote healthier skin. People who have sensitive skin may have lipid areas that are weak or thin. In some cases, there may be no lipid barrier at all. Most people have some experience with this in areas with thinner skin, like the eyelids, but those with sensitive skin may have similarly weak lipid barriers and thin skin all over. According to Dr. Ellison, “For the most part, the strength of your lipid barrier and resilience of your skin is entirely luck, or more scientifically, genetics. Some people just have, literally, thicker skin, and they are less likely to experience irritation and sensitivity than others.”
While some people are born with naturally thinner skin, almost everyone experiences a breakdown in the tough, protective outer layers as we age. As we get older, cell turnover slows, and the skin becomes thinner. Even if your skin never bothered you, as you age, you may notice certain products are suddenly causing irritation.
Certain chronic skin conditions can also cause your skin to be especially sensitive. Some conditions that cause skin sensitivity include:
- Eczema – also known as atopic dermatitis, this is a common skin condition that causes itching, rash, and inflammation. People with this condition have skin that does an inadequate job protecting the body from allergens, irritants, and other external stimuli, usually coupled with an overactive immune response
- Rosacea – this is a common skin condition that affects the face. Those with rosacea may notice frequent blushing, skin redness, broken capillaries, rashes or bumps, and swelling.
- Psoriasis – specifically, plaque psoriasis, is a chronic inflammatory skin and immune condition that causes the body to rapidly produce too many skin cells. This leads to thick, scaly flakes of skin called plaques.
- Cutaneous mastocytosis (CM) – this is a condition that causes mast cells, the body’s immune receptors, to accumulate in the skin. When these cells are threatened (injured or irritated in some way), they trigger the body to release chemicals to protect itself. This leads to swelling and inflammation.
How Do I Treat Sensitive Skin & Prevent Irritation?
For many people with sensitive skin, a professional treatment plan isn’t necessary. Instead, making some small changes to your skincare routine, learning triggers, and taking steps to soothe the symptoms of sensitive skin will effectively relieve the condition. Below, we’ve outlined our top ten tips for treating sensitivity and avoiding skin irritation.
1 – Visit a Dermatologist for Exams, Diagnosis & Recommendations
As is the case with many conditions, the treatment for skin sensitivity is very particular to the individual. That’s why our first tip is to schedule a visit with your trusted dermatologist. During your dermatology appointment, these professionals can carefully examine your skin, conduct tests for specific conditions like eczema or psoriasis, and partner with you to create a personalized plan to prevent future flareups and breakouts.
2 – Use the Right Skin Care Products
Your dermatologist can help you to find the right products for your specific situation, but in most cases, the best first step is to keep it simple. Use a small number of products with few ingredients. Look for products that are formulated for sensitive skin. This may include products that are free of sulfates, dyes, alcohol, exfoliants, and other harsh or abrasive agents. Instead, look for products that contain moisturizing agents like glycerin and hyaluronic acid and those that will help to strengthen your lipid barrier like alpha-linolenic acid and ceramides.
3 – Always Wear Sunscreen
Even if it’s not sunny or you’re not planning to be outside for very long, you should still apply sunscreen to your face, hands, and any other areas that may be exposed to UV rays. Many facial moisturizers come with a built-in sunblock, which can be very beneficial to avoid unnecessary irritation and streamline your daily routine. Look for physical sunscreens that have ingredients like titanium dioxide and zinc oxide rather than chemical sunscreens that may further irritate sensitive skin.
4 – Keep Your Skin Moisturized
Because skin sensitivity is so often related to the body’s inability to retain moisture, keeping sensitive skin moisturized is essential. Make sure to apply a good moisturizer to the skin every day to avoid irritation.
5 – Avoid Over-Washing
According to Dr. Ellison, “Many patients who visit me with sensitive skin are over-washing. They’re washing too often, using cleansers that are too abrasive, exfoliating skin unnecessarily, and otherwise damaging the outer layers of their skin. To protect your skin while washing, avoid using hot water or harsh cleansers. Instead, use cool or lukewarm water and gentle cleansers to avoid damaging the protective lipid barrier of the skin.”
6 – Avoid Products with Fragrances
Whether fragrance is naturally derived from essential oils or chemically synthesized, it can still irritate sensitive skin. Even if you undergo testing for fragrance allergies, it may still be difficult to determine which products will irritate your skin. In most cases, product ingredients will simply list “fragrance,” so it’s often hard to avoid specific fragrances that irritate your skin. Whenever possible, it’s best to completely avoid the problem by looking for products designated “fragrance-free.” Even “unscented” products can have some fragrance agents to neutralize the smell of other ingredients, so only “fragrance-free” products are truly free of irritants.
7 – Try Products Before You Make Them Part of Your Routine
For anyone with sensitive skin, spot testing products is essential. Apply the product as directed to an isolated spot first. The inner arm is often a good place for testing. If you don’t see any reaction after a few days of applying a product to the arm, you can try it on your cheek or forehead. If you still have no adverse response, you’re probably safe to use the product as part of your skincare routine.
8 – Pay Attention to How Cosmetics Affect Your Skin
In addition to cleansers and other skincare products, cosmetics can also exacerbate sensitive skin. Pay attention to the ingredients in cosmetics and look for products that are formulated for sensitive skin. Whenever possible, use makeup powders and pencils. These products sit on top of the skin rather than being absorbed into it, which can help prevent irritation. You should also throw out cosmetics that are more than six months old as the ingredient can degrade and irritate the skin.
9 – Avoid Irritation from Winter Weather
Between the cold, dry air, moisture-sapping heaters, and harsh weather conditions, winter is tough an everyone’s skin. If you already have sensitive skin, make sure to protect it during the winter. To minimize skin dryness, avoid spending too long in the shower or bath, especially in very warm water. Apply a gentle moisturizer to the skin immediately following your shower or bath. Keep skin covered with warm clothing when you’re outdoors and apply a moisturizer anytime you notice the skin is drying out.
10 – Pay Attention to How Certain Fabrics Impact Your Skin
It may sound silly, but wearing clothes made from certain fabrics can be irritating to people with sensitive skin. Soft, absorbent, breathable fabrics like cotton or linen are often the best option. Clothing should be loose-fitting and changed frequently. Avoid irritating or itchy fabrics like wool.
When is it Time to Visit U.S. Dermatology Partners?
If you’re experiencing a flareup or you want to improve your general comfort and reduce sensitive skin symptoms, a visit to the dermatologist can be helpful. If you live in the Fairfax area, don’t hesitate to reach out to Dr. Ellison. Otherwise, we invite you to use our simple online request form to find the closest U.S. Dermatology Partners location to your home. Once we receive your form, a team member will be in touch to schedule your first appointment.
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