I’ve recently been told I have sensitive skin. This isn’t something I’ve always had so was a bit confused about where it came from and what I should do about it, so I spoke to Annett King, Director of Global Education for The International Dermal Institute to help explain. Here’s a summary of what she had to say about the difference between sensitive and sensitised skin…
If you have tight, red, stinging, itchy, reactive, flushing, blushing or hot skin, you may describe your skin as ‘sensitive’. So do around 50% of women around the globe, and many could be wrong.
Sensitive skin is inherited. Sensitised skin is acquired. The behaviours of the two conditions are often similar, and treatments may be similar as well. But here’s the crucial difference: if you have truly genetically-inherited sensitive skin, then it cannot be fully erased but it can be treated. It’s in your DNA!
Sensitisation is a response to an external or introduced factor (or a combination) and is not driven by genetics. Generally, it is triggered by lifestyle choices (stress being a major factor) or exposure to environmental chemicals. So it is possible that sensitisation may be arrested, moderated and fully reversed with changes in environment, habits, etc.
What does sensitisation look and feel like?
The primary signs of sensitisation indicate that the barrier protecting the skin has been damaged.
Examine your skin through sight and touch for:
· Thinned texture, translucent appearance
· Dehydration on the cheek and forehead area
· Excessive dryness, uneven texture and rough patches
· Tightness after washing, and stinging on product application – or even simply when rinsing with water
· Broken capillaries across cheeks and nose
· Redness on cheeks, décolleté and neck, or all over
· Hot spots’, especially on the décolleté, neck and cheeks
· Blushing and itching, burning sensations
· Small, rash-like bumps or breakouts
People tend to view their skin concerns as ‘aesthetic’, but skin is a living shield which protects our tissues and organs from infection. A damaged lipid barrier can no longer offer this level of needed protection which means that sensitised skin should be treated, rather than being put up with.
What causes sensitisation?
Now for the science bit…there are two primary processes that contribute to sensitive skin. While visibly red, irritated skin may be the end result of two different types of inflammation, immunogenic (caused by a substance) and neurogenic (caused by the body), you can also have these types of inflammation without visible signs associated with it. The inflammatory process is still occurring but it is invisible to the eye and may only result in stinging, burning or itching. In this case the skin is sensitive and if not controlled it may lead to visible inflammation associated with redness and the typical symptoms.
• IMMUNOGENIC INFLAMMATION is defined as the body, in this case, the skin, responding to an introduced irritant (pollen, bacteria and artificial fragrances are common triggers) with an immune-system response. In other words, the skin attacks the intruding force, much the way your body would fight off a virus, although in the case of sensitisation, pain, redness and swelling are common responses.
• NEUROGENIC INFLAMMATION originates in the nerves, and nervous system. Chemicals and pollutants in the environment stimulate receptors in the skin to trigger inflammation resulting in the release of substances called neuropeptides that trigger the inflammatory response. Under normal conditions, these substances play a highly useful role in tissue repair, but neuropeptides also are active in triggering and aggravating sensitisation as well as a variety of painful inflammatory conditions such as itching, psoriasis, dermatitis and rosacea.
Combine either or both of these factors with a compromised barrier lipid layer and you have the perfect conditions to have inflamed, overly reactive skin that triggers either or both of these two complex processes. There may be a number of triggers but the simplest answer is ‘stress’—defined any number of ways:
• Mental/emotional ‘life’ stress
• Sheer physical stress including fatigue, dehydration or malnutrition, or overexertion from extended travel, rigorous activity or athletic training, or recovery from illness.
• Stress of an environmental variety, such as the immune system being challenged by toxins in the air, water, or other physical conditions.
These environmental and lifestyle factors contribute greatly to sensitisation, so it’s vital to think about:
• Extremes of climate, both interior and exterior, natural/manmade
• Smoking, which dehydrates the skin by depleting barrier lipids and affects collagen synthesis and cell metabolism
• Exposure to pollution – not just smog, but think in terms of ‘sick building syndrome’, chemicals encountered in the workplace, etc. Even the fumes from a new carpet, new furniture (which often is stabilised with formaldehyde) may trigger sensitisation.
• Excessive exfoliation leading to over-processed skin, especially combinations of common procedures and products such as microdermabrasion, glycolic peels, retinoids, etc
• Laser resurfacing or other trauma to the skin
• Excessive washing, especially with alkaline products like conventional bar-soap, and especially showering/bathing in too-hot water.
• Topical products and make-up containing artificial fragrances, colourants and alcohol
• Alcohol and caffeine consumption can dehydrate the tissues and dilate capillaries, resulting in flushing and redness
• Inadequate UV protection; often chemical sunscreens (non-titanium dioxide or zinc oxide sunscreens) can trigger sensitisation
• Nutritional choices: low-fat diets which may deplete lipid strength and eating spicy foods has been linked to increased skin sensitivity, possibly due to nerve activity in the skin
• Stress and sleep-deprivation
So, how to treat?
The first step in breaking the cycle of sensitisation is removing as many triggers from the contact-sphere as possible. Lifestyle choices which are under your control are an obvious place to start, such as smoking, alcohol and caffeine consumption. Likewise, stress may be managed to some degree through other lifestyle choices, such as the decision to exercise, pursue meditation, receive alternative therapies and massages, etc.
• Cleansing the skin properly is the first step in strategic care. As mentioned, alkaline soaps and hot water set sensitisation into motion so you need to use an extremely gentle, sulphate-free, non-stripping gel or cream cleanser which will fortify the protective barrier function without leaving a residue. If your skin is sensitive to water, the product may also be removed with damp cotton or a soft cloth. Ingredients to look for in this type of cleanser, which also is appropriate for newly resurfaced skin, include Raspberry, soothing Cucumber and Panthenol (provitamin B5) that helps to regenerate tissues.
• A spritz of calming spray is a recommended next step. Look for a soothing, hydrating mist to immediately relieve irritation.
• Masques are especially helpful to sensitive skin, since the prolonged contact of a calming relief masque delivers lasting effects.
• Serum concentrates speed the healing process at times of severe inflammation and ease the discomfort of long-term sensitisation.
• Appropriate moisturiser and UV protection are also essential to managing sensitisation, since dehydration, excess heat and free radical damage often are syndrome triggers. If you like exfoliating then make sure you use an ultra-gentle exfoliant, only on the condition that the lipid barrier is not damaged. In this case, use an ultrafine product which delicately polishes fragile skin with microparticles of rice bran and rice enzymes. Also note that even conventional washcloths and towels can irritate sensitive skin; use a high-tech microfibre sponge cloth for cleanser and masque removal instead.
• In terms of moisturisers, often a rich, medium-to-heavyweight product works best, to form a substantial layer of lipid barrier protections and humectant hydration around tenderised areas such as cheeks, nostrils, cuticles, or any other hot spots. UV daylight defence products should be a physical block rather than a chemical sunscreen. Monitor this usage carefully, as sun-protection often is a trigger for inflammation on sensitive skin.
Two of the best ranges I’ve found to really help with sensitive skin are:
Dermalogica’s UltraCalming range. I’d say the hero products here are the UltraCalming Mist to provide immediate relief (I even use this after waxing and it calms it down immediately) and the UltraCalming Serum Concentrate feels so lovely on the skin. Although I don’t suffer from sensitive skin all the time, I use facial hair removal cream on my face which seems to make it flare up and go bright red, so once I use these products on it, the redness disappears almost instantly! The Concentrate is so calming to apply as well and I use it as a moisturiser the day after hair removal.