Ask an Expert: What is Sensitive Skin?

Emma Hobson is a British Skin and Body Care Specialist who has been in the industry for over 23 years. With experience ranging from business owner to corporate manager, Emma has collected an extensive range of knowledge in all aspects of the professional beauty industry.

In 1993, Emma joined the Dermal Group of Skin Care Companies as Instructor for The International Dermal Institute at their London Location. Since 1995 Emma has been heading up the education department as Education Manager for Asia, Australia and New Zealand.

The first in a series of skintype profiles, Emma discusses Sensitive Skin:

What is sensitive skin?

Firstly I think it is important to understand there is a difference between someone who has a sensitive skin type (genetic) and that of a person who has a skin that has been sensitized due to some form of external aggravating factor (environmental).

A sensitive skin can be characterized as the following:

Has a genetic predisposition – If there is a family history of hay fever, asthma or eczema, the skin may be more sensitised. The medical community classifies individuals with allergies, hay fever, etc. as atopic. Thinner fairer skin is more susceptible to sensitised problems. For example, England, Scotland and Ireland have more people with skin classified as sensitive than Italy or Spain.

This could be due to a predominance of Nordic and Celtic ancestry in Northern Europe that is lighter in pigmented colour and has a significantly thinner epidermal layer 9finer skin surface layer). Thinner, more delicate skin has a less than optimum natural defense barrier of lipids and natural moisturisers.

The increased permeability allows for more easy access of potentially irritating ingredients. Sensitive skin generally has more reactive blood vessels than normal skin, which may explain why people who flush or turn red easily often have sensitive skin.

A sensitized skin can be characterized as the following:

The majority of people actually suffer form a skin condition that being ‘sensitised skin’. It can affect anyone, at any age, race and skin type from dry skin to acne.

Today Asian skin has shown to have the highest % of sensitivity particularly in the cheek area due to environmental factors (i.e. pollution). It is caused not from a genetic pre disposition (fair, fine, reactive skin) but solely due to external influences, which if eliminated, the sensitivity will dissipate e.g. stress a major factor in skin sensitization if the stress is eliminated so will the effect it is having on the skin.

The symptoms experienced are the same as a pre-disposed ‘sensitive skin’ and in some cases are actually worse as they may not always be visible. Both complain of itching, burning, dryness, flushing and stinging. Typical signs that you can watch out for may be:

* A person who suffers from nasal congestion and sinus problems
* Watery or itchy eyes and dark circles
* Sensitive to pollen, dust mites, and other airborne allergens
* Related problems of asthma and eczema are also noted
* The same trigger factors apply to both

All symptoms can be related to the Environment not just the external climate such as pollution but also our micro environment: This being the things we are exposed to in our home, car, plane and office which is often very different to the climate that we live in!

How do I know if I have sensitive skin?

Apart from the comments above, if you are not born with a genetic fair sensitive skin then you have a sensitized skin, the good news is you can do lots to get your skin back to optimal health and irradiate the sensitivity.

What ingredients should I avoid?

A sensitive skin type can find it difficult to tolerate S.D alcohol, Fragrance, some hydroxy acids such as Glycolic Acid (if they have a very low PH), Alkali products such as soap and shaving foams (for men) and products that are highly active such as cosmecuticals, concentrates etc.

A sensitised skin can have the same challenges to these products but can react to just about anything!

Will using a toner make sensitive skin worse?

A hydrating spritz toner would be fantastic addition to your skin care routine. The boost in hydration will help the barrier function and if you have a toner that has plant soothing and calming ingredient sin you can find that they can help subside the redness and sensitivity, some even help with taking the itch away from your skin.

The key is to AVOID all toners that contain S.D alcohol and Fragrance (both can irritate and dry the skin).

Some makeup and beauty products give me a stinging sensation, what is the cause of this?
Difficult to pin point exactly what his could be as different people react to different things. Commonly it could be fragrance or SD alcohol or possibly a product that was alkaline in nature or possibly a hydroxy acid product.

I suffer from rosacea, can this be treated?

Rosacea is a progressive, inflammatory vascular disorder that is characterized by four stages. It primarily affects the central part of the face and is recognized by facial flushing / blushing, facial erythema, papules, pustules, and although Rosacea is not curable, early detection of what we call pre-Rosacea by a Skin Therapist could prevent progression to permanent disfigurement or blindness.

Medical attention, client education, and symptom management can provide symptom control and remission.

The latest ingredients and treatment protocols for treating Rosacea:

The aim is to reduce inflammation and associated problems, seek out these ingredients:

Sea Buckthorn: (Hippophae Rhamnoides) Oil: Used to treat acne, Dermatitis, itchy and irritated skin, Eczema, cuts, burns, and many skin diseases due to its ability to help with tissue regeneration and to treat inflammation.

It also helps reduce the effects of sun radiation. Rich in rare Omega-7 fatty acids (also known as Palmitoleic acid, which is a major skin component often depleted in sensitized skin), phytosterols and vitamins A and E, along with antioxidant carotenoids and soothing flavonoids, Sea Buckthorn helps rejuvenate and restore health to sensitized and prematurely-aging skin.

Avena Sativa: Oats (Beta Glucan), anti-inflammatory, stops itching, burning sensation on the skin surface.

Canadian Willowherb: A plant of the Evening Primrose family used by original inhabitants in Northern Canada (for the juice) on burns and irritations for its healing and antiseptic properties. Has been compared to hydrocortisone due to its non steroidal drug qualities for affecting the inflammatory response. Reduces skin redness by 41% in 24 hrs.

Coneflower: Purple coneflower; antiseptic, fights infection, anti-inflammatory, used for wounds, acne, anti-enzyme. Echinacea…Asiatic Acid.

Centipeda Cunninghami: Sneezeweed; used by Aborigines for burns, wounds, infections; anti-inflammatory, healing agent (enhances cell renewal rates).

Licorice: anti-inflammatory, anti-oxidant.

Pilewort: (Ranunculus ficaria) Extract: Soothes and calms irritated skin while it reduces redness. Contains phenolic derivatives such as rutin and tri-terpenic saponins that help decongest skin tissues and reduce blotchiness.

Raspberry: anti-inflammatory, healing agent, strengthens capillary walls.

No SD alcohol, no exfoliation (microfoliation is still possible), no harsh abrasives.

Sunscreens are essential: Protection from the sun is important and daily use of a sunscreen of at least SPF 15. Some Rosacea sufferers can only tolerate the use of Physical Sun Screen (Titanium Dioxide and Zinc Oxide) while others who may opt for a chemical Sunscreen (e.g.: Avobenzone) because they prefer a more light weight consistency that’s not greasy or shiny. Chemical Sunscreens can cause the skin to react in some Rosacea suffers so it is always advisable to patch test before use.

Barrier type formulas for moisturizers: To prevent entry and micro cracks in the upper layers of the epidermis we need to replace the natural lipids and encourage the skin to replace its own lost barrier. Moisturizers that contain Cyclopentasiloxane, Dimethicone, Hyaluronic acid, Sodium PCA, and Aloe will help to hydrate and prevent TEWL (Trans Epidermal Water Loss) without irritation yet still provide an invisible barrier to the environment.

Regular skin treatments can be very beneficial and improve the overall success rate. It is important however that the therapist adheres to the following guidelines:

Clients should be treated with the “less rule”: Less heat, less friction, less product (no more than 5), less time (45 min treatment). No rubbing, heat, steam, European massage nothing that brings blood to the surface of the skin. We must address the redness and inflammation and repair the barrier function of the skin.

It is important to have a gentle skin cleansing regimen using non-irritating cleansers that do not contain soap, perfume or hydroxyl acids.

Cooling treatments that address the redness: cool marble stones can be held in the client’s hands at the beginning of the treatment, placing your products in the fridge before application could also enhance the treatment experience.

Galvanic Iontophoresis helps to cause vasoconstriction, reducing the redness on the skin while assisting with penetration of calming soothing ingredients.

MLD (Manual Lymph Drainage) for inflammation and lymph reabsorbtion.

Include relaxing touch therapies into the skin treatment: Stress can also contribute to an inflammatory response in the skin, and it is for this reason that it would be very beneficial to include therapies that help to lower the stress levels of the client. E.g.: Reflexology, back massage, hand massage, pressure point massage.

There are a number of triggers and tripwires which are factors that exacerbate the condition resulting in a flare up. Having Rosacea will mean that major changes will need to be adapted to lifestyle and diet together with careful monitoring of what causes flare ups on an individual basis.

It is important to treat Rosacea in as many ways as possible: clients who modify their lifestyles, eating habits and reduce their level of stress often experience a much greater degree of Rosacea clearing. While a skin care therapist can try to treat the symptoms of the skin (Rosacea) that are most visible and distressing, they should also ensure that they also educate the client about how to eliminate the trigger factors!

These are tripwires for flushing or different types of flushing that we see.

Flushing can occur when the body becomes fatigued and/or stressed which stimulates the sympathetic nervous system. Any activation of these nerves causes vasoconstriction of “body blood vessels” except in the “facial blush/flush areas” where it induces potent vasodilatation or flushing with the resulting “Rosacea flush”. Rosacea particularly gets worse during menopause when women experience flushing (due to hot flashes from the body reading that there is low estrogen, also causes sweating).

Sun exposure is the worst tripwire, increased blood flow to the surface of the skin also causes cross linking of collagen and capillary damage. Sun exposure can also contribute to lymphatic damage, causing degeneration of elastin. Weather is a “tripwire” for sufferers, particularly extreme hot & cold.

Diet: Alcohol together with, cola, caffeine, spicy food, hot soups, histamine producing foods. Chocolate, tomatoes and citrus fruits are well known tripwires. Heavy meals will cause flushing as the body tries to digest the meal. Eat regularly in small amounts.

Smoking = Capillary damage -lack of Vit C from smoking causing weaker capillaries, cross linking and robs skin of 02 sometimes this is the initiator of telangiectasia. Blood vessels less pliable due to hardening therefore less O2 delivered

Exercise can often cause flushing in for Rosacea sufferers: it is advisable to try and restrict the type of exercise to a more gentle form in preferably in a cool environment where the amount of vasodilatation is kept at a minimum. Alternatively some clients have modified their exercise routine by choosing to train early morning or late afternoon when the day is cooler, some clients chew on ice or use a cold compress on the face and neck to help reduce the amount of vasodilatation and inflammation telangiectasia.

When choosing new skincare, how should I perform a test to make sure I won’t have a reaction?

If you are believe you have an allergic reaction to a certain ingredient then read the ingredients and avoid skin contact. A patch test of a small amount of product can be done by placing a little on the crook of the arm, if no irritation occurs within 48 hours you should be fine to purchase/use the product and not have an allergy.

For skin sensitivity you will need to trial the product on your face, by either using at the centre where you are thinking of buying it or by asking for a sample and using it at home. If the is any instant irritation then remove the product immediately with cool water.

If I have sensitive skin is it something that I will have forever?

You can correct and repair a sensitised skin condition but you can’t change a genetic pre disposed sensitive skin type. My best advise it to remove or protect your skin against the triggers that are known to sensitise your skin, such as the weather (sun, cold, wind), stress, alcohol, incorrect products and introduce calmative, anti inflammatory treatment products along with improving one’s lifestyle (diet, exercise etc.)

Can my diet affect my skin type?

Diet can’t change ones skin type. Certain foods and be irritating to the body and the skin causing sensitivity such as spicy foods, MSG, alcohol and even coffee. Eat good fats/oils found in oily fish, avocados, nuts etc.

Red berries and fruits full of bio flavonoids are great to help reduce redness as they work on helping strengthen the skin capillary network. Plenty of omega oils, essential fatty acids are key components for a healthy moisturised skin.

Please suggest a skincare regime for sensitive skin….

Choose products that are formulated and designed especially for sensitised and environmentally sensitised skin. Ensure they are free of irritants and fragrance, they are not aggressive but are made to respect skin health and contain anit inflammatories and cooling and soothing agents.

It is important to cleanse tone, protect, moisturise and gently exfoliate.

Cleansing: Choose a mild cleanser that contains only gentle surfactants (cleansing agents) ensure it has calming soothing ingredients and is soap free.

Exfoliation: Since you don’t want to over exfoliate or irate the skin but you do need to keep is soft, smooth and polished try using one of the new forms of micro foliation (a mini exfoliation process) the great thing about these products is that you can use them daily.

Microfoliants normally contain a rice-based powder, skin brighteners and anit inflammatories. If you are happy to keep your exfoliation down to twice weekly try using salicylic acid or lactic acid exfoliants over scrubs or peels as they can smooth the skin without any associated irritation

Masking: I’d recommend you apply either a cooling, hydrating gel mask or a reparative vitamin therapy mask (Vit B5) for 10 mins at least twice a week you can easily fit this in your routine as you can apply it whilst you’re getting ready in the morning or sitting in the bath at night or watching the TV, follow this immediately with a hydrating booster then seal in the effects with your moisturiser.

Moisturising: is a very important step. A moisturiser’s function is to seal and protect the skin from the environment. To reduce the need to apply lashings of your moisturiser (not only costly but unnecessary) to a skin that feels tight and has patches of dryness, firstly spritz the skin with a hydrating toner that contains Hyaluronic Acid.

The Hyaluronic Acid holds approximately a 1,00 times its own weight in moisture which means the skin will feel great, hydrated and moisturised because it works by evening the skins porosity (hydrates the dry patches).

Once spritzed, you will only need to apply about a pea sized blob of moisturiser. If you work in air conditioning then the spritz toner is a great product to keep in your handbag as you can spray a fine mist over your make up to rehydrate the skin and help avoid that 4 o clock parched look.

The best moisturiser for an impaired barrier function (goes hand in hand with dehydration) is one that is designed to actually repair it. Find moisturisers and therapeutic balms that will help shield the skin against the environment and control and protect the moisture loss of the skin. Look for the ones made with silicones that coat and protect the skin coupled with evening primrose oil and Shea butter to moisturise and prevent further moisture loss.

It is important to use a complete sun block this can be built into your moisturiser or a standalone sun block. It is advisable to use physical sun screens containing ingredients such as titanium dioxide as this are known to be less irritating to the skin.

You can find some great moisturiser’s with a natural green tint that will diminish the redness, the anit inflammatories will help control the redness and flushing and being an oil free hydrating formula it will be light enough to not irate the skin.

The ingredients commonly used to do this are:

Fumaric acid, Fumitory Extract combined with lemon fruit extract (protect against pollution).

Canadian Willowherb, Safflower oil, Hops, Rosemary, Horsetail and pinecone.

Cucumber, Echinacea, Wheat Germ Extract, Marshmallow, Comfrey, Raspberry, Grape Extract, Kiwi, Red Clover, Allantoin, Marshmallow, Raspberry, Water Lily, Panthenol. Vitamin E (Studies indicate that just 2 hours of exposure to ozone can reduce Vit. E in skin by 25%)

Silicones, Bisabolol, Wheat germ extract, Clinical Colloidal Oatmeal

I always give this advice to those with sensitive skin it’s called the less rule:

Less time, don’t spend too long a period of time in one session on your skin

Less product, limited number and quantity of product is used reducing the possible incidence of a sensitive skin reaction. If the skin is sensitised it does not appreciate being bombarded with a plethora of products all at once.

Less friction, avoiding using scrubs, a facial cloth or a facial cleansing brush machine, too much rubbing and avoid microdermabrasion etc.

Less heat, avoid hot water on the skin, hot facial towels and any heat like a sauna etc.