Sensitive skin is experienced by millions of people as terse, reddened and flaky skin. The cause may be hereditary or psychosomatic or may be a reaction to external factors (cold, dryness and certain products). Sensitive skin can be treated, but it requires patience.
The concept of ‘sensitive skin’ does not appear in traditional dermatology manuals. Increasingly, however, more products are available for protecting sensitive skin and alleviating reactions to different stimuli. But how do we distinguish it from a skin that is temporarily reactive or from allergic skin?
Epidemiology studies to date cannot confirm whether sensitive skin, which affects 50% of the European population, is becoming a serious problem. In Spain in 2009, more than 11 million people said they had “sensitive or very sensitive” skin. Specialists like Laurent Misery, of the cutaneous neurobiology laboratory of the University Hospital Centre of Brest (France), are of the opinion that sensitive skin is a biological reality and that use of the term is appropriate. Others are of the opinion that it is a rag-bag term to explain allergic reactions or skins with a tendency to develop atopic or seborrheic dermatitis, rosacea or cuperosis. Ai-Lean Chew and Howard Maibach, dermatology researchers at the Faculty of Medicine of the University of California (USA) cited in numerous articles, simply state that “sensitive skin is a complex syndrome that perplexes doctors as much as patients.”
Why does skin become sensitive?
Skin hyperreactivity is subjective; in other words, our response to external factors like dry or cold weather, over-exposure to the sun or certain products (chemical and laser peeling, oral and topical retinoids, products rich in vitamin C and hydroxy acids) varies from one individual to another. A number of endogenous factors also affect skin sensitivity, including hereditary factors, systemic disorders and psychosomatic conditions.
Nonetheless, sensitivity is visible in very fine, delicate and white skin which reddens when the skin barrier is altered. These characteristics are accompanied by a wide variety of sensorial manifestations. For Dr. Leslie Baumann, dermatologist and director of the University of Miami Cosmetic Medicine and Research Institute (Florida, USA), inflammation is key; no matter the reason for the irritation, sensitive skins “have one characteristic in common: inflammation.”
The Spanish Academy of Dermatology and Venereology (AEDV) points out that people with dry skin tend to have sensitive skin, that this becomes more evident in dry weather and in winter and that the skin of children and the elderly is usually more sensitive, the former due to the lack of maturity of the skin structures and the latter due to the atrophy caused by ageing. The AEDV recommends identifying the disorders that cause more sensitive skin, such as rosacea, seborrheic dermatitis and others eczemas. This is an association that Misery and other scientists dispute. All agree, however, that assessment by a dermatologist is fundamental to distinguishing between sensitive skin and a severe allergic reaction to a specific product (redness, rash, itch, etc) so as to ensure the most suitable treatment.
How is sensitive skin treated?
The AEDV indicates that the treatment is often as simple as avoiding certain irritants that some specialists associate directly with cosmetics containing preservatives. The authors of a study titled Factors defining sensitive skin and its treatment report that products with minimum levels of preservatives and without surfactants improve the skin barrier and change the characteristics of a sensitive skin.
Juan Escalas-Taberner of the Son Espases University Hospital in Palma de Mallorca (Spain) recommends using fragrance-free products, avoiding soaps, exfoliators and products containing retinaldehyde or tretinoin, not using cotton to dry the skin, limiting alcohol consumption, protecting the skin from abrupt temperature changes, choosing smooth-textured moisturizers and, finally, accepting that the process is recurrent and requires a great deal of patience. And not just in reading labels. Misery, who has studied the psychological impact of sensitive skin and seasonal changes, acknowledges that sensitive skin has an impact on quality of life.
Meanwhile, the cosmetic industry is attempting to respond to consumer needs. “The term ‘hypoallergenic’ indicates that the manufacturers have done their best to remove common allergens and irritants from a product”, according to Dr. Susan Mayou of the Cadogan Clinic (United Kingdom) cited in the Daily Mail. She concludes that “it is less likely that hypoallergenic products will irritate your skin, but it’s not impossible”.