Sensitive Skin – What Can You Do?

By Dr. Brandith Irwin –

One of the reasons sensitive skin is so frustrating for those who have it, is that it’s not a medical term. So… people talk about it over lunch, you see ‘sensitive skin’ in the media, it’s in marketing materials and on product labels, but no one seems to agree what it means exactly.

So you, as a consumer, are left trying to sort it out on your own.

Dermatologists can help with this because we recognize different types of unpleasant skin reactions to products and environments. And we have pretty good ways to describe and treat them. But that doesn’t always help you at the time, especially if you can’t get in to be seen right away. For example, reactions to a skin care product might include hives (urticaria), irritant dermatitis (rash, little bumps or redness), just itching (pruritis), allergic dermatitis (a true allergic reaction), and the list goes on. Here’s what may help you!

Do you really have “sensitive skin?”
Here’s a questionnaire to help answer this question:

• Have you had more than 3 or more reactions to a skin care product like soaps, lotions, creams, shampoos, etc.?
• Have you had any reactions to sunscreens?
• Do you develop itching with skin or hair care products?
• Are you very careful when trying new products because you’ve had bad experiences in the past?
• Have you had reactions to prescription medications that are creams/lotions/gels etc.
• Do you have a history of allergies, asthma, eczema or hay fever? This alone does not qualify you, but statistically you have a higher chance of answering yes to the above.

You get the idea. There are exceptions to the above, of course, but this should give you a good start.

Why do I have sensitive skin?  
It’s important to distinguish between skin that gets easily irritated and skin that’s truly allergic. For example, if you have fairly normal skin and use a harsh scrub on it daily, you will get very irritated (red, even eczema) but you’re not ‘allergic’ to the scrub. This same principle applies to products – especially acidic ones. You may be fine with a Vitamin C serum that’s 10% but get irritated with one that is 20%. The same goes for certain glycolic products. But … you’re not truly allergic to it … just irritated by it. You may be able to use it just fine in a different formulation. An allergic dermatitis (reaction) occurs when your immune system gets activated against certain ingredients in the product causing redness, bumps, itching, even hives sometimes. Since there are so many chemical and plant based ingredients in each skin care product, it’s hard to figure out which ingredient(s) is causing the problem. If you are truly allergic to something, changing to a different formulation of it won’t help.

Why do I seem to keep getting worse?  
Our skin has a very important function as a barrier. It keeps bacteria/viruses/fungi, etc. out, it prevents harmful compounds/chemicals from getting into our bodies, it protects from heat, cold, water, sun and many other things.

When the barrier function of the skin gets disturbed by a rash or allergic reaction, many products that used to be fine may now cause irritation. You probably will be able to go back to those products once your skin has completely healed which can often take a month or more.

Can I identify which ingredient in my products is causing my problems?  
Yes, sometimes! Most, but not all, allergic reactions to products are caused by about 20 ingredients that are commonly used in skin care products. For example, high on the list are preservatives (there are often 3 or 4 in one product), lanolin (wool wax alcohol), propylene glycol, and fragrances.

There are others too, of course. If you want to know more exactly what the culprit is, call your dermatologists office and ask about testing for them – the term for this is patch testing.

In patch testing, small patches containing the possible allergic substances are placed on the back and left in place for about 72 hours. These are then ‘read’ by the doctor, and if you show positive for any, you will be given information on how to avoid them in the future. The most commonly used patch test system is call True Test. Some offices have several hundred antigens available for testing.

Common sense steps you can take for a reaction to a skin care product while waiting to see your dermatologist/doctor.

• Stop all your current products and change temporarily to a very bland lotion cleanser (like Cetaphil or Free & Clear) and bland cream or ointment (like Cerave, Vanicream or Cetaphil). If these products itch, burn or seem to make you worse, stop them and try Vaseline.
• Keep the affected area completely out of the sun and covered. If it’s your face, wear a large, brimmed hat.
• Also avoid cold, wind and longer exposures to water, especially swimming in chlorinated pools while you have a rash.
• Avoid heat, hot yoga and work outs temporarily.
• Don’t put home or drugstore cream remedies like lidocaine creams, Benadryl creams, or ointment antibiotics on it. Generally they will make it worse.
• You can try (cautiously) a little drugstore hydrocortisone cream on it in one spot only. If it helps, you can try it on the area. Don’t use this for more than a week without seeing your doctor.
• If you know you tolerate them, antihistamine tablets like Zyrtec, Benadryl, Claritin, etc. may be helpful.

Best Skincare for Sensitive Skin:

Product lines that are mild and generally better for sensitive and/or allergic skin problems:

• Cetaphil has one of the best moisturizer for sensitive skin and sensitive skin sunscreen
• Cerave is another great option for sensitive skin
• Vanicream Free & Clear is some of the best skincare for sensitive skin
• Clarisonic with Sensitive Skin Brush Head is one of the best cleansers for sensitive skin