LAWS OF REACTION // EXPLAINING SKIN SENSITIVITIES
“Sensitive” is a common word used to describe an individual’s skin type. Research indicates that about 50% of women and 30% of men identify as having sensitive skin. But what does it really mean to have “sensitive” skin? Sensitivity is a symptom of rosacea, but not all skin types that are sensitive have a skin condition like rosacea, eczema, dermatitis, etc. Diving into the research, we’ve learned that sensitivity is still a poorly misunderstood skin concern—but sensitive skin’s need to age gracefully too.
Very Sensitive: Reactive to a variety of triggers.
An individual with a truly sensitive skin type experiences painful or uncomfortable sensations accompanied by physical responses to a trigger. Common symptoms include localized areas of redness or flushing, burning or itching, and dry scaly patches. Generally, individuals who experience asthma or seasonal allergies, or have a history of eczema, may be more sensitive to inflammation in the form of dermatitis on the face, scalp, and/or body.
Rosacea is a type of skin sensitivity that displays the common signs of inflammation with visible broken blood vessels and, in some cases, skin thickening or acne. If rosacea symptoms are not managed early, it can lead to sensitized skin.
CAUSES AND TRIGGERS
Each person has unique responses to environmental, topical or inflammatory triggers. Most product-induced inflammatory reactions occur within 24 hours, however, when a client uses the same product for many years, their immune system becomes hypersensitive over time, building up to sensitivity.
Conditions like rosacea or psoriasis may also develop from inherited and environmental factors.
Generalized sensitivity can have specific or broad triggers.The best way to determine one's individual triggers is to temporarily quit their home care routine. Once the inflammation has subsided, they can restart their regimen with a gentle cleanser. After several days, if the skin is calm/balanced, a moisturizer can be added. The client should rebuild their regimen over a four to six week period. This gradual product introduction allows them to identify specific triggers.
Sensitive skin needs anti-inflammatory support, little-to-no stimulation, and an aesthetician's guidance. An ultrasonic facial that exfoliates the skin without triggering inflammation, assists with extractions, infuses anti-inflammatory ingredients and hydrates is a great option. Avoid chemical peel solutions, steam and hot towels, microdermabrasion, lasers, and IPL. Post treatment care includes a simplistic sensitive skin regimen and optimal sun care.
A home regimen for sensitive skin should incorporate multitasking products to avoid over-stimulating the skin with too many products. Pumpkin is one of the best ingredients for sensitivity and rosacea because it delivers fatty acids and vitamins that help address inflammation and enzymes that help improve texture for sensitivity and rosacea.
A great dietary rule for clients is to reduce inflammation and improve barrier function from the inside-out. Encourage sensitive skin clients to increase their intake of beneficial fatty acids and antioxidants, and avoid caffeine and spicy foods.
Addressing chronic sensitivity requires a commitment to some type of change. Once your client has identified potential sources of inflammatory triggers—dietary, environmental, and topical—they must avoid them as much as possible. When selecting products for their skin in the treatment room, first test patch the skin on the crease of the nose before applying it to the entire face.
Sensitized/Reactive: Strong inflammatory response.
This type of skin experiences a severe and painful inflammatory response from some kind of trauma.
**Aestheticians must communicate with clients. Especially when an individual undergoes a medical aesthetic procedure, like laser resurfacing or micro needling. If a client is experiencing abnormal inflammation, advise them to seek a medical professional to help identify the cause of inflammation and get fast relief. Sensitized skin could also be a sign of a severe allergy, autoimmune disease or infection.
CAUSES AND TRIGGERS
Sensitized skin usually happens within a short period of time due to over-use of skin care products or the wrong product combination. For example, individuals who suffer from acne have an increased tendency to sensitize their skin by overusing benzoyl peroxide, retinol, or other prescriptions.
Over-use of cosmeceutical exfoliants can increase sensitivity in most all skin types, and pairing over-exfoliated skin with a sunburn can cause painful inflammation.
Sensitized skin of the face, scalp, and other areas of the body can be the result of dermatitis, psoriasis, or eczema, and should be diagnosed by a physician.
This skin care regimen should be reduced to it’s bare necessities, as even products they've been using for years can have a cumulative inflammatory effect and trigger sensitized skin. If product use is the cause of sensitized skin, it should heal within a couple of months.
The client's' simple routine should consist of a gentle cleanser and zinc sunscreen. An OTC topical corticosteroid, antihistamine, and/or a cool compress can help manage inflammation.
Advise clients to consume plenty of fruits and dark leafy greens for their antioxidant and anti-inflammatory benefits. Avoid inflammation-triggering foods like soda, fried foods and refined carbohydrates. If the client's sensitized skin is a medical condition, an elimination diet may help identify any food-related inflammatory triggers.
When skin is highly sensitized and painful, consider most products are considered contraindications. In addition, prolonged sun exposure, outdoor activities, exercise, saunas, steam rooms and anything else that increases body heat can aggravate flushing, sensitivity, and prolonged inflammation.
Environmental: Occasional blushing/flushing.
Rosacea skin types are often identified as flushing in response to spicy foods and heat, however, facial flushing does not necessarily indicate rosacea or sensitive skin. There are three pigments in our skin give it color: melanin, hemoglobin, and carotenes. If your client's skin has a tendency to flush (face and body), it’s likely due to higher levels of hemoglobin and/or an increase in the number (or diameter) of skin capillaries.
CAUSES AND TRIGGERS
Excessive flushing and redness is not a condition that can be reversed. However, certain triggers can aggravate the symptoms. The most common are exercise, spicy foods, adult beverages, heat and intense emotions.
IPL photo facials, lactic peel treatments, and/or ultrasonic rejuvenation can help calm redness and may prevent worsening of the condition. Multiple sessions of IPL may be required to achieve initial results, followed by routine procedures of varying frequency.
Redness is primarily a vascular concern, so practicing optimal sun care helps prevent increased redness. Chronic sun damage contributes to thickening of the epidermal layers and the capillaries needed to nourish these layers, causing more redness. A comprehensive sun care regimen should include a sunscreen and antioxidant serum.
Advise flushing skin clients to consume antioxidant-rich foods like blueberries, grapes, cranberries, and dark chocolate to help improve blood circulation.
Never administer microdermabrasion on skin with redness or capillary damage that needs textural or sun damage concerns.
Delicate: Sensitive, but not responsive.
Tingling, burning, stinging or itching are common symptoms. There are no visual clues that indicate an inflammatory response is happening—because there aren't any. Delicate skin types may experience sensitivity from heightened sensory receptors. These receptors are also expressed in keratinocytes and can be responsive to skin care products and the environment.
CAUSES AND TRIGGERS
Each individual responds in a unique way to specific ingredients, and responses may only happen when the skin experiences specific environmental changes.
There’s no specific treatment available to remedy delicate skin types, however, there is no limit to treatment options appropriate for this skin type, including peels and high-tech treatments.
Hydroxy acids and retinols may be the primary culprits that cause a delicate skin type to respond, but L-ascorbic acid, retinol, benzoyl peroxide, and enzymes can also trigger a response in delicate skin. Test patch skin care products at the crease of the nose before applying them to the rest of the face to identify the specific triggers for each individual.
H. Lev-Tov, H. Maiback. (Nov-Dec 2012). The Sensitive Skin Syndrome. Indian Journal of Dermatology. 57(6): 419-423
M. Farage, A. Katsarou, H. Maibach. (July 2006). Sensory, clinical and physiological factors in sensitive skin: a review. Contact Dermatitis. (55)1, 1-14.
S. Stander, S. Schneider, C. Weishaupt, L. Misery. (May 2009) Putative neuronal mechanisms of sensitive skin. Experimental Dermatology. (18)5, 417-423.