Ongoing medical breakthroughs have broadened the treatment options in the field of antiaging. These innovations give patients the desired benefits with faster onset and longer-lasting results.
Experienced professionals can choose simple treatments, like facials, exfoliation, dermabrasion, and dermaplaning, and light-based therapies, such as laser, IPL, and LED treatment. For more dramatic results, professionals can use botulinum toxin and filler injections before considering surgeries.
These treatments work exceedingly well, but they can potentially cause significant side effects, especially when used aggressively on clients with skin sensitivities.
This short review will discuss skin sensitivities and highlight procedures that may worsen them. Lastly, it will provide cautionary guidelines for professionals to deliver the best care to this group of clients.
SKIN SENSITIVITIES
Sensitive skin is a vague description, and a large portion of Americans believes they have it. In one study, 40% of women reported having sensitive skin, as manifested by stinging, burning, or an itching sensation. In addition, many people also report to have frequent breakouts and cannot tolerate many skin care products.
Having skin sensitivities is different from having an allergic or photoallergic reaction. In an allergic reaction, allergens or ingredients trigger a host of immune reactions that present with an itchy rash. Common offenders include ingredients in the category of fragrances, preservatives, surfactants, or emulsifiers. Photoallergic reaction results from the combination of ultraviolet or visible light interacting with the allergens and ingredients that trigger the breakouts of an itchy rash. Common offenders include sunscreen filters (oxybenzone), high blood pressure medication, and even lime in drinks. Anyone can develop allergic and photoallergic reactions, but people with skin sensitivities have a high propensity to develop these kinds of adverse reactions.
STRATUM CORNEUM – THE KEY TO BARRIER FUNCTION
People who have skin sensitivities tend to have weakened or porous skin barriers. Anatomically, the skin barrier refers to the stratum corneum, the outermost layer of the epidermis. This is a thin layer of dead skin that is only 10 to 40 micrometers in thickness.
An intact skin barrier serves multiple functions, such as regulating transepidermal water loss and blocking allergens, irritants, and bacteria from entering the living portion of the epidermis and dermis. Factors that disrupt the physical integrity of the stratum corneum and weaken the skin barrier can lead to worsening of skin sensitivities.
COMMON PROCEDURES THAT DISRUPT THE SKIN BARRIER
The first step of any routine facial treatment involves cleansing the skin. Astringent cleansers, combined with a toner, not only remove dirt and makeup, but also superficial layers of the stratum corneum. When combined with a toner and excessive exfoliation, deeper layers of the stratum corneum are removed. These mechanical and chemical forces weaken the skin barrier.
Common procedures such as dermaplaning, microneedling, and dermabrasion definitely break the barrier. Dermaplaning removes vellus hair and dead layers of skin by scraping the skin with a blade. Dermabrasion removes portions of the stratum corneum and polishes the skin’s surface, making it smooth. Microneedling physically punches tiny holes through the stratum corneum. The extent of barrier disruption depends on the length of the microneedles and number of passes in each treatment.
CAUTIONARY GUIDELINES
Caution must be exercised when performing spa procedures in clients with skin sensitivities. Otherwise, there is an increased risk of the client developing potential side effects such as rash, acne breakouts, flareup of diseases, and, worse yet, bacterial and viral infections. On a less severe note, clients may look and feel better when they leave the office but will have no improvement or will complain about other unexpected and unwelcome results.
Aside from obtaining a good history before any service, professionals should consider reducing the intensity, concentration, depth of penetration, frequency, and duration of the treatment to prevent potential damage to the skin barrier. This principle is especially important if practicing in a colder climate and during the winter months.
For those with known skin sensitivities, prescribe a skin care regimen with products that are not harsh or irritating to the skin. Also, educate clients on using a simple regimen after an invasive procedure.
A large portion of Americans have skin sensitivities. Chances are, a skin care professional will encounter a few of them every day in their practice. Recognizing the signs and symptoms and tailoring treatments accordingly are important steps in ensuring optimal results.
Dr. Steven Q. Wang is the director of dermatologic surgery and dermatology at Memorial Sloan-Kettering Cancer Center in Basking Ridge, New Jersey. Aside from caring for patients, he is actively involved in clinical research, with a focus on photoprotection, antioxidants, nanotechnology, antiaging, and natural skin care formulation. He is the author of more than 80 publications in peer reviewed scientific journals and academic textbooks. He has authored five books and lectured extensively in the United States and around the world. In recognition of his expertise, he has appeared on several television and radio programs and has been interviewed by media such as the Wall Street Journal, New York Times, and Oprah Magazine. In 2016, he cofounded the Dr Wang Herbal Skincare company with his father, Gui Wang, who is a licensed acupuncturist and herbalist in New York City, New York. Their philosophy is to combine the best of herbal Eastern tradition with Western science to help consumers and patients to attain healthier and more beautiful skin. Their simple and effective antiaging skin care products are manufactured without the use of heat, thereby protecting the integrity of actives and nutrients in the products. drwangskincare.com