As they suffer from mild-to-severe sensitive skin, they may also experience other common conditions like hyperpigmentation, aging, acne, and rosacea. As this is a concern that many women and men experience, skin care professionals should have the ability to identify different types of sensitivities in order to provide an effective treatment plan and homecare regimen. This can be done through consultation, increased awareness of some of the potential causes of sensitive skin, and by helping clients discover viable ways to meet their skin care needs with products and treatments.
Although the direct cause may be unknown, there are several ways to help identify the source of sensitivity. Every professional’s first step in resolving skin care concerns is a consultation with the client. Read the client’s intake form – this form should have several questions regarding their skin, how they perceive it, the current products they are using, and their primary concerns. Talk to them about their skin and perform a thorough skin analysis. As a professional, this process can help identify the type of sensitivity that may be occurring, in order to provide an effective treatment and homecare regimen.
As skin ages, it either becomes drier with each passing decade or we begin to experience dryness with seasonal changes. In many cases, eye area sensitivity has also been a concern. Dry skin results from a decrease in oil production that can lead to poor barrier function of the skin, causing the client to possibly experience tight-feeling skin, rough texture, dullness, fine lines, less-supple skin, itching, redness, or irritation. Severely dry skin may have microscopic wounds or cracks in the barrier that can increase the risk of burning, irritation, and infection. Moisture and hydration are two necessities for dry, sensitive skin. A minimal regimen should be followed in order to prevent excessive stimulation and inflammation. Applying a light layer of a petroleum-based balm helps reduce transepidermal water loss and offer longer-lasting comfort and protection. Exfoliating enzymes and hydroxy acids should be used sparingly and with caution because these ingredients can trigger inflammation in the skin. Just remember to keep it simple.
While redness and inflammation are two key side effects of contact dermatitis, identifying the source of the concern is difficult because it may be the result of an allergic reaction or an irritant. Allergic contact dermatitis occurs when the immune response is activated, resulting in small, raised white bumps with redness and warmth. The reaction may happen within one to 10 days after exposure to the allergen; pinpointing the allergen can be a challenge because it may be botanical or metal. Irritant contact dermatitis generally presents with redness, swelling, and scaled/rough patches of skin. Exposure to harsh chemicals, soaps, or fragrances may lead to this type of skin sensitivity. Dry, impaired skin may also suffer from an increased risk of irritant contact dermatitis. First and foremost, consult with the client on their product use over the past week and have them describe the severity of contact dermatitis they are experiencing – it may be best to discontinue all cosmeceutical product use and refer them to a physician immediately. In some cases, a topical over-the-counter costicosteroid ointment and/or oral antihistamine can help manage the inflammation before the client sees their physician. Because there is such a broad range of potential allergens and irritants in cosmetic products, it is best to start their regimen with a gentle cleanser, moisturizer, and sunscreen. Depending on how their skin reacts, products may be changed or added to their rejuvenation regimen and assessed regularly.
Similar to irritant contact dermatitis, individuals with photosensitivity can present with itching, redness, irritation, or burning with sun exposure. In more severe cases, rough and raised skin patches, hyperpigmentation, or blistering may occur. Fitzpatrick skin type I has increased photosensitivity, but most cases result from the use of perfumes and some medications, including antibiotics, antifungals, coal tar derivatives, retinoids, non-steroidal anti-inflammatory drugs, diuretics, and anti-depression/anxiety. Clients experiencing chemotherapy may also have a tendency toward increased photosensitivity. Skin care professionals can suggest a beneficial antioxidant serum and sunscreen to help minimize skin burning and inflammation, while advising the client on additional sun protection measures, including a hat, protective clothing, and minimized time in the sun.
Burning, Tingling, and Stinging
When a product is applied to the skin and a burning, stinging, or tingling sensation occurs, it can be difficult to gauge the severity of the sensitivity because it is a sensation and not a visual clue. If a topical skin care product, when applied to the skin, is causing one of these sensations, encourage the client to rate the feeling on a one to 10 scale, with a one being no sensation and a 10 being unbearable burning. Ask if there are any other visible clues like redness, warmth, or breakouts. Product ingredients that are active may cause some form of a tingling sensation when applied, depending on the client’s sensitivity and amount of active ingredient in the product. Some examples of common sensation-inducing ingredients include glycolic acid, lactic acid, and L-ascorbic acid. Light tingling with active ingredients may be considered safe, whereas mild burning or stinging, with or without redness, may indicate that the product is not beneficial for their skin. Skin care professionals should use their best judgment and always err on the side of caution.
Roseacea and Acne
Inflammatory conditions of the skin can increase an individual’s risk of sensitivity. In its early stages, rosacea can be defined by sensitive skin and capillary damage with persistent flushing, as a result of climate changes, food sensitivities, and exercise. Managing the condition with prescription medication, a gentle cosmeceutical skin care regimen, light peeling services, and avoiding common triggers of inflammation is essential to help prevent more severe symptoms. Not everyone with sensitive skin has rosacea, which is why a dermatologist’s diagnosis early on is the smartest option for this condition. Acne is a condition of the pilosebaceous unit and, like rosacea, can be mild to severe. The over-
production of oil impairs the skin’s ability to properly desquamate, resulting in a blemish, while infection of the follicle breeds inflammation, redness, and an increase in skin sensitivity. Benzoyl peroxide, salicylic acid, and prescription retinoids are the most widely used ingredients to combat acne. As actives, overuse of these ingredients can also increase the risk of sensitivity and inflammation. Keeping acneic and rosacea skin conditions calm by reducing inflammation can be achieved with minimal product use, prescription care, routine extractions, or light facial peel services.
Healthy Practices for Sensitive Skin
There are many products formulated for sensitive skin. Depending on the type of sensitivity the client is experiencing and the immediate concerns they have, a beneficial combination of products can be suggested. The first step in determining the best regimen for sensitive skin is a thorough consultation and skin analysis. Sensitivity to a product or ingredient can vary between individuals and, at some point, even products formulated for sensitive skin may induce a reaction. In some cases the reaction is fast. A cream is applied to the skin and the skin reacts with burning and redness. It is safe to conclude that the cream is a problem and the client should discontinue using it. However, some reactions may take weeks or months to surface. Even though the client has been using the same cream for nearly a year, it could induce an allergic reaction or the sensitivity may emerge from a combination of variables.
According to the American Academy of Dermatology, fragrances are a common concern for individuals who are prone to allergic reactions. On the ingredient deck, they are listed simply as ‘fragrance.’ However, there are over 1,000 different chemicals and natural oils that can create a fragrance, and many can increase the risk of allergic contact dermatitis. This not only applies to skin care products, but perfumes, body products, and hair care. Although more manufacturers are using natural essential oils to enhance the aroma of a product, the risk of sensitivity is not always reduced. Use caution when choosing a product labeled as hypoallergenic or dermatologist recommended. These claims are not backed behind federal standards for defining or testing a product, unlike gluten-free or organic claims. In addition to fragrances, sensitive skin types should also limit or eliminate the use of hydroxy acids due to increased inflammation and burning of the skin.
As mentioned previously, there are many variables to consider when treating sensitive skin. In some cases, the client may be inducing skin sensitivity from product overuse or a poor combination of products for their skin. The most frequent product over-users tend to be middle-aged women overusing their prescription retinoid, or acne sufferers, who sometimes presume that a lot of product applied excessively will help cure their skin. Unfortunately, too much of a good thing can result in adverse side effects like sensitivity, dryness, skin peeling and sloughing, and inflammation. Less is more when it comes to active ingredients and, more importantly, make sure the client is using a beneficial combination of ingredients for their skin type and concern. For example, an adult woman with dry skin experiencing acne breakouts on her chin should not use a comprehensive acne regimen. It will most likely increase her dry, dull skin and increase sensitivity to other products. She needs a beneficial balance of hydration, moisture, and protection in her regimen with a targeted spot treatment for breakouts.
Listen to your client. When they mention that they have sensitive skin, listen to them. In many cases, the skin does not look sensitive upon analysis, but always err on the side of caution to help prevent an adverse reaction. Refer back to some of the potential causes of sensitivity previously listed. Each one may present a little differently, depending on the client’s skin, and they may have sensitivity paired with another skin concern, including hyperpigmentation, acne, or aging.
Improper use or dose of prescription retinoids can increase sensitivity. Have the client consult with their prescribing physician. As their skin care professional, help guide them on the beneficial uses of the prescription, while keeping their homecare regimen targeted to prevent further inflammation. Clients prone to sensitivity should avoid fragrances completely. This includes skin, body and hair care products, and scented laundry detergent. They should also opt for less-harsh cleaning products to use at home or wear protective clothing if they are going to be handling cleaning products.
As clients suffer from mild to severe sensitive skin, professionals should have the ability to identify different types of sensitivities, in order to provide an effective treatment plan and homecare regimen. As a professional, this process can help identify the type of sensitivity that may be occurring, in order to provide an effective treatment and homecare regimen that targets the client’s concern and puts them on the best path to rejuvenation.
Tina Zillmann is the founder of Advanced Rejuvenating Concepts and Skin Rejuvenation Clinique. As a business owner, aesthetician, product developer, and licensed laser professional, she is fluent on all aspects of the aesthetic business. She has been awarded on television and in print as a local skin care expert in San Antonio, Texas and nationally as a public speaker and published writer in the skin care industry.