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by Dr.Jing-Long Zheng

Truth about sensitive skin - Dermatologist's take on living with sensitive skin!

Lifestyle changes and mandatory mask wearing during COVID-19 pandemic have made skin sensitivity a common issue among clinic patients. However, the public in general has inadequate knowledge about sensitive skin and the ingredients to look for in skincare products. To improve sensitive skin conditions, we must address the root cause or risk worsening sensitivity. In this article, we will take a look at the science behind sensitive skin as well as the right treatments for the problem. 

Sensitive or allergic? The two are different conditions 

Although the term "sensitive skin" is commonly used in conversation, it is not a clearly defined medical term. Generally speaking, "sensitive skin" refers to "skin that has low tolerance for external irritation," and the discomforts associated with such irritation may include: burning sensation, redness, itchiness, pain, roughness, tightness, flaking, and rash. "Allergy," on the other hand, is an inflammatory reaction caused by the skin coming into contact with certain allergen; for example, some people are allergic to animal hair, and simply by avoiding contact with allergen will gradually eliminate skin discomfort. Medical intervention may be required in severe cases of allergy. Although the underlying mechanisms are different for the two conditions, they do share similar discomforts such as redness, flaking, dryness, itchiness etc., therefore it is important to determine the root cause before applying solution. 

 

Symptoms of skin sensitivity may range from slight discomfort and dry itch on the minor end to swelling and painful itch on the more severe end. Most of the discomfort and be eliminated through general skincare, but if discomfort persists, it is recommended to seek professional medical assistance.

Causes of sensitive skin

Reports of sensitive skin have increased progressively in recent years. According to survey, 70% of people have problems with skin sensitivity, and 30-40% of whom have medium or severe level sensitivity. Only a small percentage of these people were born with weaker skin barrier, more fragile blood vessels, and congenital skin conditions such as atopic dermatitis and rosacea, while the majority had developed poor skin health due to "external factors" such as:

1. Environmental changes (e.g. UV ray exposure)

2. Climate change

3. Air pollution

4. Improper cosmetic treatment

5. Improper skincare routine

6. Prolonged mask wearing

7. Other internal factors: change of lifestyle, lack of sleep, dietary habits etc.

So what is it that makes our skin sensitive to irritation? First of all, cells in the stratum corneum may be misaligned or in such disarray that weakens or damages the skin's function as a barrier, which results in loss of moisture and lipids and opens the skin to contact with foreign substances. Upon contact with irritable substances, the nerve cell sends signals that trigger a series of inflammatory reactions, and this is when we experience mild symptoms of sensitivity such as dryness, dry itch, and slight discomfort. The skin is still in a relatively healthy state at this point, but sensitivity may escalate if proper relief and repair actions are not taken. If the skin stays in an inflamed state for extended period of time, we may deplete the skin's antioxidant reserve and cause damage to cell function, which ultimately results in a breakdown of collagen and speeds up aging, making the skin look dull and inelastic. For this reason, we should adopt appropriate prevention and care based on the degree of sensitivity experienced to return our skin to its healthy state.

Figure: An explanation to sensitive skin

Prevention of sensitive skin

People with sensitive skin may try to prevent irritations by making the following lifestyle changes:

1. Sleep:
Maintain regular and adequate sleep while avoid staying up late at night. Doing so would prevent the sebaceous gland from becoming over-active due to disruption of circadian rhythm or inadequate sleep.

2. Diet:

Avoid sugary, salty, fatty, and highly processed or refined foods, as they have negative impacts on the body and the skin. You may also consider supplementing vitamin C, vitamin E, D3, and calcium.

When you order your next cup of tea, be extra careful about the amount of sugar added to it, or consider switching to sugarless green tea entirely for the added anti-oxidation benefits. Do take note that alcohol is something we must reduce or eliminate entirely. People with rosacea, in particular, are very likely to experience a rise in skin temperature along with redness and discomfort after consuming alcohol.

3. Skin cleaning and care:

People with "sensitive skin" should not try to remove dead skin cells too excessively as part of their skincare routine, and should avoid using facial cleansers that are too powerful. People with weak skin barrier may consider choosing skincare products that are designed specifically for sensitive skin.

 

Avoid washing body or face at too high temperature, as an increase in skin temperature may cause discomfort.

Furthermore, sun protection is also something that people with sensitive skin should pay attention to.

Skincare ingredients suitable for the sensitive skin

You may choose skincare solutions based on the type of symptom experienced:

 

● Minor sensitivity: for non-recurring and short-term discomforts such as dry itch, minor flaking, and dryness, try using products that contain hydration or relief factors such as hyaluronic acid, ceramide, natural moisturizing factor (NMF), ocaline etc., as well as vitamin B5 for barrier repair and hydration and niacinamide (B3) for relief and whitening.

(Relevant reading: The right hydration ingredient for you! Save time and achieve more with the right choice!)

● Minor to medium/severe sensitivity: if you experience recurring or long-term discomfort such as swelling or painful itch, you will need ingredients that offer stronger relief and reparative properties. Skincare solutions that contain "licorice extract," "cica extract," and "vitamin B5" are ideal choices.

● To lessen sensitivity of the skin: people who have sensitive skin, atopic dermatitis, or are prone to dry itch in winters should pay more attention on keeping the body hydrated. Do not shower at too high a temperature, and make sure to apply lotion after shower. Consider choosing lotions that are made with oats to relieve and reduce sensitivity of the skin. Generally speaking, secretion activities of the sebaceous gland decrease with age, and you should increase the frequency of lotion use if you feel itch in the body.

● Care for combination sensitive skin: in the clinics, we often see people who have sensitive skin in the cheeks but dry or oily skin in the T-zone. For mixed skin patients, it is advisable to care for different skin conditions separately. For example, people whose cheeks are prone to redness, swelling, or painful itch may use solutions with reparative ingredients to relieve discomfort in that area; if slight discomfort occurs in other dry skin areas, use product with hydration ingredient to relieve the discomfort.

(Relevant reading: Hydration for the skin)

● Ingredients to avoid for the sensitive skin: alcohol, artificial fragrance, coloring, and paraben are common additives found in products on the market. Consumers should avoid them as they tend to irritate the skin.

 (Relevant reading: Cleaning, hydration, and sun protection - the three essential steps of skincare!)

● High-concentration and high-purity ingredients for skin sensitivity: concentration and purity of ingredient are also important points to consider when choosing products. Higher concentration allows a product to deliver its intended benefits more effectively, whereas higher purity level ensures the absence of impurities and minimizes chances of irritation. 

Sensitive skin and masks

In recent years, the clinic has seen an increase in the number of patients seeking medical attention for skin sensitivity caused by prolonged mask wearing. Most of these patients experienced increase in acnes, because face mask increases skin temperature and secretion of sebum; the next common condition was rosacea, as rising temperature in the face causes vasodilation and worsens redness and itchiness.

 

For discomforts caused by mask wearing, we recommend using skincare solutions with reparative ingredients. If you experience dryness or flaking, try opting for solutions that contain hydration factors such as hyaluronic acid, squalene, and NMF, ocaline, as well as vitamins B5 and B3. For people who experience recurring and more severe discomfort from sensitivity, we recommend choosing products that contain cica extract and licorice extract. Do take note that expensive skincare solutions do not guarantee better results, what's more important is choosing ingredients that are right for you.

 (Relevant reading: Are you a victim of these hydration myths? Dermatologist unveils the key to "hydration")

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