Sensitive Skin? Take care

We often hear people complaining about sensitive skin. The point is: there is no common agreement as to what this means

Sensitive skinFor some, sensitive skin may mean stinging, or irritation of the skin on exposure to environmental insults such as the sun, heat or cold, or harsh winds. Or, application of skin care products such as cosmetics, soaps, sunscreens etc.,

Some others may demonstrate dryness, redness, flaking or pimples on applying skin products. And, in some it could be related to the underlying dermatologic [skin] conditions such as acne, or rosacea, or seborroeic dermatitis, atopic dermatitis etc., This is not all. Hives, contact dermatitis and irritant dermatitis are also perceived as manifestations of sensitive skin.

Sensitive skin is the type of skin that demonstrates greater reactivity, objectively or subjectively, to external factors such as chemical substances, environmental allergies, mechanical trauma etc., This, in turn, could emerge from factors such as heightened sensory inputs, augmented immune responsiveness, or compromised barrier function of the skin. Any one of these factors or all of them could lead to sensitive skin.

Common concerns

As many as 20-40 per cent of our population have sensitive skin. People with sensitive skin are those who have a family history of atopy [running nose or wheezing], or a dry, lustreless skin, especially in the elderly. Frequent and hot showers, or too harsh cleansers can compromise our skin barrier and, thereby, increase the sensitivity of the skin. Similarly, dry weather and air-conditioning also tend to make the skin more sensitive by increasing transepidermal water loss. People with a tendency for eczema are also prone to have a sensitive skin.

Some areas of the skin are more sensitive than the others. The sides of the nose and the nasolabial folds, the skin near the eyes, over the folds and over the hands and feet that are subject to maximum insults, are especially vulnerable.

Sensitive skin care is more than just choosing the right sensitive skin care product. Sensitive skin has a low tolerance level to certain products or environmental conditions. People with sensitive skin often react quickly to chemicals, heat or wind by developing red, blotchy and irritated skin.

Certain ingredients of skin care products can also sensitise the skin. Sodium laurel sulfate [a common ingredient of soaps, shampoos and cleansers], acetone and drugs like retinoids, alpha hydroxyl acids [AHA] etc., can cause irritant dermatitis. On the other hand, many herbal preparations like rosemary, sandalwood, arnica, natural oils like jojoba oil, tea tree oil and lavender oil, make-up ingredients like PABA derivatives, dyes, fragrances and preservatives can all cause allergic contact dermatitis and heightened sensitivity of the skin.

Hair removal products and waxes can also cause irritant dermatitis and chemicals like alcohol, ammonia, henna, menthol, benzoic acid etc., can cause contact allergy, resulting in irritation.

Close encounters with these agents can cause objective symptoms such as redness, swelling and oozing in some, while in others, water, wind and sunlight can cause subjective symptoms such as stinging and itching. Stress can also make the skin more sensitive to environmental insults.

Management

Natural skin care is an effective way of treating sensitive skin, because natural products are less likely to trigger allergies. Here are some of the best natural ways to treat sensitive skin -

  • Use almond or jojoba oil to cleanse your face
  • Comfrey steeped in water can make a good toner
  • Make a facial exfoliate by mixing grapefruit with oatmeal
  • Cucumber and yoghurt also make a good face mask for sensitive skin
  • Green tea has anti-inflammatory properties, which may help prevent sensitive skin reactions
  • Aloe vera can cause red, irritated and blotchy skin. Apply directly on the skin.

The first step in the management of sensitive skin is to identify known causes of the problem. A detailed history of various products that have been applied onto the skin would help in most cases. If necessary, a patch test may have to be performed to identify the offending agent/s.

  • People with a sensitive skin should discontinue the use of "offending" products and/or gradually reintroduce mild, surfactant-free products
  • Care should be taken with regard to make-up, including the use of nail polish
  • Cleansing should be gentle and infrequent
  • Use of skin care products should be limited to mild liquid cleansers, chemical-free, physical barrier sunscreens like titanium dioxide, or magnesium oxide and a bland, gentle moisturiser
  • Empathy from care-givers and techniques of relaxation would help those who are frustrated with the problem.

Needless to say, responsible marketing of cosmetic products and openness about declaring the constituents on labels would certainly make things easier for the cosmetologist and the patient alike in identifying offending agents and choosing a suitable product for use.

When choosing make-up, especially foundation and blush, buy oil-free products. Make-up that is water-based won't clog pores. Look for oil-absorbing foundations that help keep oil off the face. As for the rest of your body, check ingredients and avoid harsh chemicals in soaps, shampoos, body cleansers, creams, bath oils etc.,

Skin Care at Work

At work our skin is exposed to a variety of substances and environments which can aggravate sensitivity. The skin is a complex structure. It is the body's first line of defence against physical, chemical and microbiological hazards.

The skin is absorbent to some substances and this can be exploited to administer drugs topically.

There is a delicate balance to be maintained in cleansing and protecting the integrity of the skin while preventing damage such as dermatitis. Prolonged exposure to some substances, even hot water, can challenge the skin's protective mechanism.

  • Direct and indirect heat can alter the make-up of skin cells altering the amount/nature of natural fats on the surface
  • Cold can reduce circulation to the periphery and can result in dry skin
  • Sun UVA and UVB rays can burn the skin, cause dryness and skin cancer
  • Wind can also exacerbate the effects of cold and UV light
  • Sharp items break the continuity of the barrier and predispose the body to infection
  • Excessive moisture [including sweat] can both irritate and increase its permeability
  • Abrasive materials can rub away the outer surface exposing the more delicate dermal layer as well as nerve endings and capillaries
  • Dirt and grime can aggravate the skin by blocking pores and reducing its ability to sweat.

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