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.,

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Common skin infections are caused by bacteria [boils], fungus [tinea, candidiasis etc.,] or viruses [warts, herpes etc.,].

Skin infections almost always have certain underlying or predisposing factors. A compromised skin barrier often provides access to microbes to get into your skin.

Cracks in the skin are also a major concern. They can occur owing to extreme dryness, injuries, or other skin diseases.

The use of harsh soaps can likewise deplete the oil content of the skin and render it dry. Scrubbing the skin excessively while bathing, scratching etc., can also cause abrasions on the skin.

People who are prone to allergies have reduced local immunity. This makes the skin vulnerable. On the other hand, drugs such as steroids, and illnesses like diabetes, can increase the probability of infection. Being overweight, including excessive sweating, poor hygiene, poor nutrition etc., can also predispose us to infections.

Contrary to claims, the use of anti-bacterial soaps can destroy the normal skin flora and allow microbes, like Streptococci, to cause skin infections.

Infections of the skin may be localised to a small area, or extended to involve large areas. It is important to identify skin infections, promptly. Early and effective treatment can often cure skin infections – including problems that tend to stay put otherwise for too long.

Bacterial “bugs”

Bacterial infections present as reddish bumps; they are sometimes filled with pus. Common sites include our lower extremities – especially, legs. In children, it’s usually the face that is often affected.

Bacterial infections can spread to other areas of the body by contact; this may sometimes be associated with fever. Doctors often recommend the use of anti-bacterial creams, or oral antibiotics, directed against specific bacteria.

Boils occur over hairy areas and may be precipitated by shaving, waxing and tight clothing. Repeated boils over the beard area can cause scarring and permanent loss of hair.

Fungal incursions

Fungal infections are of three types. They characteristically affect certain parts of the body. Tinea, commonly known as ringworm, is seen as a red, ring-like lesion over body folds like the thighs, below the breasts, arm pits etc., It is often associated with intense itching. This is best treated by a dermatologist, or an alternative health therapist, with specific drugs for a specific duration.

Pityriasis versicolour is another common fungal infection. This is seen as multiple, tiny white patches over the neck, chest, back and face. The infection is usually precipitated by excessive sweating. This very common infection is caused by the fungus, Malazessia furfur. The infection can disconcertingly recur, again and again; fortunately, it is not contagious.

Candidiasis is a fungal infection commonly found between the toes, over the fingers, arm pits etc., It has a reddish tinge. It envelops moist areas and presents sometimes with intolerable itching. It is also commonly seen in the new-born in the neck region. Among housewives, it is generally present between the fingers and toes; in men, between the toes. In obese individuals and diabetics, the infection is commonly seen between the thighs and other folds. Keeping the area dry helps to prevent this problem. Anti-fungal lotions and creams, or pills, are often recommended for preventative and curative therapy.

Warts

Warts are benign growths caused by a virus. They are seen as brown-black growths with a rough surface. Warts often occur over the hands, feet, and face. They tend to spread to other areas of the skin through contact.

While some alternative therapies can help you get rid of warts, the most recommended form of conventional treatment is extraction. Warts may also be removed by electrocautery [application of a needle heated by an electric current to destroy the wart], chemical cautery, or cryosurgery [application of extreme cold to demolish warts].

Contagiosa molluscum, or small, flesh or red coloured, smooth-domed papules, are often seen as pearly growths, in children, and adults, whose immune system is compromised, or weak.

Herpes simplex virus infections are caused by viruses HSV-I and HSV-II, with the latter being sexually transmitted. It occurs in and around the mouth and genitals. It includes primary and recurrent infections. Most of us would have suffered a primary infection of HSV-I sometime during our lifetime, without even knowing about it. Recurrent infections occur following fever, stress, dental extraction, or cosmetic procedures on the face. Treatment with anti-viral agents when initiated as early as possible is most useful and effective.

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