Sensitive skin and rosacea

Sensitive Skin and Rosacea

It’s easy to take skin care for granted when someone doesn’t have sensitive skin. You may like a certain skin care brand but some of the products may give you a negative reaction whereas others do not. It’s frustrating, time-consuming, and expensive to try different products to see which ones won’t trigger a reaction.

Why is my skin so sensitive? Why does it get sensitive to certain products and not others? Do I have rosacea? What can I do to prevent and treat this?

If these are questions that you’ve been seeking the answers to and more, continue reading below!

What is sensitive skin? Do I have sensitive skin?

Sensitive skin can be a natural phenomenon as some individuals are born with more sensitive skin than others due to a genetic difference in the protective skin barrier or because their immune system is overreacting to an irritant or allergen on the skin; or sensitive skin can be a non-permanent result caused by multiple factors (which will be discussed below).

Sensitive skin can be seen in two ways: objective or subjective. Objectively sensitive skin is when we see visual manifestations such as erythema or papules. Subjectively sensitive skin is when the individual feels sensations such as skin dryness, tightness, irritation, or burning. You might have sensitive skin if your skin experiences these objective or subjective symptoms.

60-70% of women and 50-60% of men self-reported having sensitive skin. The higher incidences for women might be because women tend to have thinner skin than men, and are more exposed to products (such as makeup) which increases the chance of exposure to triggering ingredients.

Just like other skin conditions such as acne and hyperpigmentation, anyone can develop sensitive skin. In the next section, we’ll explore what causes skin to be sensitive in the first place.

What causes my skin to be sensitive?

Sensitive skin can be caused by multiple factors such as someone being naturally prone to triggers; external factors like the weather or ingredients from products; and underlying skin issues.

Sensitive Skin causes

1. Age, gender, and area

Age, gender, and the specific area on your face/body may influence your skin’s sensitivity. You may be more prone to sensitive skin as you age since skin gets thinner and drier with time, which means that your skin barrier function is more compromised. This causes more irritants to penetrate your skin and cause symptoms of sensitive skin. Thin skin is also more prone to flushing due to increased barrier damage and vascular reactivity. In addition, men tend to have thicker skin than women meaning that their skin barrier is less susceptible to damage. Moreover, the face is usually more sensitive as facial skin is relatively thinner than other parts of the body, there is a greater use of cosmetics in this area, and more nerve endings are present on the face.

2. Climate and temperatures

In addition to natural causes, external causes can induce sensitive skin. Indoor air such as air conditioning or heater as well as climatic factors like hot/cold weather, drier climates, wind, etc. can increase water loss thus increasing skin sensitivity. And that’s not all – pollutants can penetrate your skin barrier and unprotected sun exposure cause photosensitivity. Just as a reminder, do not use chemical sunscreens especially if you have sensitive skin since the ingredients get absorbed into your skin and cause unnecessary irritation (read more about chemical sunscreens here).

3. Skin care ingredients

Specific ingredients may also trigger a negative reaction. For example, glycolic acid is one of the gold standard ingredients for chemical peels (you may read more about chemical peels here. However, glycolic acid’s molecule size is small and penetrates fast and deep into the skin which may cause irritation in some individuals. In this case, lactic acid is a great alternative since the molecule is bigger so it penetrates slower and triggers less of a reaction. It should be noted however, that while your skin may seem sensitive at first, you can build tolerance to ingredients i.e. you may have a reaction for the first few uses but this will get better with increased use. Other key skin care ingredients that may cause initial reactions include: benzoyl peroxide, retinol, and vitamin C (L-ascorbic acid).

4. Skin's pH level

In other cases, products may disturb your skin’s natural pH level (around 4.5 – 5.5). Your skin’s pH levels are challenged each day by pollutants, foods you eat, skin care products, and more. Once your skin’s pH levels are disturbed, it may break your skin’s healthy barrier thus amplifying sensitive skin symptoms and making it prone to infection as well as increased susceptibility to dermatitis and rosacea.

5. Underlying skin condition

Lastly, you may have an underlying skin condition such as dermatitis, psoriasis, or eczema where the skin’s barrier function is already sensitive or already has inflammation which amplifies these skin reactions. People often mistake rosacea as sensitive skin but these conditions are not the same condition. So how do you tell if you have rosacea, sensitive skin, or both?

Is Rosacea and Sensitive Skin the same?

Sensitive skin and rosacea may be related but they are not the same condition. In many cases, sensitive skin can be solved by avoiding triggers whereas rosacea is more complicated.

Rosacea is a chronic inflammatory skin disease that affects 5.46% of global adult populations. Though many studies have been conducted, its cause is not clear. However, it is largely influenced by genetics as you are more susceptible to having this condition if you have family members with Rosacea. Rosacea can affect anyone but mostly occurs in white middle-aged women with fair skin.

Rosacea often goes undiagnosed because it usually shows up during adulthood and overlaps with other skin conditions. For example, rosacea and acne seem similar because both involve papules and pustules (pimples); dermatitis usually go hand-in-hand with rosacea; and flushing i.e. red skin is commonly seen in all sorts of skin diseases. However, two very diagnostic features of Rosacea are phymatous signs (such as enlarged pores and nodular irregularities) and persistent erythema. All other signs are secondary features that may or may not be present.

Rosacea can occur by a variety of factors that are similar triggers for sensitive skin such as: heat/cold, UV radiation, eating certain foods/drinks, using improper skin care ingredients etc. It is best to avoid aggravating rosacea and treat it as you would any type of skin irritation.

So how do you treat sensitive skin?

Treatment for Sensitive Skin

The symptoms for sensitive skin may be frequent as many of the treatments cannot necessarily treat the root of the issue but helps reduce the symptoms. The best way to combat sensitive skin (and rosacea) is to avoid triggers, control symptoms, and do laser treatments.

Treatment for Sensitive Skin

Avoid triggers:

  1. Wear sunscreen! If you have sensitive skin, you should wear sunscreen as UV rays are one of the most common triggers since sun is everywhere. Proper sun protection is inarguably the most important part of skin care as it prevents all sorts of skin conditions such as acne, hyperpigmentation, premature aging and more.
  2. Find the right products for your skin. You need to be careful about the products you use on your skin whether it’s makeup or part of your daily skin care routine. Many products on the shelf contain irritating ingredients such as alcohol and fragrances, and the purity of the ingredients are questionable. You may also react negatively to one chemical but your friend might not – it can truly be an exhausting and expensive journey to figure out the right products for you.
  3. Protect your skin’s natural pH. Also, some products alter the natural pH of your skin, compromising your skin’s barrier and causing inflammation. To avoid stressing your skin, you can use products that are close to your natural pH level or use toners to bring your skin’s pH levels back to normal.
  4. Avoid shaving and waxing. Avoid shaving/waxing if you can – if this is not possible, make sure to moisturize your skin adequately. Shaving/waxing damages the superficial layer of your skin each time, leading to increase symptoms of sensitive skin. One of the best methods to avoid shaving/waxing in the first place is to get permanent laser hair removal so that you don’t need to damage your outer skin barrier.
  5. Make better food choices. Certain foods may trigger sensitive skin such as alcohol which can actually cause broken vessels that are permanent damages to your skin and are easily visible.

Control symptoms:

  1. Keep using sunscreen. Sunscreen is not only important in preventing sensitive skin triggers but protecting it from getting any worse. You should wear broad-spectrum mineral-based sunscreen as this type of sunscreen will not be absorbed by your skin and irritate you further. To learn more about the difference of mineral (physical) vs chemical sunscreen click here.
  2. Use a gentle cleanser. If you already have symptoms of sensitive skin, using non-irritating skin care products is critical in calming and controlling your skin. Not all cleansers are the same since there are different types for different skin types. Many skin care products will use the terms “for sensitive skin” but actually isn’t. Usually, reputable sensitive skin products will be recommended by dermatologists and/or be pharmaceutical-grade products.   In general, look for cleansers that are alcohol and SLS-free. 
  3. Antioxidants (vitamin C) will neutralize harmful irritants. Free radicals, pollution, and other irritants in the environment constantly targets your skin. Antioxidants (mainly vitamin C) neutralizes these irritants, preventing them from damaging your skin. 
  4. Moisturize and repair your skin. Products that moisturize your skin and repairs the health of your skin barrier are key factors in reducing dryness, itching, redness, and providing calmness to your skin. Choose hydrating moisturizers with ingredients like ceramides, glycerin, dimethicone, or hyaluronic acid.
  5. Avoid fragrances. One of the easiest ways to spot irritating products is to avoid any ingredients that include “fragrances”. Fragrances are unnecessary ingredients that just “make it smell good” but can be the cause of many symptoms on your skin. Using skin care products with fragrance is almost like spraying perfume directly onto your face!

Intense Pulsed Light Treatments:

Lastly, for symptoms that are persistent or permanent, Intense Pulsed Light (IPL) treatment is an option. Sometimes, the redness you see on your skin is from broken capillaries and can only be corrected by IPL treatments. Broken capillaries can be caused by multiple factors such as scratching your skin; when you try and pop your acne; straining your face; unprotected sun exposure and more.

IPL treatments also thicken your skin so that it is less susceptible to damage and visibility of redness is reduced.

Questions or Comments?

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