We all have sensitive skin. But when it gets hypersensitive we need to take extra care to keep it looking good.
“I can’t use Product X; I’ve got sensitive skin.”
Whenever I hear someone say this, my inner skin biologist has a wry smile.
But I do know how much it affects people. One of my sisters, one of my daughters and some friends with “sensitive skin” have asked my advice, and it’s not always easy to give.
First let me explain the wry smile. Skin is designed to be sensitive, and sometimes, when things get out of control, it becomes hypersensitive.
Many of us will recognise this: everything hunky dory then something will cause discomfort or an itch or – unusually and unluckily – red raw skin! For the unlucky ones it can be a constant state of skin discomfort, bordering on skin disease, and that’s when you might be better off seeing your GP.
So let’s agree to call it hypersensitive skin; that way we may be able to understand what causes it, to help prevent it and maybe even allow you to use Product X.
Our skin’s main task is protection. Sensing the external environment – being sensitive – is another clever trick the skin has up its sleeve to keep you protected. Whether it is nettles stinging you, sun’s rays burning you or simply feeling the movement of cooling air across the skin surface, all these allow our bodies to avoid things which could harm us, or to work with the environment to stay protected.
But 50 to 70% of people (usually a higher proportion of women than men) consider themselves to have sensitive skin or hypersensitivity.
The exact percentage of people who consider themselves to have sensitive or hypersensitive skin depends on the questions you ask, how you ask them and who you’re asking, but most of the surveys point in the same direction: it’s often facial skin where women first notice their hypersensitivity.
There is no one diagnostic test for hypersensitivity in skin but there are some things people have in common. Tightness of the facial skin is one of those, especially after washing, but also as a result of exposure to cold. Mild tingling or itching also features and so does dry, dull skin. Other deeper effects include flushing or outbreaks of blotchy red skin. In severe cases skin can be swollen and itchy. For some people hypersensitivity means an outbreak of spots.
Hypersensitivity means many things to many different people. This is why it can be so difficult to manage (and why people like me can sometimes struggle to give the best advice).
Several related but different systems are at work in hypersensitive skin. To make it even more complex, an outbreak you put down to Product X may have nothing to do with a cosmetic. Think of all the things your skin gets exposed to during the day. From the outside – household products, plants, clothing, your (or your partner’s) fragrance – or from the inside – foods, drinks, medicines – these can and do cause real problems for a lot of people.
A deficient skin barrier is often the starting point – cleansing regimes that are too harsh, regular exposure to drying environments, or a genetic predisposition to a weakened barrier – one or more of these can leave you prone to hypersensitivity.
So your choice of products is important.
Go for cream cleansers rather than high-foaming cleansers; use richer, more protective moisturisers.
This is a good place to start and using very basic products can help. By this I mean avoid heavily fragranced moisturisers or those that have highly active ingredients. As we age, our barrier can become less effective.
Unless the barrier is well formed, potential irritants can begin to cause more deep-seated problems. A weakened barrier exposes the second line of defence in the skin – the living epidermal cells responsible for keeping the barrier intact. These cells are primed to respond to any source of danger as if it was a foreign invasion or a wound. A weak barrier sends them into overdrive producing new cells on the surface to “push out” the foreign material. This leads to scaliness on the surface; a thicker but temporarily weaker barrier. This is great way of preventing entry of infectious agents or toxins, but not great for your looks.
Prevention is better than cure, so keeping the barrier in good condition is very important for cosmetic appearance.
What if the scaliness has already developed? You can exfoliate provided you use extremely gentle products. Often moisturisation alone can help skin recover its barrier; products with low levels of lactic acid can help, but this can cause some hypersensitive people to sting. (Lactic acid stinging around the nose is a useful but not diagnostic screen for hypersensitivity.)
Skin can also become red and blotchy and this may be the result of a poor barrier; but there are other causes
too. The cells deep in the skin responsible for controlling blood flow can also become hypersensitive. Hormones such as oestrogen and cortisol might cause this. So might your personal or family history of other allergies including hay fever.
Everything that affects cortisol levels – from lack of sleep to the stress of a relationship break-up – can impair the skin barrier and lead to hypersensitive skin. Treating yourself to a good moisturiser at times like this really can do you good.
All these are part of the reason why skin can become so reactive around the menopause. While the products you choose can help to comfort your skin, the role of cosmetics is limited.
And what about spot outbreaks? A small but significant number of women will continue to have breakouts long after the teens. Again the hormonal changes around the menopause can be a particularly tricky time for this. The advice here is once again to choose products better suited to this problem.
Trying to strip the skin and dry out spots may not be the best policy – as you should by now realise, drying the skin results in a damaged barrier and can cause greater sensitivity. Products with “anti-acne” ingredients such as salicylic acid or Vitamin A-like ingredients need careful use; they don’t suit everyone.
Retinol (a form of vitamin A permitted in cosmetics) can have a beneficial effect on the whole of the skin, including rebuilding the barrier. One of the problems of using it is temporary scaling, so it’s best to ask a professional adviser what’s right for you.
So we all have sensitive skin; that’s what it’s there for, to sense things. Hypersensitivity is caused by all kinds of things including stress, hormones and dryness. Stay calm – easier said than done – and keep it simple.