The Truth About Sensitive Skin
How to determine what's causing that redness, flaking, stinging, and itching—so you can put an end to it once and for all
Let's start with the basics. While it may be a commonly-used term, "sensitive skin is not an actual medical diagnosis, it's a complaint," says Deirdre Hooper, co-founder of Audubon Dermatology and assistant clinical professor at the LSU Department of Dermatology. "People notice that their skin doesn't look good, doesn't feel good, or both," she says, noting that dryness, redness, flaking, and itching are all common. Usually, one of three specific skin conditions causes the symptoms. Learn how to spot the difference between each one, and what to do in each scenario.
If redness is your main concern, you may have rosacea, which is characterized by excessive flushing brought on any number of environmental triggers, says Hooper. Common culprits include extreme temperatures, spicy food, and alcohol, and the redness tends to be concentrated in the cheeks and center of the face. Sound like you? "Be aware of your personal triggers, but you may also need to see a dermatologist for a prescription treatment," she says. Be sure to try the eight best foods for common skin conditions.
Eczema, Or a Compromised Skin Barrier
Think of the outside of your skin (the skin barrier, as it's commonly called), as a layer of bricks and mortar. When chips or cracks form in this mortar, the barrier becomes compromised; all kinds of irritants from the outside can now get in. While eczema is often genetic (some people are just born with a less-than-stellar barrier), certain habits, such as over-exfoliating and using harsh products, can also break down this outer layer.
To help alleviate the symptoms (which include flaking and itching) you need to repair the skin, advises Hooper. This means putting treatment products temporarily on-hold; common anti-agers such as retinol and AHAs (exfoliants) are all potentially irritating to a compromised barrier, she says. Gentle, creamy cleansers and ceramide-based moisturizers (a key ingredient for helping replenish that "mortar") are your best bets. You can also try these natural eczema remedies.
Third scenario: "Something specific is causing a reaction on the skin," says Hooper. This could be either an allergy or an irritation, each of which manifests slightly differently. "Allergic contact dermatitis occurs when small chemicals get into the skin and become immunologically recognized," explains Sharon Jacob, professor of dermatology at Loma Linda University. "Each time this happens, the skin's memory of the chemical grows and eventually, even a small amount can cause a reaction." (This is why you can seemingly suddenly develop an allergy to something that's never caused an issue before.) Common skin allergens include nickel (found in jewelry and eyelash curlers) and fragrance. In the case of irritant dermatitis, a chemical is damaging the skin cells, says Jacob. Common culprits include retinol and surfactants.
How can you differentiate between the two? "Irritations typically occur within a day and will burn, whereas allergies pop up within three to five days and tend to itch," says Jacob (though of course there are exceptions). Allergies will also raise tiny blisters and will occur anywhere on the skin, while irritation causes dryness and flaking and is generally restricted to the face, adds Hooper.
Either way, if you suspect some kind of contact dermatitis, pair your skin care routine down to the bare necessities: a non-soap cleanser, mineral sunscreen, and a fragrance-free moisturizer. Stick to this minimal regimen until your skin improves (if it doesn't get better in two weeks, see a derm). Then, slowly add back one product at a time, using each one for two to three days before adding another, suggests Hooper. This will help you determine which product is causing the allergy or irritation.