Do you have sensitive skin or has your skin become sensitized, is your barrier function damaged or are you the reactive type? Here we take a deep dive into what this all means for your skin and what the heck you should or could be doing differently. By the very nature of this complex issue, I have decided to split this post into two parts, in part one we look at what can cause sensitive skin and part two what we can do, or avoid to help our skin heal.
what sensitive skin means
If your sensory perception of your skin feels something like this - tightness, burning, tingling, pain, dryness, stinging and pruritus (itching) then you would be classed as having sensitive skin. Environmental factors play a role, as does having fair skin, lifestyle choices, stress, and hormones - throw rosacea, atopic dermatitis or psoriasis into the mix equals complete CHAOS! This is a complex issue and we can see that sensitive skin may be triggered by hypersensitivity to a range of stimuli which can be physical, chemical, psychological, and/or hormonal, multiple factors such as age, skin pigmentation, anatomic region, cultural factors and pre-existing diseases all have an influence. Now let's unpack all this information and look at each different aspect to understand what is potentially happening to your skin.
1. SKIN REACTIONSIrritation - Is caused by a chemical compound, the skin will react as soon as it is exposed to them, the concentration of the chemical irritant will dictate the severity of the skin reaction experienced.
Sensitization - This is a type of allergic reaction that you may not notice upon immediate exposure to the chemical compound, further exposure to the compound will cause an inflammatory response by your immune system causing further sensitization. In other words, this has been acquired over time and by repeated exposure and can happen to anyone. It’s a never-ending cycle, too - once you’ve had a reaction to a product, your skin’s uppermost layer (stratum corneum) is compromised, giving way to the potential for even more problems.
Phototoxicity (PT) - Also known as photosensitivity, is a skin reaction that occurs in the presence of Ultra Violet (UV) light. Certain compounds found in essential oils are capable of absorbing energy from UV light much more effectively than skin. The application of the Essential Oil itself will not cause PT unless the skin is exposed to the sun or another UV light source. PT agents are known as 'Bergapten' or 'furocoumarins' these are polycyclic molecules whose structure gives them the ability to absorb ultraviolet photons, store them for a while and then realize them in a 'burst' onto the skin.
2. ENVIRONMENTAL FACTORSAir Pollution - The generation of free radicals that may oxidize amino acids in tissue proteins and initiate lipid cell damage of polyunsaturated fatty acids, resulting in dermatitis and atopic eczema [when exposed to high levels of traffic-related air pollution] Particles in the nanosize range, especially those from traffic sources, are considered among the most harmful components causing oxidative stress in skin meaning premature aging - pigment spots and wrinkles. Pollution breaks down the acid mantle of the Stratum Corneum and damages the barrier function.
Exposure to UV rays - has been linked to skin photoaging and to the development of skin cancers. UVA penetrates deeply into the basal layer of the epidermis and dermal fibroblasts. UVB has also been linked to the development of skin cancers. UVB is largely absorbed by epidermal cellular components.
Dry - Sucks the moisture from your skin by literally drying it out, this climate can also induce and/or worsen some skin conditions - such as eczema and psoriasis.
Humid - Humidity often causes your pores to go into overdrive producing sweat to cool your body - which leaves you more prone to breakouts.
Cold strips skin of moisture and dries it out.
3. LIFESTYLE CHOICES
Dietary Choices - Alcohol dehydrates your body generally, including the skin. This happens each time you drink. Drinking too much is also thought to deprive the skin of vital vitamins and nutrients. Over time, drinking heavily can have other, more permanent, detrimental effects on your skin. Rosacea, a skin is linked to alcohol.
Caffeine - Is highly acidic, high doses of acidic caffeine disrupt your stress hormones, which control your skin’s oil production. Caffeine can act as a diuretic, dehydrating your skin if you drink too much.
Sugar - Breaks down collagen, the springy substance that makes your skin look plump, youthful, and lifted, it can weaken the immune system, and a suppressed immune system is bad at fighting off bacteria. Bacteria = clogged pores = pimples. Sugar triggers insulin production, which triggers protein-utilization malfunctions affecting the production of the proteins and amino acids that build up collagen and elasticity. It also creates more testosterone, which makes pores larger and skin oilier.
Cosmetics - Soaps, perfumes, stripping ingredients, excessive cleansing, and excessive exfoliation.
Smoking - Chemical substances from cigarette smoke activate transepidermal water loss, degeneration of connective tissue, causes deeper wrinkling, premature facial skin aging in smokers along with orange-purple skin discoloration. Free radicals from cigarette smoke are associated with oxidative stress resulting in lipid cell damage. A higher occurrence of acne among smokers and a correlation between the severity of acne and the number of smoked cigarettes has been shown also cigarette smoke is associated with psoriasis.
Medications - Steroid creams that are often prescribed for severe irritations, eczema and allergic reactions cause a thinning of the skin which, while reducing the inflammation, leaves you vulnerable to further irritants.
4. ENDOGENOUS FACTORSHormones - Estrogen levels decline as we age, to create significant changes in how the skin looks and feels. It becomes dry, less elastic and more fragile. In humans, over age 40 the biggest culprit of dry and sagging skin is declining estrogen. Skin appears thin and sallow, with fine lines turning into deep creases. The areas around the eyes and lips may droop slightly and lose firmness and because of less blood flow and circulation, skin starts to appear less vibrant.
Testosterone - It stimulates the sebum-producing glands, which are important for protecting skin with natural oils, but overproduction can lead to acne.
Thyroid - Is a hormone that influences your skin’s appearance. An overactive thyroid can cause warm, sweaty, and flushed skin, while an underactive thyroid can lead to dry, coarse skin with a reduced ability to perspire.
Stress - Is proven to slow down the skin healing process, including skin barrier recovery, daily stress or poor stress management can leave the skin barrier in a permanently weakened state.
5. CUTANEOUS FACTORSAtopic Dermatitis - Is the genetic form of eczema, which affects about 10-20% of people worldwide. Eczema is a chronic, long-lasting form of dermatitis.
Rosacea - Is an oxidative stress condition - this is due to an imbalance between antioxidants and reactive oxidizing species within the skin. The phenomenon is identical to what is known as free radical damage and underlies the worsening of rosacea through inflammatory pathways.
Psoriasis - Is characterized by skin cells that multiply up to ten times faster than normal. As underlying cells reach the skin's surface and die, their sheer volume causes raised, red plaques covered with white scales.
Genetic - You're born with certain skin characteristics: thinner / delicate / possibly translucent skin /skin tends to be redder due to blood vessels being close to the surface of the skin with visible capillaries on the rise and across the cheeks - this is common for Northern European ancestry.
Disturbed Barrier - Studies suggest that sensitive skin is the result of the impaired barrier function of the stratum corneum (SC), this is the very outer layer of the epidermis, therefore, the body's first defense against the environment, sun damage, penetration of foreign matter toxins and microorganisms. A healthy functioning SC is a key to healthy robust skin. Research suggests a link between atopic dermatitis and sensitive skin.
Sensory Nervous System - A Disturbed Barrier of the SC can lead to the exposure of immune system cells and sensitive nerves, resulting in marked cutaneous responses (sensitive skin) to otherwise harmless stimuli.
Age - Your skin barrier weakens with age, generally the whiter or paler the skin, the thinner the barrier, which means you're more prone to rashes, redness and irritation.
Hydration - the body is composed of 75% water, as we age this gradually reduces until we die when we are close to 0% (harsh but true..)
CONCLUSION / Part 2 of this BLOG we will discuss what we can do, and/or avoid to help our skin heal it's inate barrier function.
Until next time..
be human, be kind, be you.
- Misery L, Sibaud V, Merial-Kieny C, Taieb C. Sensitive skin in the American population: prevalence, clinical data, and role of the dermatologist. Int J Dermatol. 2011;50(8):961–967.
- Namadar AC, Palit A. Sensitive skin: an overview. Indian J Dermatol Venereol Leprol. 2013;79(1):9–16.
- Farage MA, Maibach HI. Sensitive skin: closing in on a physiological cause. Contact Dermatol. 2010;62(3):137–149.
- Draelos ZD. Sensitive skin: perceptions, evaluation, and treatment. Contact Dermat. 1997;8(2):67–78.
- Naylor EC, Watson RE, Sherratt MJ. Molecular aspects of skin ageing. Maturitas. 2011;69(3):249–256.
- Misery, L., Loser, K. and Ständer, S. (2016), Sensitive skin. J Eur Acad Dermatol Venereol, 30: 2–8. doi:10.1111/jdv.13532