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Back To Basics: A Guide To Sensitive Skin - An Interview with Dermatologist, Dr. Mara Evangelista-Huber

Back To Basics: A Guide To Sensitive Skin - An Interview with Dermatologist, Dr. Mara Evangelista-Huber

Welcome to our new series, Back To Basics! We are excited to share the insights of true experts in the field of skin and hair care. Today, we're chatting with dermatologist and dermatopathologist, Dr. Mara Evangelista-Huber, to learn all about sensitive skin and clear up some common misconceptions. We'll also explore underlying conditions, what ingredients to look for in a product, and some that you may want to avoid. So keep reading for a deep dive into the science behind it all!

  

What is Sensitive Skin? What is the difference between sensitive skin and "sensitized skin"?

For some individuals, sensitive skin is a chronic problem due to a skin condition such as atopic dermatitis, allergic contact dermatitis, or rosacea. For others, sensitivity is temporary and referred to as "sensitized skin," which is triggered by factors such as skincare products or changes in humidity or temperature. In both cases, the skin's barrier function is compromised, resulting in water loss and penetration of irritants. Therefore, it is important to maintain the skin barrier, particularly for those with sensitive skin.

What ingredients should you look for when you have sensitive skin?

Those with sensitive skin can benefit from mild surfactants, especially in cleansers and washes, as well as moisturizing, soothing, and barrier-reparative ingredients.

Examples of gentle surfactants:

  • Acylsarcosinates
  • Betaines such as Cocamidopropyl betaine, Cocamidopropyl betaine + Sodium laureth sulfate
  • Cocamidemonoethanolamide
  • Cocoglucoside
  • Coconut-based amphoteric surfactants ("cocoampho-") Glucosides (decyl, lauryl, caprylyl)
  • Isethionates
  • Sodium cocoyl isethionate
  • Sulfosuccinates

Examples of moisturizing ingredients (list is a mixture of occlusives, emollients, and humectants):

  • Alpha hydroxy acids Amino acids Ceramides Cholesterol Dimethicone
  • Fatty alcohols (e.g., cetearyl alcohol)
  • Fatty esters (e.g., isostearyl palmitate) Glycerin
  • Hyaluronic acid and sodium hyaluronate Hydrolyzed proteins (e.g., hydrolyzed collagen) Lanolin
  • Mineral oil
  • Petrolatum
  • Plant butters (e.g., cocoa butter, shea butter)
  • Plant oils (e.g., sunflower, rose hip, olive, argan) Plant waxes
  • Propylene, butylene, and pentylene glycols Sorbitol
  • Squalene/squalane
  • Thermal water
  • Urea

Examples of soothing ingredients:

  • Allantoin
  • Aloe vera extract
  • Bisabolol (Chamomile extract) Calendula extract
  • Centella asiatica
  • Colloidal oatmeal
  • Fatty acids
  • Green tea extract
  • Licorice
  • Niacinamide
  • Vitamin E/Tocopherol

Examples of barrier-repair ingredients:

  • Fatty acids
  • Niacinamide
  • Ceramides
  • Squalane

What triggers sensitive skin?
Trigger agents differ from person to person. These are some common sensitizers:

1. Ingredients in skincare products (more on this below)
2. Environmental Agents:

  • Extreme temperatures
  • Insect bites and stings, dust mites
  • Pet hair, animal fur, and dander
  • Pollen and plant saps
  • Pollutants and cigarette smoke
  • Rough fabrics, synthetic fabrics such as polyester, and tight clothing Ultraviolet radiation
  • Water properties, such as chlorine
  • Weather and humidity

3. Sweat
4. Stress

Let's discuss contact dermatitis, which is a skin reaction to cosmetics. This occurs when the skin comes into contact with a substance that causes an allergic or inflamed reaction. Around 10% of people have experienced this, but the exact number is not known. Hairdressers, cosmetic manufacturers, and massage therapists are more prone to it. People with sensitive skin or pre-existing skin conditions like atopic dermatitis or rosacea are also more susceptible.

Contact dermatitis can occur in two ways: irritant contact dermatitis (ICD) and allergic contact dermatitis (ACD). ICD is more common, accounting for about 80% of cases, than ACD. ACD can be caused by different components of cosmetics, including fragrances and preservatives. The European Commission has identified 26 fragrance ingredients as high-risk for causing allergies (December 2011):

  • Amyl cinnamal
  • Amylcinnamyl alcohol
  • Anisyl alcohol
  • Benzyl alcohol
  • Benzyl benzoate
  • Benzyl cinnamate
  • Benzyl salicylate
  • Cinnamyl alcohol
  • Cinnamaldehyde
  • Citral
  • Citronellol
  • Coumarin
  • Eugenol
  • Farnesol
  • Geraniol
  • Hexyl cinnamaladehyde
  • Hydroxycitronellal
  • Hydroxyisohexyl 3-cyclohexene carboxaldehyde (HICC), (also known as Lyral) Isoeugenol
  • Lilial
  • d-Limonene Linalool
  • Methyl 2-octynoate
  • g-Methylionone
  • Oak moss extract
  • Tree moss extract

Regulations may include additional substances, such as menthol, terpineol, linalyl acetate, camphor, vanillin, and geraniol derivatives, as well as natural extracts like ylang-ylang oil, cinnamon oil, and lavender oil. While contact dermatitis to cosmetic ingredients is rare, those with underlying skin conditions or high exposure to irritants and allergens may want to avoid common sensitizers like fragrance, preservatives, and certain surfactants.

What is an ideal skincare routine for sensitive skin?

1. Avoid over-cleansing and scrubbing, use a gentle cleanser with mild ingredients. Those with sensitive skin may choose to cleanse only at night and splash water on their face in the mornings.

2. After cleansing or bathing, use a moisturizer appropriate for your skin type. Lightweight moisturizers work well for oily skin, while creamier, thicker formulations are better suited for dry skin.

3. Simplify your skincare routine by using fewer products with shorter ingredient lists. Multifunctional products can help reduce the number of items in your routine. If you're using potentially irritating ingredients, look for products with moisturizing, soothing, and barrier-reparative ingredients to reduce the chances of irritation. Potentially irritating ingredients include:

  • Alpha and beta hydroxy acids (e.g. glycolic acid, salicylic acid)
  • Benzoyl peroxide
  • Retinoids
  • Vitamin C (especially L-ascorbic acid)

    4. Don't introduce more than one product at a time. This way, if you experience reactions, you can easily identify which product you are reacting to.

    5. For sensitive skin, gradually introduce products with potentially irritating ingredients. Use twice a week for 2-4 weeks and then slowly increase frequency. Select products with ingredient pairs that work well together, such as retinoids + ceramides, sunscreen + antioxidants, and vitamin C + niacinamide. If the skin does not improve, see a certified dermatologist.

     

    References:
    10.1016/j.anai.2018.03.003.
    10.1016/j.det.2020.02.011.
    10.2165/00128071-200405050-00006.
    10.1111/j.1600-0536.2011.02004_2.x.
    10.1016/j.jaad.2018.07.017.
    10.13075/mp.5893.00176.
    https://www.fda.gov/cosmetics/cosmetic-ingredients/allergens-cosmetics
    https://www.cosmeticsdesign-europe.com/Article/2019/09/06/Cosmetics-free-from- claims-guidance-EUexplained
    https://www.sgs.com/en/news/2022/01/eu-changes-to-cosmetic-all