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20 common questions to ask the Doc!

What is sensitive skin?

Many people say they have sensitive skin because:

  • Certain skin care products, or household products that contact their skin, cause stinging, burning, redness, and/or tightness.
  • Although they have no visible effects after contact with a product, it always makes their skin feel uncomfortable.

Dermatologists, doctors specializing in skin, consider the diagnosis of sensitive skin when they:

  • See skin reactions such as pustules, skin bumps, and/or skin erosion.
  • Observe excessively dry skin, which doesn’t adequately protect nerve endings on the skin and may lead to skin reactions from cosmetics or skin care products.
  • Notice a tendency to blushing and skin flushing, which may also be signs of sensitive skin.

How do I know if I have sensitive skin?

Have your skin examined by a dermatologist. That’s the most certain way to find out if you have sensitive skin, or if there is another cause for your skin condition.

What causes sensitive skin reactions?

Causes of sensitive skin reactions include:

  • Underlying skin disorders or allergic skin reactions related to immune system dysfunction such as atopic dermatitis (eczema), urticaria (hives), rosacea, or allergic contact dermatitis.
  • Overly dry or injured skin that can no longer protect nerve endings, leading to skin reactions.
  • Excessive exposure to skin-damaging environmental factors such as sun and wind, or excessive heat or cold.

Less well defined are genetic factors and age, gender, and race differences in skin sensitivity. For example, a type of eczema called nummular dermatitis is most commonly found in men over age 60.

Are there medical tests for sensitive skin?

Patch testing may identify hives, general itchiness, or eczema as signs of allergies that are causing or contributing to sensitive skin. Otherwise it is difficult for doctors to test for sensitive skin because of the many and varied factors that can cause it.

Should men be concerned about sensitive skin?

The look of healthy skin is just as attractive in men as in women -- and more men are realizing it. Maybe that’s why dermatologists report that increasing numbers of men are seeking diagnosis and treatment for sensitive skin these days

What are some tips for caring for my sensitive skin, especially for my face?

Cleansing: Dermatologists say that people’s sensitive skin responds differently to different cleansing methods. But most agree that "deodorant" soap or highly fragranced soap contains strong detergents and should not be used on the face.

Soap-free cleansers such as mild cleansing bars and sensitive-skin bars, along with most liquid facial cleansers, have a lower pH than soaps. They have less potential for facial skin irritation, along with cleansing creams and disposable facial washcloths.

Moisturizing: These products help your skin retain moisture so it resists drying and abrasion. See guidelines to choosing skin care products for your sensitive skin below.

Cosmetics: See guidelines to selecting cosmetics for your sensitive skin below.

What should I look for in skin care products that are less irritating to sensitive skin?

  • Only a few ingredients
  • Little or no fragrance
  • Methyl paraben or butyl paraben preservatives
  • If you have sensitive skin, avoid products containing:
    • Antibacterial or botanical ingredient
    • Skin-penetrating solvents such as ethanol and propylene glycol; opt for non-penetrating ingredients such as polyethylene glycol

What types of cosmetics are less irritating to sensitive skin?

  • Use face powder, which has few preservatives and minimal risk of skin irritation.
  • Use a silicone-based foundation for minimal skin irritation.
  • Do not use waterproof cosmetics, because you need a solvent to remove them.
  • Use products with fewer than 10 ingredients.
  • Use black eyeliner and mascara, which appear to be least allergenic.
  • Use pencil eyeliner and eyebrow fillers; liquid eyeliners contain latex and may cause an allergic reaction.
  • Use earth-toned eye shadows, which are generally less irritating to upper-eyelid skin than darker colors such as navy blue.
  • Throw out old cosmetics, which can spoil or become contaminated.
  • Do not use nail polish if there’s any risk you’ll touch your eyes or face with it before it dries.

With an unfamiliar skin care product, how should I test for a sensitive skin reaction?

Before putting a new product on your sensitive skin, do the following:

  • Every day for 5 days, apply a small amount behind an ear and leave it on overnight.
  • If your skin does not become irritated, follow the same procedure, this time applying the product on an area alongside an eye.

If you continue to be irritation free, the product should be safe for you to apply on any area(s) of your face.

What are tips for protecting my sensitive skin in winter and summer?

First, you should know that the American Academy of Dermatology recommends protecting your skin with sunscreen year-round. Use a product with at least a sun protection factor (SPF)15 rating, and use it every day that you will be in the sun for longer than 20 minutes.

And remember, the sun’s skin-damaging UV rays are strongest between 10:00 a.m. and 4:00 p.m. Avoid going out in the sun during these hours whenever possible -- any time of the year.

During winter, to help prevent skin dryness, flaking, itching, and cracking:

  • Don't overheat your home.
  • Take warm, not hot, baths and showers -- and fewer of them -- and use a soap-free cleanser.
  • Minimize skin dryness after bathing: Pat your skin dry and apply moisturizer while your skin is still moist.
  • Use a moisturizer containing petrolatum, mineral oil, linoleic acid, ceramides, dimethicone, or glycerin.

During summer, keep in mind that tanning actually damages your skin if your are lacking melanin -- it is not wise to lie out in the sun, even if you’ve applied sunscreen. See guidelines for choosing a sunscreen below.

If you do go out, wear a wide-brimmed hat and sunglasses and tight-woven clothing that covers your arms and legs, apply your sunscreen 15 minutes to 30 minutes before going out, and reapply it every two hours or after swimming or if you’ve been perspiring heavily.

What should I look for in a sunscreen to protect my sensitive skin?

As noted above, your sunscreen should be rated SPF 15 or higher. Particularly if you’re a woman, your sunscreen should contain only the “physical” ingredients zinc oxide or titanium dioxide. This is because you cannot have an allergic reaction to these physical sunscreens: They deflect the sun’s UV rays instead of absorbing them, as chemical sunscreens do.

When and how do doctors diagnose and treat sensitive skin?

Most people with sensitive skin don’t seek medical help for mild irritation from skin care products -- instead, they’ll try different products until they find one that doesn’t irritate their skin. The dermatologist is typically consulted only after the patient’s discomfort has become acute.

When consulted, the dermatologist will first look for the presence of skin conditions such as eczema, rosacea, or hives due to contact with a skin irritant. Patch testing may be done to check for allergies. The dermatologist will also ask about the patient’s skin care regimen, identify any potential irritants, and recommend milder skin care and household products with less potential for irritating sensitive skin.

Which clothing fabrics are less irritating to sensitive skin?

Smooth, soft, natural fabrics, such as fine cotton and silk, feel best worn next to the skin. Cotton is cool where silk is warm; both are absorbent, helping to draw body moisture away from the skin. Rayon and linen are also comfortable for sensitive skin but are heavier than cotton or silk. Clothing should be loose fitting with a minimum of potentially irritating creases and folds.

What diseases and conditions may be associated with sensitive skin?

If you have skin disorders, such as acne, psoriasis, contact dermatitis, rosacea, eczema, or develop hives from contact with a skin irritant, you’re likely to have sensitive skin as well. And keep in mind that stress, although it doesn’t cause acne, can make it worse.

Does the U.S. Food and Drug Administration (FDA) regulate the safety of cosmetics?

The FDA’s Center for Food Safety and Applied Nutrition regulates the manufacture and marketing of cosmetics -- but not the way it regulates prescription medications and medical devices.

The FDA cannot require that cosmetic manufacturers provide manufacturing data on their products, conduct product recalls, or report cosmetic-related injuries. However, it can inspect cosmetic manufacturing facilities. And it can take action against manufacturers whose products or any of their ingredients are found to be:

  • Unsafe
  • Improperly labeled
  • Adulterated
  • Misbranded

Are skin care products labeled “hypoallergenic” safer for sensitive skin?

Hypoallergenic skin care products are not necessarily safer for sensitive skin. The FDA states there are no federal standards governing manufacturers’ use of the term “hypoallergenic” -- so it can mean whatever a particular company wants it to mean.

How can I tell if a particular skin care or household product is or is not likely to irritate my sensitive skin?

The National Institutes of Health (NIH) and the National Library of Medicine (NLM) Specialized Information Services group maintain a Household Products Database online. You can look up products by brand name to determine what’s in them and whether anything they contain could irritate your skin.

Can healthful eating help sensitive skin?

Eating healthfully, of course, is good for your whole body, including your skin. But there is one nutritional group that, when lacking, can cause dry, flaky, sensitive skin: the B complex vitamins riboflavin, niacin, B-6, B-12, and biotin.

Taken in adequate amounts, B complex vitamins can actually help relieve skin dryness and itch as well as stress. Ask your dermatologist or nutritionist if you could benefit from including more whole grains, rice, wheat germ, oatmeal, sunflower seeds, fish, eggs, almonds, liver, yeast, and low-fat dairy products in your diet.

Can a child with a disease or condition related to sensitive skin outgrow it?

A child with sensitive skin due to eczema has a 90% chance of outgrowing it before age 5 and a 40% to 50% chance of outgrowing it by adolescence. It’s estimated that some 80% of people aged 11-30 have outbreaks of acne; for most of them, acne typically goes away sometime in their 30s. Psoriasis is considered a chronic (lifelong) disease.

Can sensitive skin be inherited?

A number of the skin diseases and conditions associated with sensitive skin are known or believed to run in families. They include acne, eczema, psoriasis, and rosacea. Skin irritation from a reaction to a skin care, cosmetic, or household product is not inherited.