And how do you treat it?

There is light at the end of the tunnel for patients with sensitive skin and rosacea – but treatment requires a holistic approach.

Many individuals are classified as having sensitive skin and may experience a reaction to a specific product or substance. Sensitive skin is not actually a dermatological skin condition but rather a non- specific lay-term describing the way skin reacts to various factors. Australian surveys have shown that approximately 60 percent of individuals describe their skin as sensitive.

Skin irritation is characterised by redness, itching, burning or dryness and may be classified as either contact irritation, rosacea or an actual allergic response. It is generally used to describe skin with reduced tolerance to certain topically applied skincare ingredients and environmental conditions. It is also important to realise that rosacea is a chronic skin condition that is not curable but may be controlled with a good skin regimen and sensible diet.

Contact irritants, as distinct from allergens, in skincare products are the cause of most common skin reactions. Due to the sheer number of products in contact with the skin each day, it is often difficult to may be causing irritation. The most common contact irritant is artificial fragrance.

If your client is sensitive to an ingredient in a particular skincare product, it is advisable to eliminate all skincare products until the irritation has cleared. Gradually introduce one product at a time over several days until you discover exactly which product is causing the contact irritation. You may also apply the suspect irritant to a small area of the skin such as the side of the neck and check for irritation. Do not apply the potential irritant if the patient has exhibited an allergic reaction. Allergic reactions should be referred to a dermatologist for diagnosis and treatment.

Ingredients to avoid

It is best to avoid the following ingredients if your client suffers from sensitive skin or rosacea:

  • SLS and sulfate-based cleansing ingredients – these are more irritating than other foaming and cleansing ingredients
  • Artificial fragrance – this is the number-one cause of skin irritation
  • Propylene glycol – a common skincare ingredient
  • Certain essential oils – never apply undiluted essential oils directly to the skin
  • Acidic products – these are often not tolerated by clients with sensitive skin. It is best to avoid AHAs (particularly glycolic) and L-ascorbic acid
  • Abrasive scrubs
  • Artificial colour – irritation is due to the small particle size which may penetrate the skin surface
  • Chemically based sunscreens – a common skin irritant
  • Alcohol-based products – this dries the skin surface and makes the barrier more susceptible to irritation from other ingredients

Foods to avoid

There is a significant link between diet and inflammation. It is best to avoid any foods or liquids that cause blood vessel dilation or internal inflammation. Inflammatory foods include:

  • Sugar
  • Refined carbohydrates (particularly white bread, rice and pasta)
  • Alcohol
  • Trans fats, hydrogenated fats and animal fats that are solid at room temperature
  • Spicy foods
  • Caffeinated drinks
  • Over consumption of dairy products
  • Excessive wheat, particularly genetically modified (GM) wheat
  • An imbalance between omega-6 and omega-3 fatty acids – more omega 3s are needed to balance the omega 6s which can be inflammatory. Fatty fish and walnuts are great sources of omega-3 fatty acids
  • Many artificial food additives; common ones include MSG flavour enhancer, sulfites, benzoates and FD&C artificial colours

Treating sensitive skin is both challenging and complex. You are best advised to refer to a dermatologist to isolate an allergen or specific skin irritant. However, keeping the skin routine simple, including anti-irritant ingredients and avoiding potential skin irritants can significantly improve sensitive skin and rosacea. AMP

Topical skin detox

If your client has had a severe skin reaction to an ingredient, it may be necessary to implement a two-week topical skin detox. This involves only using pure glycerin (as a twice daily wipe on/rinse off cleanser) and castor oil (used sparingly as a day and night moisturiser) for two weeks. These ingredients are highly unlikely to cause an adverse reaction and will still enable the skin to be cleansed and hydrated during the detox phase. Following the detox, introduce one new product every few days and monitor the client’s tolerance.

Food intolerance vs food allergy

Many people may be lactose intolerant, gluten intolerant and even coeliac. These conditions are dietary and not related to application of these ingredients on the skin. It is therefore acceptable to apply products containing these ingredients to the skin provided they are not ingested or present in lip and dental products.

Some individuals may suffer from food allergy. This is very different from food intolerance. In this case, any skincare product containing the allergen must be avoided as penetration may cause a severe allergic reaction. The client must read the ingredient labels to ensure the product is free of their specific allergens. If an individual has a nut allergy, for example, all nut and nut-derived oils should be avoided in skincare products.

Cosmeceutical ingredients for sensitive skin

Keep the daily routine simple. If your client is commencing a new skincare regimen, introduce one product at a time to ensure your client can tolerate each product. Clients with sensitive skin are advised to use products that have a low irritancy profile and that sooth, calm and repair damaged and vulnerable skin, including:

  • Niacinamide/Vitamin B3 – this is an essential ingredient to help repair the skin barrier and reduce irritation
  • Anti-irritant botanical extracts such as aloe vera, alpha bisabolol, allantoin, colloidal oatmeal, beta glucan and Canadian willowherb
  • Certain essential oils in low levels such as chamomile and lavender
  • Anti-inflammatory non- comedogenic oils such as shea butter, olive squalene, seabuckthorn oil and castor oil (PEG free)
  • Zinc oxide for broad spectrum sun protection and reducing redness; opt for mineral makeup with high levels of zinc oxide
  • Salicylic acid (low dose) – salicylic acid is actually an anti-inflammatory ingredient. However, ensure there is no allergy to salicylates
  • Polyphenols – this is an antioxidant found in green tea, white tea and tomato skin extracts
  • Caffeine (lose dose topical application) – in low doses this anti-inflammatory is able to constrict blood vessels and minimise the appearance of facial redness and rosacea

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