SENSITIZED SKIN: Where to Start and What to Do by Kat Khadija Leverette, L.E.

hether the struggle is with persistent redness and rashes; sensitivity to the sun; full-blown allergic reactions; or tightness, flaking, and itch- W ing; working with sensitive skin can be quite challenging because of all the potential variables. Sensitive skin is really a lay term, not a medical condition, and has come to be associated with people who have allergic reactions or experience irritation from a variety of allergens, random substances, or triggers. Though not necessarily sensi- tive, many people mistakenly believe they have sensitive skin because they react to shaving or their acne worsens from pore-clogging ingredients or poor food choices when, in actuality, what they suffer from is sensitized skin. Sensitive skin is not a diagnosis: there are sensitive skin conditions and there is skin that is sensitized. That said, overworking the skin is one of the main reasons it will act sensitive.

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August 2017 | DERMASCOPE 49 Rosacea is usually a constant Some doctors specialize in this water fish, anchovies, sardines, once it appears. It is character- patch testing and may test for over flax seeds, chia seed, walnuts, ized by red flushing; small, visible 100 different substances. seafood, fish roe, spinach, and capillaries; watery eyes; and small kale. Supplement dietary intake inflamed bumps; but it can be WHERE TO START with flax seed oil, enteric-coated controlled. Take the necessary steps Do extensive detective work to fish oil capsules, and vitamin E to treat rosacea before it becomes determine the probable trigger(s), supplements. Have clients check severe and avoid the triggers that like addressing sun exposure, with their physician if they take exacerbate it. fragrances, soaps, products, the other medications. If redness and flaking comes weather, chemicals, inflammatory Avoid inflammatory foods if and goes, it might be environmental foods, and alcoholic beverages. The autoimmune conditions such as ec- and/or lifestyle-related, such as a client should keep a journal and log zema, psoriasis, lupus, and diabetes skin condition like contact derma- exposure to everything by date and are a problem. These foods include titis, photodermatitis, seborrheic time, including what is put in and on sugar, dairy, fried foods, refined dermatitis, or one of several types of the body, stresses, breakouts, sting- flour, white rice, vegetable oils, eczema. Autoimmune diseases are ing, flushing, and bouts of itching. saturated fats, artificial sweeteners, becoming more common and often Firm red nodules, sores, and scaly grain-fed meats, artificial additives, come with skin rashes, severe sun growths that develop a crust and/or lunch meats, refined carbohydrates, sensitivity, and inflammation. bleed, but fail to improve, should be white bread, trans fat foods and fast Dermographism, or skin writ- evaluated by a dermatologist to rule foods, monosodium glutamate, glu- ing, is an exaggerated skin reaction out pre-cancers and skin cancer. ten, casein, and omega 6 fatty acids. to scratching or light friction, such as a massive amount of swelling after YOU ARE WHAT YOU EAT STAY FRAGRANCE- AND a few simple extractions. Though Omega 3 essential fatty acids DYE-FREE frightening to witness the first time, and vitamin E improve health, Choose fragrance-free products it does not require treatment and strengthen the skin’s barrier, and when possible. Perfumes, mixtures disappears on its own because it help reduce the inflammation, of fragrant essential oils or aroma is part of that person’s individual dryness, and flaking of seborrhea, compounds, fixatives, and solvents range of normal. eczema, psoriasis, and itchy rash- can be irritating to sensitized skin Patch testing is not always ac- es. Clients should eat omega-rich and very reactive in sunlight. curate because many doctors test for foods, like salmon and other cold- Make sure all personal care, only the 24 most common allergens. household, and laundry products say that they are free of per- fumes and dyes, unscented, or fragrance-free on the label. Sensi- tive laundry detergents are often sold in white containers. Stop using chlorine bleach, starch, borax, and fabric softeners. Try chemical-free dryer balls, which are long-lasting, save money, and are environment-friendly. Look for dermatitis on the side of the face, neck, and body where one sleeps and perspires and any- where clothing is fitted, tight, or the skin comes in contact with chemi- cal residue from washing powders, liquid detergents, chlorine bleach, additives and fabric softeners. Clients should not apply fragranc- es directly to the skin, especially on sun-exposed skin. Do not use sprays like cologne, household cleaners, bug

50 DERMASCOPE | August 2017 spray, or hairspray as overspray can come in contact with the skin. Everyday products, including cosmetics, personal care products, soaps, and household products, con- tain harsh dyes to make them more commercially appealing. Choose colorless products that clearly state they are fragrance-free and dye-free.

CLOTHES AND BEDDING Choose materials made of natural fibers, such as cotton, silk, linen, or a blend of these materi- als. Chemically-derived synthetic fibers, like polyester, acetate, nylon, modal, and spandex can be occlu- sive and are more likely to irritate sensitized skin. Despite being natural, wool can feel scratchy, so it is best to avoid it. Steer clear of fabrics labeled more. Safe metals include titani- ger UVA rays. It is these longer, static-resistant, stain-resistant, per- um, nickel-free stainless steel, sur- skin-darkening, cancer-causing manent press, wrinkle-free, or moth gical-grade stainless steel, 18-karat rays that penetrate the cloud layer repellant because extensive chemi- yellow gold, nickel-free yellow and car windows, that cause sun cal processes are needed to pro- gold, and sterling silver. Choose damage. In addition to sunburn duce the finished product. Because plastic or titanium eyeglass frames and sun rash, the skin can be- imported textiles are shipped in if metal allergy is a problem. come uneven and blotchy, freck- containers sprayed with toxic pes- les can multiply, the texture will ticides and fungicides, launder all PRACTICE SAFE SUN eventually roughen. Furthermore, new apparel, towels, and linens in Sun exposure can cause a skin cancers can form. fragrance-free detergent before use. rough, swollen, itchy rash called photodermatitis on those who SKIN CARE PRODUCTS MINERALS AND METALS are naturally sensitive to the sun, Eliminate everything except Sensitivity to mineral makeup suffer from an autoimmune dis- lukewarm water; a gentle low-lather, can often be blamed on bismuth ease, or take one or more photo- sulfate-free liquid cleanser; and a oxychloride, a synthetically-pre- sensitizing medications. fragrance-free cream with a short, pared powder created from bis- Choose physical sun protec- simple ingredient deck. Introduce muth, chloride, and water. Used to tion formulated with zinc oxide new products one week apart. In blur fine lines and add a pearlescent and/or titanium dioxide, which the absence of irritation, wean on to glow to mineral powders, these tiny are much less irritating to the skin mild anti-aging and acne products crystals must be buffed into the and eyes than chemical sunscreen very gradually and apply very spar- skin, which causes the itching and agents. Before going into the sun, ingly. To reduce or eliminate sting- irritation. Though it is not the only even for a short time, clients should ing, wait at least 10 minutes after cosmetic ingredient to spell trouble apply a generous amount of physi- cleansing before applying products for sensitized skin, it is the most cal sunscreen to all exposed skin. It with active ingredients. common offender. must be reapplied often, even when If clients must wash their Metal allergy is also common exposed to indirect sun, and after hands often, advise them to and nickel is usually the culprit. swimming, exercising, perspiring, choose a gentle lotion cleanser. While several metals are safe on and rubbing with a towel. Moisturize with a fragrance-free their own, some are so soft that Do not be fooled by cloudy hand cream hourly. Wear latex- small amounts of nickel are often skies. The glare that causes free gloves when possible and added to make jewelry, grommets, people to squint on overcast days avoid hand sanitizers that contain buckles, eyeglass frames, and confirms the presence of the lon- alcohol and fragrance.

August 2017 | DERMASCOPE 51 USE CAUTION WITH ACIDS Acids found in cleansers and ton- ers can wreak havoc on sensitized skin. Ingredients like glycolic acid, salicylic acid, mandelic acid, and ascorbic acid are added to cleansing products because they exfoliate the skin, help fight breakouts, cut oiliness, and per- form other corrective functions. More often than not, tightness, flaking, PROTECT SKIN FROM Modify cleansing and skin care rashiness, and rebound oiliness are the CHEMICALS routines during the colder months, unwelcome consequences. Sensitized in dry climates, and in hard water When choosing skin care prod- skin will improve dramatically with a areas. Non-foaming, sulfate-free ucts, make every effort to avoid as gentler approach to cleansing. cleansers, milder exfoliants, and many known irritants as possible. fragrance-free moisturizers suited AVOID ALCOHOL Cosmetic ingredients known to to skin type will help restore the cause problems include sulfate glow to compromised skin. Products containing alcohol, an surfactants; fragrances; aromatics; ingredient that is also known as eth- Do not scrub the skin. Cleanse masking fragrances; colors additive with only the fingertips and blot anol, can strip and compromise the dyes; and preservatives that include skin’s barrier and cause over-drying, dry; never rub the face with a tow- parabens, formaldehyde, formalde- el. Because so many things, includ- skin irritation, allergic reactions, hyde releasers, lanolin and its deriva- and rebound oiliness on sensitized ing even gentle active ingredients tives, and chemical sunscreens. and professional treatments, can skin. Eliminate astringents that Use nitrile gloves; vinyl gloves contain alcohol and exfoliants like cause superficial flaking and peel- are thick and cumbersome and ing, the temptation to speed up salicylic acid; instead, mist with a latex gloves cause skin reactions on water-based hydrating toner. the process by scouring off dead too many people to continue using skin cells can be irresistible. It is also wise to limit alcohol them, even if they are un-powdered. consumption. Drinking alcohol Grainy scrubs, baking soda paste, sonic cleansing brushes, exacerbates conditions like rosacea, GENTLE SKIN CARE causes flushing, and dehydrates the spa gloves, buffing pads, loofahs, Sensitized skin can be treated body, which compromises the bar- washcloths, and even towel-drying successfully by tweaking homec- rier function of the skin. can spell trouble for sensitized skin. are and making simple changes. Side effects include redness; burn- ing; prolonged scaling; increased sun-sensitivity; a thick build-up of keratin; and an uneven, blotchy skin tone. Attempting to scrub off flaking and thickened dead skin will backfire. The body quickly produces a thicker buildup to protect itself, just like calluses form after repeated friction from ill-fitting shoes and pedicure paddles. Once this behav- ior is discontinued, sensitized skin can improve dramatically. Hot showers and baths disrupt the skin’s moisture barrier and strip natu- ral oils, leaving it dry, exposed, and susceptible to irritation. Help maintain healthy skin by using gentle body washes that will not add to the dryness.

52 DERMASCOPE | August 2017 Clients should blot the skin dry with a soft towel laundered in fragrance- Ask questions. Once professionals understand why free detergent and immediately apply fragrance-free lotion while the skin is someone’s skin is reactive, along with why they still damp to lock in moisture. Hard water can be devastat- think their skin is sensitive, be prepared. ing, especially during the colder months. Filtered showerheads and “ Make sure spa sheets and robes handheld sprayers can make hard HYDRATION water feel like rainwater, soften skin Water intake hydrates the skin are laundered in detergent that con- and hair, and eliminate hard-to- from within, improves elasticity, tains no fragrances, dyes, or chlo- remove lime scale. plumps fine lines and wrinkles, rine bleach. Professionals should be and helps achieve a healthy glow. proactive if they use a linen service. Always use fragrance-free” back bar, HAIR REMOVAL When the skin is well-hydrated, it Clients should shave with care. is easier to address dry skin, ecze- higher-pH lactic acid peels, mild Use a fragrance-free shaving cream or ma, seborrheic dermatitis, rosacea, enzymes (without steam), and physi- foam and a fresh blade and shave in and eczema. Caffeine, alcohol, cal sunscreen. Put hot wax, sonic the direction of hair growth. Do not and smoking dehydrate the skin, brushes, steamers, scrubs, strong dry shave, shave with soap, shave too so it is best to cut back drastically chemical peels, tightening masks, close, or use chemical depilatories. or stop completely. aromatherapy oils, dermaplaning, When waxing, never use hot Running a cool mist humidi- and microdermabrasion to the side wax or treat irritated skin. Opt for fier at night will hydrate the skin when dealing with sensitized skin. threading, lukewarm wax, or cold and help counteract the drying Ask questions. Once profes- sugaring instead. If ingrown hairs effects of cold weather, dry climate, sionals understand why someone’s and razor bumps are a constant heaters, and air conditioners. Clean skin is reactive, along with why problem, consider laser hair remov- as directed to prevent fungus and they think their skin is sensitive, al using a Q-switched laser. It is both bacteria growth. be prepared. Skin care profession- safe and effective for all skin tones Do not overheat homes and als should have protocols in place and ethnicities when performed by avoid heat sources like hot stoves, and dispense drama-free products an experienced technician. ovens, hairdryers, fireplaces, so they are able to help sensitized- space heaters, hot showers, and skinned clients solve their skin direct sun. problems, not create them. When it comes to sensitized APPROACH FOR THE skin, professionals should always remember that every client is dif- AESTHETICIAN ferent, nothing is carved in stone, Skin care professionals should and they will learn something new educate themselves about skin every day. Still, it is tremendously conditions like seborrheic derma- rewarding to be able to help serve titis, eczema, rosacea, psoriasis, this large under-served group of po- contact dermatitis, photoderma- tential clients who really want to use titis, and autoimmune disorders. professional services and purchase Explore the roles that inflamma- products, but usually cannot. tory foods, the environment, and chemical irritants play in making matters worse. Kathryn Leverette is a Be on a constant mission to licensed aesthetician, acne identify potential irritants and en- specialist, and ethnic skin courage clients and staff to switch to care expert in the San Fran- milder skin care, hair and house- cisco Bay Area. Her skin care hold products, and explore the practice, Clinically Clear™ Skin Rehab Center, is dedi- many lifestyle issues that challenge cated to acne, pigmentation, and ethnic skin. those with sensitized skin.

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