Sensitive skin is described as skin that has a tendency to experience redness, burning, itching, swelling, flaking, and dryness. While the symptoms and characteristics of sensitive skin are often easy to identify and label, the causes are more complicated and, at times, unclear. According to Philippe Allouche, M.D., founder and co-owner of Biologique Recherche and CEO of Biologique Recherche USA, the causes of sensitive skin vary and may involve an underlying genetic susceptibility in addition to internal and external factors that can trigger or exacerbate the condition.
Age can have an influence on susceptibility to sensitive skin (data suggests that younger people are more prone than older people), but it can also be caused by environmental factors, including heat, cold, sun, wind, pollution, and air conditioning. “It is known that the decrease in temperature and humidity levels that typically occur in winter and in cold environments reduce the water content of the stratum corneum and favor the expression of sensitive skin symptoms,” says Allouche.
According to him, lifestyle and environmental factors, such as lack of sleep; sun exposure; stress; a diet rich in spices, alcohol, and coffee; personal hygiene practices like certain shaving techniques among men; and excessive showering, can also contribute to sensitive skin. And medical conditions, such as hormonal changes, menopause, contact allergies, dermatitis, eczema, rosacea, psoriasis, dry skin, and vitiligo can be related to sensitive skin.
Lastly, another important factor is the misuse or overuse of cosmetics and skincare. “Artificial fragrances, dyes, preservatives, and even things that we normally consider natural can actually cause contact allergies on the skin,” says Joyce Imahiyerobo-Ip, M.D., dermatologist and consultant for HydroPeptide. “Sensitive skin can occur from excessive use of certain skincare products that would normally otherwise be good for your skin. Over-cleansing, for example, with cleansers that contain acids like salicylic acid or glycolic acid can be irritating to the skin, as can excessive use of topical retinoids or exfoliating facial scrubs.”
A Growing Concern
According to Mintel’s Global New Products Database, in 2014, sensitive skin claims represented 25 percent of total skincare claims, compared to 15 percent in 2009. What’s more, 71 percent of facial skincare users say they are interested in ultra-gentle products, and sales of sensitive and gentle skincare products are estimated to be more than $202 million. Robin L. Carmichael, president and chief operating officer at Helix BioMedix, believes that sensitive skin is becoming more of a concern because of an aging boomer population that wants to take better care of their skin and because people today are exposed to more chemicals, pollutants, and environmental insults that take a toll on the skin. “As we have evolved skincare to provide cleansing and exfoliating tools to help remove dry, dead, flaky skin, sometimes users can be too aggressive—too much of a good thing is bad,” says Carmichael.
Susanna DiSotto, director of marketing at Satin Smooth, says more people are using and exposing themselves to products that cause reactivity, which can lead to an increase in clients with sensitive skin. “Most skincare products have warning labels about initial irritation caused from retinoids, sunblock, acids, and antioxidants, but botanicals—even organic or biodynamic ones—may cause mild to severe allergic reactions,” she says. “Known irritants, such as sulfates and propylene glycol, are only recently being called out as culprits.” In addition, household and environmental irritants from everyday products such as dish soap, shower gel, and toothpaste are often ignored by clients until symptoms appear. She also believes the increase is due to better awareness of skin diagnoses and treatments, and more people seeking treatment for sensitive skin.
When it comes to treating sensitive and rosacea-prone skin, it’s important to consult with clients prior to any treatment. “Knowing when it is safe to treat a certain condition and how to do it is the key to success,” says DiSotto. “Always do a thorough consultation to determine allergies, medications, conditions, and past experiences. Do patch tests, know every ingredient in the products you are using to ensure you don’t cause a reaction, and introduce products one at time to establish tolerance.” According to Allouche, estheticians should never perform a facial on red or inflamed skin, and red skin must be calmed down before any procedure. It is also important to realize the difference between a light redness revealing a good response to treatment and a true overreaction.
At The Spa at Trump at Trump International Hotel & Tower Chicago, estheticians perform a consultation prior to each service so that they are aware of any and all skin conditions and concerns. “Sensitive skin can be a very subjective term,” says esthetician and spa host Kaylin Smith. “We, as spa professionals, need to do thorough consultations on our sensitive guests to find the underlying causes for their sensitivity and how they define sensitive skin. Their responses should dictate what treatments and products we choose.”
The face is the most common area for sensitive skin, because of the high number of cosmetic products used on it, and the fact that it has a weaker skin barrier than other parts of the body, as well as a large number of nerve endings. “The nasolabial fold is considered to be the most sensitive part of the face due to the permeability of its stratum corneum, its high density of sweat glands and hair follicles, and its rich innervations,” says Allouche. “The next most sensitive areas are the cheekbones, the chin, the forehead, and the upper lip. So these areas should be treated with extreme caution.”
According to Josanna Gaither, director of education and aesthetics at Natura Bissé, because inflammation, when constant, can cause sensitivity and a breakdown of the skin structure, sensitive skin is also a leading cause of aging. Fortunately, many spas have added treatments to their menus that are designed specifically for sensitive skin. At The Spa at Trump, for example, clients with sensitive skin can opt for the Pure & Delicate Facial ($165, 60 minutes), which calms and strengthens delicate and irritated skin with a cocktail of 18 different plant extracts, complexes, and lipids, and a gentle massage.
Similarly, at The Spa at The Hotel Hershey (PA), the Soothing Facial (starting at $130, 50 minutes) is designed to provide immediate and long-lasting relief and comfort for sensitive and sensitized skin. It utilizes spa thermal water and powerful botanicals to help balance hypersensitivity and protect and soothe the skin. “More aggressive services such as microdermabrasion and peels can now be safely customized for sensitive conditions, and even waxes are customized to help protect sensitive skin,” says DiSotto. Spas are also taking steps to alleviate many issues for sensitive clients by creating greener spaces that feature better ventilation, filtered water, non-VOC paint, and natural laundry detergent.
Spas should only use fragrance-free products that are formulated for sensitive skin, such as non-rinsing cleansing lotions and moisturizers with a mild texture. “When treating sensitive or rosacea-prone skin, I strongly recommend choosing a professional pharmaceutical-grade, physician-only skincare line that provides the highest-quality ingredients and manufacturing standards,” says Candace Noonan, director of education for Environ and DermaConcepts. “This will ensure that the line is produced with little to no skin-sensitizing preservatives.” And Dasha Saian, CEO of Saian, advises spas to avoid using the steamer and hot towels during facials, as well as doing extractions, mechanical exfoliation, and excessive massage. “Stimulating sensitive skin can lead to broken capillaries, increased redness, and irritation,” she says.
According to Ryan Christopher, director of education at Cosmedix, skincare professionals, instead, should focus on treatments and ingredients that reduce inflammation, such as cooling gel masks with aloe and serums infused with ingredients like L-alpha-bisabolol, which help to tone down redness. “Spas can find much success in catering to clients with sensitive skin,” he says. “Create a calming facial or body treatment and post signage advertising this exclusive service, or set up a ‘soothing experience’ by offering aloe- or cucumber-infused water with a cool lavender towel prior to the treatment. Creating a protocol for sensitive skin allows the spa to have consistency among providers so that every client with sensitivity receives the best results.”
Formulas for Success
Because of the increase in clients with sensitive skin and the desire for gentle skincare products, many manufacturers are responding with products designed to treat sensitive skin. “Manufacturers are trending toward less irritating chemicals in their products,” says Brenda H. Cumming, RN, who sits on the board of directors for Lira Clinical. Instead, they are using more skin-friendly alpha-hydroxy acids, such as lactic and mandelic acids, and using titanium or zinc oxide instead of chemical sunscreens.
Manufacturers are also creating products that contain anti-inflammatory, hydrating, restoring, and skin-soothing ingredients such as almond oil, aloe vera, apricot kernel oil, arnica, ceramides, green tea, hyaluronic acid, licorice, propolis, shea butter, squalane, vitamin E, and white tea for treating sensitive skin. “Skincare manufacturers and spas alike are responding to consumers’ demand for clean and hypoallergenic skincare by employing cleaner techniques and by avoiding ingredients that are known to be common allergens like preservatives, phthalates, and parabens,” says Imahiyerobo-Ip. She points out that there is a difference between “clean” products and “natural” products. A common misconception is that if someone has sensitive skin they should look for natural products, but this is not always the case. “Many ‘natural’ products contain several allergens,” she says. People who have sensitive skin may be as reactive to essential oils as they are to preservatives, so the key is to create and use products that contain hypoallergenic ingredients and are free of preservatives and fragrances.
With the growing number of spa-goers who describe their skin as sensitive, it is critical that spas treat this skin type properly with gentle techniques and products and recommend an effective at-home skincare regimen. It’s also important to keep in mind that in addition to inflamed and red skin, the word “sensitive” may also describe the feelings of many clients suffering from this skin type. “Education and follow-up is key to ensure client retention,” says DiSotto. “Sensitive clients may go through several products and treatments unsuccessfully before finding the perfect fit. Be prepared to help them on their journey with knowledge and empathy.”
Calm skin and reduce irritation with these products and treatments formulated for sensitive skin types.
1. Amber Products Facial Alginate Masques: Balance the moisture barrier with this nourishing mask filled with arginine, an amino acid that hydrates the outer layers of the skin. store.amberproducts.com
2. Apothederm Moisturizing Cleanser: Protect skin from free radicals and remove makeup, dirt, and impurities without stripping the skin of moisture with this gentle cleanser composed of avocado oil, carrot, evening primrose oil, and seabuckthorn fruit extract. www.apothederm.com
3. Biopelle PrescribedSolutions Don’t Be So Sensitive Post Procedure Cleanser: Remove dirt and impurities without irritation with this light oil-free cleanser that hydrates the skin. www.biopelle.com
4. CelleClé MicroLift Shield De-Stressing Treatment Moisturizer: Combat the signs of aging caused by stress and environmental aggression with this moisturizer that reduces redness while smoothing and softening fine lines and wrinkles. www.cellecleskincare.com
5. [ comfort zone ] Skin Resonance Cream Oil Cleanser: Infused with olive and sunflower oils, this cleanser and makeup remover transforms to an oil when applied and leaves a protective veil of moisture after removal. www.comfortzone.it
6. Dermalogica UltraCalming Cleanser: Formulated for reactive skin, this pH-balanced, non-foaming cleanser helps calm and diminish redness while fortifying the skin’s protective barrier. www.dermalogica.com
7. G.M. Collin Vasco-Tonic Concentrate: Featuring antioxidants, botanical extracts, and vitamins, this serum works to eliminate redness, diminish dark undereye circles, and soothe the skin. www.gmcollin.com
8. HydroPeptide Soothing Balm: Containing antioxidants, nourishing botanicals, and emollients, this calming, cleansing, and age-defying facial oil restores hydration and promotes rapid recovery. www.hydropeptide.com
9. Ilike Organic Skin Care Ultra Sensitive System Whipped Moisturizer: Grapeseed, plantago, and yarrow hydrate, protect, and soothe skin while reducing inflammation. www.szepelet.com
10. Natura Bissé NB Ceutical Skin Protectant S.O.S. Instant Rescue: This effective formula contains soothing active ingredients such as calendula that strengthen the epidermal barrier and provide instant relief for sensitive or irritated skin. www.naturabisse.com
11. Sesha Skin Therapy A.C.E. Cream For Sensitive Skin: Rejuvenate and nourish skin with this gentle formula containing sodium hyaluronate for maximum hydration and vitamins A, C, and E. www.seshaskin.com
12. Skin Script Cacteen Balancing Moisturizer: Reduce sensitivity with this moisturizer that balances skin with the healing properties of the fatty acids in olive oil and pear cactus. www.skinscriptrx.com