Special Interest Topics

Sensitive Skin - 10 Do’s and Don’ts

1) Don’t Overdo It!  Too many of my patients end up with “itchy red bump” syndrome, a condition that results from putting too much stuff on your face! The skin is an incredible microcosm of activity: sweat glands, epidermal renewal, dermal trafficking of immune cells and oxygenation. This delicate balance can be upset by well-intentioned patients who apply more than 3 products to the face at the same time. My rule of thumb is no more than 3 items per application. More than 3 items and you risk interaction between products that can be extremely irritating to the epidermis. With multiple products applied at the same time, you also risk epidermal suffocation. Your skin can’t possibly absorb more than 3 products anyway, so chill out! 2-3 targeted items to the skin’s surface is plenty.

2) Don’t Pick!  As a dermatologist, it is frustrating to watch some patients destroy their own skin by picking. In fact, the temptation to pick is so common that dermatologists have coined 2 terms to describe this phenomenon. Acne Excoriee is a term used to describe the appearance of picked pimples. Neurotic Excoriation describes scratches made by anxious patients who traumatize their own skin. The skin is a durable, dynamic organ, but is very susceptible to the blunt trauma of fingers. For example, when you squeeze a pimple, only 20% of its contents are ejected from the skin. The remaining 80% is forced deeper into the dermis, resulting in prolonged inflammation and delayed healing. So please, leave your face alone. If you absolutely must, find an instrument at your local drugstore called a “comedone extractor” to gently extract white and blackheads only.


3) Do Find Oil-free Everything!  Not all products will advertise “non-comedogenic (non acne-causing),” but a quick scan of the ingredient list should yield this important answer. There is no place for mineral oil on the face…ever. Not only has the application of mineral oil on the face been shown to cause acne, but you’ll also clog eccrine sweat glands of the face resulting in irritating skin imbalances.

4) Avoid Foundation!  Your skin needs to breathe! Obviously not like your lungs do, but the surface of the skin is a crucial interface for epidermal cooling, important natural flora bacteria and yeast, and lipid layering. Foundation impedes all this by disrupting the skin’s natural renewal and turnover process. Sure, you can use a foundation to gently blend skin tone irregularities, but please don’t spackle your poor face with a thick blanket coat.

5) Don’t Judge a Cream by Its Fragrance!  Sure, some topical creams smell amazing and can be very tempting to purchase, but don’t get suckered in by the sweet smell of a poorly-compounded solution. Fragrance is a leading cause of contact dermatitis, an itchy red rash that can take weeks to improve. Find products that contain minimal fragrance or, better yet, no fragrance at all!

6) Easy on the Plants!  Don’t put a greenhouse on your skin! So many of my patients believe if it’s a plant, it must be good for your skin. Not so! Many botanicals commonly found in over-the-counter skin products are complex proteins that can trigger the skin’s immune system and result in significant allergy and irritation! Botanicals within products should serve a specific purpose and not be included as window dressing. Remember, poison ivy is a botanical too!

7) Don’t Use Toner.  A dangerous make-up counter myth that toner is required for skin “stripping”. Acetone or alcohol based toners strip important protective lipids from the skin’s surface, leaving a very vulnerable, exposed epidermal surface that is more susceptible to dryness and infection with microorganisms. There are light acid peels that can be helpful in epidermal replenishment, but a daily toner can mean a regular insult to your skin that can be difficult to repair.

8) Do Reap the many benefits of anti-oxidants!  Anti-oxidants are wonderful, powerful ingredients for a variety of reasons. Not only do anti-oxidants help to ease damage caused by ultraviolet rays, but they can be very helpful in delaying damage to collagen from other environmental insults such as wind and industrial pollutants. Sunlight and other environmental threats to our skin create free radicals (charged atoms) than can pick apart or degrade collagen fibres over time. Anti-oxidants serve to absorb these free radicals thereby blocking their harmful effects.

9) Stay Hydrated!  Delores Krieger once said, “we don’t stop at our skin.” The skin is the perfect mirror of internal health. Entire sub-specialties of dermatology, not to mention Eastern medicine, are dedicated to the “reading” of the skin to determine internal health. Our bodies must maintain optimal hydration to function properly and keep immunity boosted. Much of this water ends up within the largest organ of the body, the skin. So stay hydrated – this means what may seem like a massive amount of water each day – 8 glasses! So drink up, your skin and (your internal organs) will thank you for it.

10) Don’t Overwash!  So many of my patients wash 4-5 times daily and make a mess of things. Washing with a detergent or medicated soap can strip away layers of the epidermis, leaving the skin chapped and irritated. One of my patients replied, “Of course not doctor, I only use this mild cleanser on my face 3 times each day… and a scrub brush!” Please be careful with the skin, it is the only one of your organs that you wear on the outside. It has the unique challenge of facing the elements unlike your liver or your heart. Even washing with a gentle cleanser and a scrub brush can be incredibly wearing on the skin’s surface. Twice daily washing with a gentle cotton-based cloth (or even your fingers) is enough to remove daily impurities without compromising your skin’s integrity.

11) Do Wear Sunscreen.  An 11th on our Top Ten List! Why? Because sensitive skin or not, protection against UV rays remains the single most important thing you can do to protect your skin, delay photoaging, and keep your dermis healthy! I recommend SPF 30 or higher for patients - not only when planning to spend the day outside, but also as part of your daily skin regimen. Over 80% of the sun damage we view as adults (age spots, sagging skin, large pores) was initiated when we were young, so it is never too early in life to begin using sunscreens. Apply early in the day and if you’re living anywhere near the equator, re-apply at mid-day.


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