Managing Sensitive Skin – Managing irritated skin

Skin can become sensitive for many reasons, and any time in life, from babyhood to old age. It occurs when skin’s protective barrier function is compromised, causing skin to become susceptible to external irritants, such as bacteria, chemical substances, allergens or others. Symptoms can appear on the face, body and scalp, and include redness, scaling and swelling. These can be itchy and disturbing in everyday life and can result in intense physical discomfort. While some people are predisposed to these ‘outbreaks’ of the condition, others are surprised by these sudden ‘skin moods’. Sensitive skin often reacts unpredictably and can appear anywhere on the body.

Understanding the importance of skin’s natural defences, and the factors that weaken them, can help to decode this ‘skin talk’. The unpredictability of sensitive skin means that in many cases, effective solutions are about prevention rather than cure. The aim therefore, is to control and minimise its causes and stimuli.

Skin has a natural protective barrier, which keeps bacteria and harmful substances from entering the body, while limiting water loss and preventing dehydration. This process keeps skin healthy and moisturised, maintaining its elasticity and firmness.

However, external factors like climate and internal ones like stress can undermine this process, weakening skin’s natural defences and making it feel rough and dry. External stimuli can then exacerbate the situation, causing skin to become inflamed.

To recognise sensitive skin, look for:

• Visible signs like erythema (redness or a rash), scaling, swelling or roughness
• Sensory signs like itching, tightness, burning or stinging

It can occur on the face, lips, hands, body and scalp. And can be triggered by physical change too, either temporary, such as pregnancy, or ongoing, such as ageing. It shares some similarities with dry skin, but is not always related to that condition nor will its symptoms necessarily be alleviated by dry skin care solutions.

To recognise hypersensitive skin:

Sensitive skin is closely related to hypersensitive skin and the symptoms and triggers are similar. However, with hypersensitive skin, the skin's nerves are even more sensitive and reactions can therefore be more frequent or severe. Hypersensitive skin is not a disease, it is a sensory feeling caused by an increased sensitivity of the skin's nerves. Typically sufferers experience uncomfortable sensations such as stinging, burning or itching - none of which are visible - and these can be accompanied by visible signs such as redness or dryness (although this is not always the case). In severe cases Rosacea or Couperose-prone skin can develop. Rosacea is a chronic inflammatory disorder that affects up to 10% of the adult population and is particularly prevalent among people with fair hair. Symptoms include erythema (redness), red bumps, red blood vessels and irritated eyes.

If you are unsure about what skin condition you have, our skin test may be able to help. Alternatively, ask your pharmacist for advice. For a formal diagnosis you should consult your doctor or dermatologist.

The uppermost layer of the epidermis is the horny layer (stratum corneum), which forms skin's barrier against the outside world. It prevents invasion by microorganisms and substances such as chemicals and allergens. It also minimises transepidermal water loss (TEWL), protecting the body from dehydration.

The horny layer resembles a wall, made up of 'bricks' or skin cells, which provide stability, and 'mortar' or epidermal lipids, which create permeability and at the same time a solid cohesion. On its surface is a protective acid mantle, the hydrolipid film. This emulsion of water (hydro) and fat (lipo) has a slightly acid pH value of 5, this:

• maintains the healthy skin flora and skin scaling process (or desquamation), which is an essential part of skin’s renewal
• and neutralises alkaline substances such as soaps and conventional surfactants.

Skin’s enzymes activate its own natural defences. They’re responsible for maintaining vital barrier functions, regulating moisture balance and stimulating skin renewal. If enzyme activity is reduced or inhibited, skin defences are weakened, leading not only to increased trans-epidermal water loss, but also to the penetration of irritants.

Irritants like soaps can further worsen skin’s condition through their alkalising effect, making it susceptible not only to inflammation but also infection from bacteria, viruses and fungi.

• Baby skin is thinner and its barrier function more limited than that of adults, making their skin far more sensitive to chemical, physical and microbial influences. Read more about skin in different ages.
• Conversely, as skin ages, substances that are integral to the structure and functioning of the hydrolipid film and protective acid mantle become scarce leading to a pH imbalance and increased water loss. The number of Aquaporins in skin also depletes with age. Aquaporins are skin’s own moisture distribution channels, which supply it with the water and glycerol it needs to work as a protective barrier. When Aquaporins are depleted, skin’s barrier function can be compromised and water loss increases. This can make ageing skin more prone to sensitivity.
• Hormonal imbalance, brought on by stress or through specific life events such as pregnancy, the menstrual cycle, puberty or the menopause. This can reduce the effectiveness of the skin’s barrier function.
• Some people are more likely to experience irritated, sensitive skin. These include people with dry or damaged skin, Atopic Dermatitis, acne and hypersensitive skin conditions such as Rosacea, all of which may react to irritants such as perfumes and colorants.
• Undiagnosed or untreated intolerances and allergies to foods such as gluten, dairy, additives and eggs can result in skin inflammation and rashes.
• Dehydration, from excess sweating or lack of water, can also dry out skin, and place it under stress.

• Seasonal and climate changes, and fluctuations in temperature can all increase skin sensitivity. In cold weather, skin glands reduce their secretion of substances necessary for the maintenance of the protective acid mantle, causing skin to dry out. Central heating, air conditioning or the dry air in aeroplanes can also have this effect. In hot weather, skin glands produce more sweat, which evaporates, leaving skin feeling dry.
• An increased use of soaps and detergents with conventional surfactants can cause significant damage to skin’s surface, removing skin-protecting lipids and causing an imbalance in skin’s natural pH levels.
• Some medical treatments such as radiotherapy and certain drugs can temporarily result in sensitive skin. It should clear up once the treatment ends.

Read more about factors that influence skin.

An increase in attention to personal hygiene has meant that people are more likely to shower or bathe frequently in very hot water and rub themselves dry. This can result in a loss of natural moisturising factors and surface lipids. Cleansers with conventional surfactants will clean skin, but will also dry it out.

Small changes to bathing habits can help restore skin’s protective barrier by reducing the temperature of the water, not spending so long in the shower or bath (especially in an area with hard water), using mild tensides or shower oils and patting the skin dry.

Recent research into nutrition has shown that an increase in food high in antioxidants and Vitamin C and low in carbohydrates and saturated fats can help stressed skin recover and return to a healthier condition. It can also make sense to check for food allergies or intolerances. Visit a nutritionist or your doctor if you think this might be the case. Also drinking enough water is important, especially for elderly people.

Stress management can also play its part in reducing skin sensitivity. Proven methods include taking regular exercise and practicing relaxation techniques.

It can be tempting only to respond to sensitive skin when it flares up. However, if you put a regular moisturising routine in place – and maintain it – these incidents may reduce and even disappear. This routine may differ for sensitive face and body skin.

• Choosing a daily cleanser
  Many cleansers are so effective they clean away not only the dirt on our skin but also the hydrolipid film that protects it. For sensitive and dry skin it’s important to choose a body cleanser that strengthens the barrier function and protects against moisture loss. Eucerin pH5 Soft Shower is an extremely gentle cleanser which is suitable even for frequent showering, and Eucerin Sensitive Skin pH5 Washlotion respects the acidity of the skin. Eucerin pH5 Shower Oil leaves a protective film on the skin to prevent it from drying out. Facial sensitive skin needs a mild cleanser that will not irritate skin such as the Eucerin DermatoCLEAN range.
• Choosing a daily care product
  When choosing a skin care product for sensitive skin, it isn’t simply enough to ensure it is free of irritants. The product needs to actively work below the surface of the skin, stimulating skin’s own regenerative processes and natural defences.
  To do this, the product will need to include active ingredients such as Dexpanthenol and Glycerin, both of which are nature-derived and proven to work with skin to improve moisture levels.
  
  It will also ideally restore skin’s natural pH balance of 5 through the inclusion of an ingredient like pH5 Citrate Buffer.

In scientific tests these three ingredients have been shown to activate and protect skin’s enzymes, helping to restore its natural barrier function, leading to improved moisturisation and strengthened resistance to irritants.

Gluco Glycerol is another key ingredient that supports skin hydration. It stimulates skin’s own moisture distribution channels – the Aquaporins. It has been clinically proven to significantly improve moisture level and support skin’s natural barrier function.

Dexpanthenol, Glycerine and pH5 Citrate Buffer are combined in the Eucerin Sensitive Skin range of products, which includes lotions, creams, oils and shampoo for facial, hand and body skin, and the scalp.

Gluco Glycerol is the hero ingredient in the Eucerin AQUAporin ACTIVE range of facial moisturisers.

• Looking after your hands, face and lips
  The hands and face are often the most exposed to the elements and to frequent washing. This can make them particularly vulnerable to dryness and even cracking. Care products can be used as frequently as necessary to both protect and soften stressed skin. Eucerin Sensitive skin range offers extremely gentle cleansing options, which maintain skin’s natural barrier function.
  Similarly sensitive lips can be protected against UV and temperature changes with Eucerin Lip Active, which contains not only Vitamins E and C, but also SPF 6. These vitamins are supplemented by active ingredients Bisabolol and Dexpanthenol in Eucerin Lip Repair, which soothes and regenerates dry, cracked lips.

Hormonal changes in pregnancy can make skin suddenly sensitive. Gentle, natural oils can help reduce itchiness and the occurrence of stretch marks. Care products containing Vitamin E and high-quality vegetable oils that are rich in Linoleic Acid strengthen skin’s natural barrier function and enhance its elasticity like Eucerin Natural Caring Oil.

Once baby arrives, you may find his or her skin is also easily irritated and even inflamed. Extremely gentle, alkaline-free cleansers like Eucerin Baby Bath & Shampoo will prevent baby’s skin from drying out. While Eucerin pH5 Washlotion is suitable for the whole family, having been shown in tests to be well-tolerated. Read more about skin in different ages.

In some cases, sensitive skin can become uncomfortable and even painful, feeling dry, tight and itchy. When this happens, an oil bath can provide immediate relief and start working to intensively rehydrate stressed skin, making it feel softer and calmer. Eucerin pH5 Oil Bath contains mild surfactants, which protect skin’s enzyme activity, and have been shown to be well-tolerated even by newborn baby skin.

For more information about sensative skin, its causes and symptoms, please view our pratical advice video here.