Saturday, November 23, 2013

Greatest Pet Peeve: Sensitive Skin

There is perhaps no statement that causes me to to shut down quicker than when someone says "I have sensitive skin". This most happens when asking for product recommendations or general advice on skincare. While I know nothing is meant by this comment, from a professional perspective (and hearing it ALL THE TIME), I can't help but have a visceral reaction to it. I urge you to read this with an open mind if you've used this phrase before with your dermatologist because it could help you communicate better with your dermatologist. Here's why:

  • It doesn't mean what you think it means. Sensitive skin is actually more of a marketing term that some companies used in the early 90s that really took off. Initially the intention was to sell products that would relieve redness and inflammation. But consumers took this phrase and through a continuous consumer-led cycle redefined this to stand for "products suitable for sensitive skin", giving the impression that sensitive skin is a "skin category" - which it isn't. The skin is a spectrum and there is no set guideline for when it is sensitive and when it is normal, after all, do you ever hear the phrase "products suitable for insensitive skin"? 
    • It is a non-quantifiable word that is utterly meaningless in helping me access and diagnose your skin. Sensitive skin means your skin has had a sensitivity to something (if it does not, you shouldn't say you have sensitive skin).Those who have skin that is reactive to lot of products most often have a sensitivity to a common ingredient. It is not helpful to say you have sensitive skin but if you can follow it with what you are actually sensitive to (synthetic fragrance, silicones, etc), and what it does to your skin, that would help. 
    • It is overused. 80% of women claim to have sensitive skin, if we were to take this statistically, it really means the "majority of people have sensitive skin" which given the definition of sensitive is statistically impossible. The real world implication is that most people who say they have sensitive skin just have normal skin since they're in the majority. This really just goes back to my former statement that there is no quantifiable measure for sensitive skin so everyone uses it in different ways that in the end don't really represent anything. 
    So think about it from your dermatologist or skincare professional's view. 8 in 10 patients they see say their skin is sensitive, after a while of this what this means is that they're numb to the word rendering it ineffective. Anyone can have a sensitivity to anything. I once heard a girl say her skin was allergic to water, true story. So whether a patient reports having sensitive skin or not, as dermatologists we still have to go in preparing for the possibility that there are some things you could be sensitive to and some things you won't be. 

    Psychologically, the reason a lot of people use sensitive skin, is as a crutch against the possibility of an adverse reaction and for companies/professionals to provide more accountability/attention to their specific skin history. So although the word to us is meaningless, when we hear someone use it, we're already mentally categorizing the patient as potentially high-maintenance and problematic. For the patient, using this strategy is also not advantageous because most of the time the response you'll hear back is "then use less of this product" or "discontinue use if irritation occurs" which is pretty general knowledge that should be a given.

    So next time you visit your derm or talk to a skincare consultant, try to explain what you mean if you truly believe your skin is "sensitive" - what is it sensitive to? what are the ingredients you need to avoid because of this? what are the reactions and what interactions do you believe led to this reaction? The result is that you'll give us more to work with so we can better help you and you'll actually end up getting the information you were looking for.