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. 



    8 comments:

    1. Thank you for this post! I'm constantly irritated by aestheticians, product specialists, etc. saying that I have sensitive skin when I say that a specific product didn't work for me because it congested my skin or made me breakout. I don't consider that sensitivity... or is it? I have realized, however, since switching to clean products, that a lot of products aimed at acne-prone skin (Yuli's elixirs and serums!) as well as serums with vitamin C in most forms don't suit me. They make my skin appear blotchy with a rough texture or worse, small whiteheads all over. The exception is La Bella Figura's new Modern Day Radiance. Would you know why that might be? Or what other vitamin C products might work for me? I'm not too keen on repurchasing it because their container is than ideal. The product appeared curdled after 3 months of opening and I was told that it was because of air getting into the bottle. I think that that might have compromised the effectiveness of the product even though they maintain that that isn't the case.

      Also wanted to say that I am so grateful to your blog for providing an educated and scientific viewpoint within the world of green beauty products, with all of the conflicting and often misleading information floating around in cyber space, and no dermatologist I've ever consulted in NYC being well versed in this area of expertise. I do hope that that changes with time. I'm sick of having Accutane, laser procedures, Botox, retin-A, etc. pushed on me as a solution to any and every problem when I'm explicitly asking for more natural and holistic suggestions. I loved your post on retinoids!

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      1. Yes you're completely right! A lot of professionals will use this term just because you have a reaction to an ingredient. It doesn't mean your entire skin is sensitive or "weaker".

        A lot of people do have sensitivity to Vitamin C, while I haven't done a lot of studies on this, there seems to be a correlation between Vitamin C sensitivities and complex regimens. Meaning those who change their skincare quite often or who use other powerful products (especially exfoliating products, acids, etc.) tend to experience more sensitivity to Vitamin C as the product absorbs.

        As for why you're probably not experiencing any reactions to LBF's Modern Radiance, it's because that product doesn't contain Vitamin C besides the trace vitamins found in some of the fruit extracts. In terms of concentration, it's actually not a lot but I can understand how you might think there are since that is how they market this. I go into it a bit on this post and in the comments section as well: http://greenderm.blogspot.com/2013/09/september-reader-questions.html#comment-form

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      2. RM, I'm not a dr. or anything, but I used to experience a lot of irritation with antioxidant/vitamin c products. My cheeks would look like I had a rug burn or something... not a pretty look! I've actually been using a lot of Yuli products, including Liquid Courage, without any problems. Thankfully! However, one thing I figured out from before is that anything with grapefruit was likely to irritate me! So, maybe if you find the common ingredient in the ones that don't work and avoid that, you can find an antioxidant/vitamin c that works for you.

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    2. So, just curious: In your last post, you said that those with sensitive skins shouldn't use The Clean Dirt more than 2x/week. In light of this post, what exactly does that mean?

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      1. Hey I think you might also be the one who commented again below this post, so I hope I answered you. But in general it's not saying "sensitive" is a word you can't use but rather how people use the word that renders it unhelpful.

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    3. In fact, you often refer to sensitive skin and sensitive skin types in your earlier posts. What do you mean by it? I am genuinely curious.

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      1. Hey anonymous, that's a completely fair question and good observation. This post really shows my greatest pet peeve in a dermatological setting, which is where patients will come to me for help. The goal is to help access and diagnose problems. Therefore it's not beneficial to use am umbrella term that is ultimately devoid of meaning. And I explain how to proactively get around this by helping to communicate with me, you help yourself (i.e. I can better understand what it is you're sensitive to rather than giving you the belief that sensitive skin is an actual type of skin).

        In terms of this blog and the skincare reviews I post, the point is to provide more information for the actual product so one has to kind of go toward a more sweeping generalization. Therefore when I use the term sensitive skin which I will use in future posts as well it's really to point out "look if you're sensitive to a lot products or your skin reacts to a lot of ingredients/abrasiveness you definitely want to approach this with caution".

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    4. Thanks for your reply, that definitely helps clear things up!

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