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. 

Get skin ready for Fall-Winter

Break out the sweaters, fall is here! It's a season I've come to love as it means I can walk along to campus to gorgeous autumn foliage. It also means that it's time to transition your skin care. I've compiled some tips to help prepare your skin for the colder months to ensure you maintain that radiance.

1. Humidifier

Winter is notorious for dry and chapped skin. Invest in a quality humidifier to put moisture back into the air. Not only is this wonderful for maintaining skin moisture, it also keeps your immune system in shape to fend off the spread of seasonal diseases and viruses. I personally prefer the humidifiers that allow you to adjust strength and temperature because there is no "one size fits all". I like to set the humidifier slightly hotter than room temperature so that I don't need to use the heater as much which helps maintain the natural moisture in the air.

2. Exfoliate

It's not just the lack of sun making you feel that your skin is more dull and lifeless during the colder months, its actually the combination of the drier climate and application of more occlusive moisturizers that can keep dead skin cells from turning over. This contributes to the dull, sallow complexion and can even clog pores. May Lindstrom's The Clean Dirt is one of the most well known green exfoliators out there. Some people call this a cleanser, she calls it a cleansing clay, but I think of it as a clean version of Bobbi Brown's Buffing Beads except with spices to stimulate circulation. This is sure to slough off dead skin cells. Sensitive skins should not use this more than twice a week to prevent the possibility of irritation.

Photo from Eva Chen's Instagram

3. Face Oil

I was surprised to see on my instragram feed over the weekend that Lucky's new EIC, Eva Chen posted the above picture with the caption: I know it's officially fall when I start using face oils. These are my four favorites!


It's good to see a face oils get recognized in the mainstream because they're so efficient. A few drops provides the moisture capabilities of a moisturizer while also feeding skin with a lot of nutrition. It is really the best combination of a serum + moisturiser. And because it is so pure and concentrated, the chances of congestion and irritation are actually less than using a cream moisturiser which tends to use more chemicals, emulsifiers, waxes, etc which can clog pores and irritate skin.

To read more about picking oils, read my post on how not all oils are equal and for those with acne-prone skin who are taking the plunge into oils, this is a list of recommended face oils.

Photo from YULI's Facebook

4. Anti-irritants

Our skin is sensitive to temperature extremes. In brisk, harsh cold climates, the winds and snow can feel like whips lashing against the delicate skin. I remember a key sign of winter when I was a child was when my dad would bring home hand balms. Balms not only help skin retain moisture, but their thick barrier also forms a protective shield against the harsh environmental exposure.

I really like YULI's Cocoon Elixir because it contains anti-irritants that help to relieve redness and soothe skin with calming calendula, chamomile, and healing lavender. And for when skin is really problematic, it contains anti-inflammatories to treat those painful itches caused by dry harsh air.

Photo from Salonzola Instagram

5. Protect your lips

This should be obvious as your lips are one of the most exposed parts of your face. To prevent chapped, dry lips, I recommend an occlusive balm. A personal favorite is Intelligent Nutrient's Lip Delivery which features beeswax, coconut oil, and shea butter which are among the most powerful moisture retaining ingredients by far comparable to even their chemical sibling petrolatum. I also love that besides just waxes and thick oils, it has antioxidants and real nutrients which makes it almost like a balm-serum.

Photo from I Am Natural Instagram

If your lips are beyond the need for a simple moisture fix, use YULI's Cellular Lip Conditioner to heal and treat dry/cracked lips and layer it under your balm to fix damaged lips and soak in moisture. It's called a super-concentrated lip serum which means there are more actives that repair lips beyond forming a barrier.

Both products are not only natural & mostly organic but they're food-grade and safe enough for pregnant women which is so important because upwards of 80% of lip products are ingested.

Photo from Clementine Fields Instagram

6. Moisture

Everyone should use a moisturiser but if you have dry skin, it is even more important to step up moisturisers in the winter to keep your skin in check. I personally like Tata Harper's moisturisers, I buy the Repairative Moisturiser (above) for my mom as it is suited for dry/mature skin, while during the coldest bits of winter, I apply a pump of the Rebuilding Moisturiser over dry patches around my mouth. My favorite quality about the moisturisers from this line is that they're packed with skin restoring ingredients. Some moisturisers just help lock in hydration but Tata definitely makes hers a hybrid between moisturiser/anti-aging treatment. I almost see no need to add an anti-aging treatment on top of her creams for this reason.

Some people don't like that the Tata Harper line is very fragrant but I consider it a step above other companies that use parfums (synthetic fragrance). So if you don't have any sensitivities to the fragrance she uses, I consider her moisturisers really effective for dry skin.

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Have any questions over how to transition your skincare regimen to winter? Ask in the comments!

Green Beauties, Your Makeup Could be Causing Your Breakout

One of the greatest ironies I see in the green beauty world is women with acne switching to green makeup in hopes of getting their skin under control. While it is true that mainstream beauty brands use more chemicals and toxic ingredients, what causes acne are suffocating or irritating ingredients such as fragrance, mineral oil, and silicones. All this aside, switching from these ingredients to lines that use coconut oil and waxes is not going to be better for your skin.

I would almost say as a rule that if you have blemish prone skin, do NOT use RMS Beauty which uses coconut oil in nearly everything. My parents have seen many patients who go to them with massive clogged pores and breakouts after switching to "holistic natural" products and cleansing/moisturizing their skin with these thick oils. I'm not saying coconut oil is a bad ingredient, not at all, if you have dry skin or skin that just doesn't break out, you will even find it to be very useful but for people who break out, you should absolutely refrain from using this on your skin. The moisturizing properties aren't worth it because it will break you out eventually.

So that is makeup itself, now let's talk about how we remove makeup. Many green beauties swear by oil cleansing. I can see why, it works wonders in removing stubborn makeup as the oil pulls products from skin that water cannot. However, if your skin is prone to breakouts, I would definitely advise against just oil cleansing. No matter how well you wash, there will be residue left over that accumulates in your pores leading to more breakouts down the road. If you want the performance of a oil cleanse, I suggest the double cleanse method. Use an oil to clean your face, wash it as much as possible. Then go over it with a traditional cleanser that can take off the left over oil and actually clean out the other grime in your skin that oils do not remove.

Remember that just because something is holistic and green, it doesn't mean that it is suitable for you. Acne is a treatable condition, for most people who have those persistent but not severe types of acne, it is nearly always preventable by changing a few things in their routine.

September Reader Questions

I'm trying my best to answer all of your e-mails but it can be challenging to answer product specific questions for things that I have not used before, and I try to frame my answers as objective and well researched as possible. From your questions it definitely seems that citrus oils and sun protection is a big question in the green beauty market. Please note, these are simply my views.

"My sunscreen contains citrus oils, is this okay?"
From: A lot of you!

The answer is that this depends on the product. What is the the sun protection factor, is it a physical or chemical sunscreen, what is the concentration of citrus oils in the formula? A lot of companies use citrus oils because it provides natural fragrance, otherwise many people might be turned off by the natural scent of the cream. Obviously, I would like to use a product that didn't contain citrus oils in my sun protection, but I don't think it will be make a sunscreen bad (especially if it contains a high degree of physical blockers which will guard the photosensitizing ingredients from UV rays).


"I read that ascorbic acid is a cheap form of Vitamin C that isn't complete, is this true? It is in many of the vitamins I take and skincare products that I use."
From: Lara, Mark, and Meghan

I received variations of this question and I just want to get this out there: Ascorbic Acid IS Vitamin C, there is nothing wrong with it and not all forms of ascorbic acid are cheap. This type of erroneous information is why there is perhaps no green beauty company I'm more frustrated with than La Bella Figura. I know that this was part of their campaign to publicize their "non-synthetic" Vitamin C from Kakadu Plum Extract but I've mentioned before how this is a fallacy (see active vs concentration question). While Kakadu Plum Extract does contain a high concentration of Vitamin C, it would be like saying rubbing a lemon on your face is going to be better than using a Vitamin C serum because "it's a non-synthetic, whole source". It's just wrong.

Here are a few of the reasons:
1. Not all of the extract is absorbed into skin and the amount that is contains non-Vitamin C as this is a food product. In fact fiber rich fruits such as this contain mostly cellulose and fiber which is present in nutritional content even in extracts, so a good chunk of the extract is most likely not even active. Versus pure-active Vitamin C ascorbic acid which is shown to deeply penetrate skin.
2. You can't control the concentration of vitamin c in food extracts, and you need a certain percentage concentration to make it effective in topical products.

I really really urge you to think about the qualifications these ladies behind the brand have for developing these products because their haphazard marketing and research has caused so much confusion in the space. So please, the next time before you start calling out perfectly reasonable ingredients, ask yourself where your beliefs came from and how reliable the source is. 


"I read about the concern people had for May Lindstrom's The Youth Dew for its citrus oils. May says that the amount isn't significant to cause damage and she has never received a complaint about it. Can you provide some guidance?"
From: Mary, Elise, and Susan

I have tried The Youth Dew and it is a wonderful face oil. Not too heavy, moisturizing, and smells great! In fact when I use it at night, my skin feels very balanced in the morning, can't complain! I probably wouldn't use it during the day time just because there are so many great oils you can use that contain zero photosensitizing ingredients compared to her small but still existent amount. May probably has never received a complaint about this before because it isn't an immediately perceivable issue, like a blemish or skin rash. Dark spots and sun spots can take months and years to form, so by the time you get those spots, you've probably already moved onto another product or you don't even realize what caused it, erroneously attributing it to natural effects. Many many of the patients my parents see come from using products that contain citrus oils across the line such as Ren and they wonder why their skin is so much more prone to developing sun spots - this is why.

Review of Vered Herb Infused Toner

My first full product review! When it comes to toners, we're fortunate to have many types to choose from but it also means the definition of a toner is different for everyone. The purpose of a toner is to tone the skin, ideally to prime it for the serums and moisturizers that follow. For some, toners are make-up removers, for others they're the alcohol-heavy astringents that remove layers of oil, and more recently, they've become facial mists. But this isn't a post that will attempt to define what a toner is, instead I'm going to review Vered's Herb-Infused Toner which reminds me of a throwback to the classic toners that you apply with a cotton ball and have a significant alcohol content.

This product is described as "a non-drying face toner that thoroughly cleansers, balances, and nourishes all skin types." Reading this, I believe Vered may have intended this to sort of be an all in one: cleanser, toner, moisturizer. With that said, I don't believe this will be suitable for all skin types, and those with drier skin may likely find themselves reaching for a moisturizer. For my skin, which is relatively normal yet prone to oiliness (men tend to have largers pores, thicker skin, and produce more oil than women due to testosterone), this worked well when used once a day. During my trip with limited supply to water, I saw wonderful benefits to using this twice a day in the morning and before dinner due to the heat/sweating as there was always enough oil/grime/dirt to remove. However at home, I felt that using it more than once resulted in my skin feeling dry and slightly stripped of healthy oils.

Part of the reason for this is because this product relies on a mixed base consisting of alcohol, water, and glycerin. To give her credit, the alcohol is sourced from organic grain alcohol which is a clean form of alcohol but it is an alcohol all the same. I like alcohol for its anti-bacterial nature but it is not the best ingredient for sensitive skin as it can easily disrupt the moisture and lipid barrier. I much preferred the other ingredients Vered chose to use such as the calming calendula, healing echinacea, astringent orange and lemon peel, and soothing comfrey.

For those who might have oily less sensitive skin, I think this would be wonderful. In fact, you'll enjoy the grape juice scent mixed with the very attractive burgundy color of the product. When applied on a cotton round, you can easily see the oil and grime coming off without applying much pressure that may get your face red. I prefer to use this as a pre cleanse after the gym to remove everything while I'm getting ready for a shower, then I use a gentle cleanser to remove whats left of the toner and impurities.

This is a purists toner, a throwback to those days when toners meant alcohol, cotton pads, astringents but that doesn't mean it is a bad thing especially when wrapped in a attractive package that includes organic ingredients that are ethically sourced, high quality essential oils, and a beautiful scent that is sure to put a smile on anyones face. So for anyone transitioning from their La Mer and Clarins make-up removing, astringent toners, look no further: Vered Herb Infused Toner

My Skincare - Aug/Sept

L to R: Osmosis Shelter SPF 30, Vered Herb Infused Toner, YÜLI Cocoon, YÜLI M.E. Skin Fuel, Dr.Alkaitis Organic Soothing Gel, Dr.Alkaitis Organic Nourishing Treatment Oil

I haven't really been updating my blog because I was accepted into a volunteer program for medical students so I have been working at what the team calls a "pre-doctors without borders" environment. It is extremely tough work but not to sound cliche, the feeling of accomplishment in providing medical aid to those without healthcare is even more amazing.

There is a 3 room clinic so most of us work outside in the make-shift tents all day and we have limited source of clean running water that we have to ration. I thought this would be a good post to show how my green skincare regimen provides the versatility and performance that shows how amazing these green products are when put to the test.

Cleanse

This is a terrible shot but I was trying to shoot this with my phone in one hand and The Clean Dirt in the other, not easy! The Clean Dirt is great because you just need to splash your face a little bit and ration a little trickle of water to mix the dirt into a paste. It helps to exfoliate skin and break through the dirt. I use this probably three times a week so prevent my skin from looking dull or rough. I didn't bring the full bottle because I tried to travel lightly so I poured these into smaller containers.

Quick Clean: I was sent a full size of Vered's Botanical Herb-Infused Toner which I will review shortly. I find that when water is scarce or I just need a quick clean (often after working an entire day then going directly to a dinner), I dab this liberally over a cotton pad and it takes all the excess oils and dirt off my face. 

Sunscreen: My mom carries Osmosis in her office and it is a solid line, though not one for green beauties (for instance, while they don't use parabens, they use a lot of honeysuckle which contains a natural form of parabens that impacts the body in the same harmful way). I like their Shelter SPF30 sunscreen because it's a great physical block that also moisturizes skin. It's one of the only sunscreens that doesn't sting my eyes if I get some in through sweating. 

Face Mist: I knew that I would be in a hot and dry climate so I needed something cooling, refreshing, but that could also relieve my skin of sunburn, heat, and environmental irritation so YULI's Cocoon Elixir was the perfect choice. True to it's word, redness and inflammation is calmed down quickly, and let's just say if I ever find this bottle gone, it's usually with one of my fair skinned cohorts who have taken a liking to this. Oh and it feels and smells so good.

Night time: At night I like to use the Dr.Alkaitis Soothing Gel to help keep breakouts from forming and also provide a little moisturization. I also think it's important to have an anti-bacterial product just because things aren't as clean here. If my skin is ever feeling a little warm or exhausted, using this with Cocoon is a sure bet to calm everything down.

Moisturizer:

Body - I like to use Dr.Alkaitis Nourishing Treatment Oil as it is a thicker oil that can feed my depleted, sun-drenched skin. The oil helps dry/damaged skin which is perfect for extremeties that can often be neglected in the heat.
 

Face - I really enjoy YULI's ME Skin Fuel, which besides the superb ingredients which I mentioned here, is very light and balancing. It's perfect for providing skin with nutrients and moisture without weighing it down. I try to put a few more drops around parts that have high sun exposure as this has natural UV protectors. There are a lot of blemish calming ingredients in here and even angry red flare-ups seem pacified after applying this. At the end of a long day, my skin absolutely drinks this stuff up and I wake up with really happy skin. 

So this is my routine, relatively low dependence on water and very versatile. Most of all, the performance is amazing. I'm able to finish my routine in 1-2 minutes while everyone else is waiting in line for water. I've also noticed that I'm the only one who hasn't suffered sun burns, acne, or skin flaking this entire trip, so I give a lot of credit to these products.

Reader E-mails: Benzoyl Peroxide, Skin Purging, Active vs Concentration

I received my first e-mails over the weekend so I thought I would answer it on here. Paraphrasing just the questions here.


"I have been on every acne medication and my prescription just increases more and more. Even my 10% Benzoyl Peroxide cream is not doing anything to hold the breakouts. I'm using maximum strength cleansers, toners, creams but my skin seems to be getting worse. I feel like the only answer is to go on Accutane, what do you suggest?"
From: Jas

I definitely think you should see a dermatologist regarding your acne. Without seeing you in person, I really can't give you a set plan. It does seem like your response to break outs is to up the ante by strengthening your products. I get the logic behind it, but in general I don't advise anyone 'fight' with their body, it never goes well. I'm assuming when you say maximum strength products, your cleansers have exfoliating acids, your toners have astringents and alcohols, and you're using a 10% BP solution. You're declaring chemical warefare on your skin. Instead, I would urge you to try and 'work' with your body by giving it a more gentle regimen.  Try to use a gentle, non stripping cleanser that won't irritate your skin or cause imbalance in sebum level. Switch your toner to a healing one that doesn't have alcohols. I know you probably see the benzoyl peroxide solution as an essential product but try to just let your blemishes go down on their own for 2 weeks. You won't see immediate changes, but I believe helping your skin heal itself will be the best thing you can do at this point. Depending on your severity, a dermatologist might prescribe Accutane but see if you can manage your skin on your own first. Just remember: your skin WANTS to be healthy, help it, don't hinder it.

"I have really sensitive skin and since switching to natural skincare, I have experienced redness and irritation. I am currently using the Marie Veronique Organics line and while I really love the ingredients and philosophy, I find my skin has broken out like never before. I contacted them to ask about it and they said that my skin is just purging, is this normal?"
From: Leah

I haven't personally used any products from MVO but I do like the ingredients list. I also see a lot of good comments for their products and I like the science behind it. What is important to remember is that every one has their own unique skin chemistry so just because the formula of a product is high quality and good, it doesn't mean that it will work with your skin. Purging and 'adjusting' can indeed happen, but if it's been over a month, your skin is no longer 'purging', I think you might be sensitive to a particular ingredient. Natural skincare is often times more potent than the alternative because you're getting less chemical fillers, so this belief that natural skincare is best for sensitive skin isn't necessarily true.

"I have been using Arcona's Night Worker which is a Vitamin C serum. I really like how it makes my skin feel but the active ingredient is ascorbic acid, which I read from La Bella Figura is a lab synthetic derived from GMO corn in China so it is less effective than a product that uses a natural complete form of Vitamin C like the one in their Modern Radiance Concentrate. Is this true?"
From: Elleco

I think using a natural complete form of any vitamin or supplement is a good idea in the same way that getting your vitamins from fruits and vegetables are preferable to getting it from a pill. Let's go beyond the large words for a minute: natural complete form just means a natural ingredient that has vitamin c, of which many ingredients in Arcona's Night Worker all contain, such as Black Currant, Evening Primrose, Borage, and Lemon. So even with all these ingredients, why would a company still choose to use Ascorbic Acid? Because although the natural ingredients do provide Vitamin C, what matters in dermatology is the concentration. Anything less than a certain threshold is not going to produce results when applied topically, and Ascorbic Acid offers a more concentrated dosage that naturals cannot provide. I understand that La Bella Figura has a product to sell and I think based off of the ingredients list, they have a great product. I don't think they mean to be misleading but the conclusion they drew comparing a natural whole source Vitamin C to being an effective topical active is indeed a fallacy. I really wish there was a better system of accountability in the natural beauty industry but as it's still very small with individual who might not have the education or industry experience to understand the intricacies of dermatology and skin care, not every statement is scientifically vetted, which leads to misinformation for the audience.

Any other questions, just e-mail me: greentechderm at gmail dot com