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"'Sensitive skin' isn't a medical term; it's a colloquial one to describe easily reactive or irritated skin usually on the face," says Dr. Jaggi Rao, an associate clinical professor of dermatology at the University of Alberta in Edmonton. "It typically appears as redness, swelling, itchiness and dryness."
Dr. Richard Thomas, a dermatologist at The Face & Skin Clinic in Vancouver and clinical assistant professor of dermatology at The University of British Columbia, divides sensitive skin into two categories: The first group includes medical conditions like eczema, rosacea and dermatitis; the second, harder-to-define group encompasses "those who have no history of skin conditions but complain of itching or burning from a variety of stimuli."
As Rao says, "Everyone will have sensitive skin at some point in their lives."
Regardless of which category describes your skin, helping it become as smooth as George Clooney's repartee is as much about what you put in your body as what you put on your face. Skotnicki-Grant says that women with rosacea should eliminate red wine because it contains tyramine, a compound that encourages blood vessels to open and causes an immediate flush. "The next day, patients can develop acne-like bumps on their nose and cheeks," she says.
The sun is a particularly dangerous foe for all sensitive-skin sufferers. "Excessive exposure to UV light causes inflammation and increased sensitivity," says Thomas. Skotnicki-Grant recommends steering clear of sunscreen ingredients like oxybenzone and Parsol 1789 (which can be too harsh on delicate skin) and instead choosing products that contain titanium dioxide (which has smooth, non-occlusive particles that won't rub against the skin).
Figuring out which products work best for sensitive skin is a daunting - and often individual-task, but, according to Skotnicki-Grant, here are the ground rules.
Quaternium-15, a preservative found in some cleansers and makeup that slowly releases formaldehyde - the embalming liquid - is on the list of ingredients to avoid. Sodium lauryl sulfate is a surfactant that adds lather and thickening power to shaving creams and cleansers but strips skin of its natural oils and leaves it primed for irritation.
Soap does the same thing. "Most soaps are very alkaline, which means that they have a pH of about 8," says Skotnicki-Grant. "This can be irritating to skin whose normal pH is 5 or 6." Non-soap cleansers, such as Spectro Jel and Cetaphil, are good substitutes, says Thomas, but avoid alcohol-based toners, which can aggravate and dry out skin. Facial scrubs and products with alpha- and beta-hydroxy acids are other no-nos.Don't let dubious labelling confuse you. Skotnicki-Grant scoffs at the term "hypo-allergenic."
"Allergy is all or none," she says. "You can't be a little allergic to peanuts: You either are or you aren't. 'Hypo-allergenic' isn't a medical term, and it gives consumers a false sense of security." In fact, says Skotnicki-Grant, "Most products that are labelled 'hypo allergenic' contain fragrances and formaldehyde-releasing preservatives."
Like "hypoallergenic," "unscented" isn't a regulated term and only means that you can't smell anything, says Skotnicki-Grant. "But the product often contains fragrances to mask the chemical smells of the ingredients," she adds. However, the term "fragrance-free" is regulated - products listed as such don't contain any of the more than 300 chemicals that are classified as fragrances by the International Nomenclature of Cosmetic Ingredients.
The latest wave of sensitive-skin products are designed to tackle specific issues. Clinique's Redness Solutions system - a cleanser, two moisturizers and a protective cream that is also a makeup primer - is designed for redness-prone skin. According to Tom Mammone, executive director of research and development for Clinique, the line addresses the two most common types of redness: reactive (which means reacting to a particular product, allergen or environmental irritant) and persistent (for those who suffer from constant redness). Bisabolol, an anti-irritant derived from camomile, is one ingredient that specifically targets redness. "It inhibits one of the main enzymes responsible for causing inflammatory signals in the skin," says Mammone. "The enzyme can be found in bee venom, which explains why we get irritated from a bee sting."
Other options for redness-prone skin include Darphin's Intral collection, which features extracts of camomile and peony. Like Clinique, Intral's formulations are tinted green, which helps cancel out red tones in the skin. La Roche-Posay's Hydreane moisturizing cream promises to reduce sensitivity with its Hydrolipid innovation - a delivery system designed to permeate the skin without irritation based on its engineered similarity to skin cells. Then there's the Sensibio line from Bioderma. Its patented complex of ginkgo biloba, soybean and green tea minimizes the production of vascular endothelial growth factor (VEGF), a substance created by cells that stimulates the growth or dilatation of new blood vessels. Dilated blood vessels are bad news for women with redness: When blood vessels dilate, the resulting flush shows up on the surface of the skin.
"Reducing VEGF means reducing the dilation of blood vessels and, as a consequence, redness," explains Alain Denis, scientific director and research and development manager for Bioderma.
As sophisticated as these new products are, there's no guarantee that you won't react to them, so read the ingredient lists on beauty products as closely as you would food labels, advises Thomas. If the problem is troubling and persistent and can't be resolved by using gentle, fragrance-free skin care, see a dermatologist.