Sensitive Skin | Dermatologist Guide

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Sensitive skin is one of the most common presentations to a medical dermatologist. Recent studies show that up to 68% of the population reports skin sensitivity.
The topic of sensitive skin is extraordinarily complex as skin sensitivities fluctuate with seasons, flare factors, age as well as the underlying disease state.

Diagnosis of sensitive skin

Medical dermatologist will always seek the cause of sensitive skin. There are numerous inflammatory skin conditions that can give rise to skin sensitivities such as acne, rosacea, atopic dermatitis, seb derm, irritant contact, allergic contact, photo allergic reactions, psoriasis, and many, many other conditions. In some cases the cause is multifactorial. Finding the diagnosis can often take multiple visits to the dermatologist. Test such as patch testing, photopatch testing, RAST testing, and ROAT or repeat open application tests can help medical dermatologists arrive at a diagnosis. As a procedural dermatologist I work in a team to help medical derms. Physical treatments for skin sensitivity include lasers for rosacea, as well as many other procedures outlined below.

SKIN CARE TIPS

SUNSCREENS
Mineral sunscreen over chemical sunscreen eg. Avobenzone, cinnimates, oxybenzone. My choice? Invisible Zinc. In acute flare ups, avoid all creams for 2-4 days until barrier function is established.
MOISTURISER
Twice a day. Choose a moisturiser with no active ingredients. Dr Sam’s moisturiser is great. Also consider Obaji, both Hydrate and Luxe. HAs from The Ordinary can be a good humectant.

THINGS TO AVOID or CAUTION with
1. SLS, preservatives Parabens, formaldehyde, and fragrances.
2. Irritants such as Citrius, teatree oil, sandlewood, bergamot, Photosensitizers
3. 3. Avoid high strength AHAs and acidic formulations. This includes AHA such as glycolic lactic acid, best use salicylic acid in moderation. Use Vitamin C with caution.
4. Avoid physical exfoliation such as microbead products. Use baby wipes to remove make-up. “Simplify to amplify.”
5. Vitamin A, retinol and retinoids can be used with extreme caution. Dilute the product in a moisturiser base, use 2-3 nights per week and titrate accordingly.

PHYSICAL or PROCEDURAL METHODS for SENSITIVE SKIN
A medical dermatologist may refer you to a procedural dermatologist. Once a diagnosis has been established by my colleagues, procedures as outlined below can help control inflammation and provide safe, non-contact skin rejuvenation. I do not recommend chemical peels if you have sensitive skin, instead laser and light technology can help.

Lasers – dermal toning, laser genesis, pico lasers, Clear and Briliant, Fraxel, IPL or BBL

Dermal toning uses both pico and nanosecond pulseduration with longer wavelengths such as 1064nm and 755 nm Alex. As the laser penetrates into the deeper dermal layers the epidermis is largely spared. 5-10 sessions required for optimal results. With picosecond lasers similar results can be seen in less than half the time. The flipside is that the incidence of PIH is more common in more powerful short pulse duration lasers.

Laser genesis is particularly useful in this setting. Much like dermal toning, laser genesis provides a gradual increase in collagen over 3 months. As with dermal toning, the long wave 1064 nm is the wavelength of choice as it penetrates into the deeper dermal layers reducing inflammation as well as blood vessels. I use the newest laser from Candela called the Prima for laser genesis.

Fractional lasers such as Fraxel Dual 1927/1550 can be highly effective in providing dermal remodelling for any skin type, and any skin colour. Density of fractional laser beams, the fluence of power and number of passes can be controlled and a tailored solution given to patients with sensitive skin.

IPL or BBL stands for Intense pulse light or broad band light is a flexible physical modality- unlike lasers this treatment uses high fluence light with specific filters. IPL can treat many conditions, however using a specific filter IPL can reduce redness, inflammation and surface veins. Sensitive skin conditions such as acne, rosacea and flushing/blushing can be decreased after 2-4 sessions of IPL.

PDL or pulse dye laser can significantly improve rosacea. The 595nm wavelength is ideal for blood vessels with the target being haemoglobin. In most cases inflammatory skin conditions can be improved within 2-3 sessions, spaced 2-3 weeks apart. Pulse dye laser can also improve dermal collagen.

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Regards,

Dr Davin S. Lim
Brisbane. Australia
Cutis International

(Note my sub-speciality is procedural dermatology. If you have medical conditions such as sensitive skin, a medical dermatologist can help you. In some cases extensive testing maybe required to arrive at a diagnosis.)

Видео Sensitive Skin | Dermatologist Guide канала Dr Davin Lim