If it seems like hypersensitive skin is afflicting everyone right now, it’s because it is. As a society, according to Aveeno’s State of Skin Sensitivity report, about 71 percent of people deal with it. Blame the overuse of multistep skin-care routines with skin-stripping actives, but seriously sensitive skin is rising. So, what’s the root of this skin crisis, which can perpetuate chronic dermatitis, acne and the inability to tolerate certain skin-care ingredients? And how can those living with these changes restore their skin to a healthy state? We tapped the pros to sort it all out.
Featured Experts
- Marina Peredo, MD is a board-certified dermatologist in New York
- Anna Chacon, MD is a board-certified dermatologist in Miami
- Tina Alster, MD is a board-certified dermatologist in Washington, D.C.
- Jennifer Segal, MD is a board-certified dermatologist in Houston
What Is Hypersensitive Skin?
There’s sensitive skin, and then there’s extremely sensitive skin. One parallels the other with a heightened histamine response, but with some differences. Sensitive skin, which is subjective, is characterized by itching, burning, stinging, tightness and dryness, and is often without visible clinical signs, explains New York dermatologist Marina Peredo, MD. On the other hand, hypersensitive skin (classified as reactive or intolerant skin) more rapidly reacts to triggers. It frequently displays signs of more extreme redness, tightness, stinging, itching, burning, dryness, scaling and swelling, as well as pain.
Not everyone who experiences super sensitive skin is genetically predisposed to it. Skin can evolve to become more sensitive over time, and anyone can develop hypersensitivities, especially when the skin barrier becomes damaged and can no longer protect the skin as intended. No matter the cause, whether it’s environmental factors, hormonal changes, aggressive exfoliation tactics, contact dermatitis, or the natural aging process, living with hypersensitivity can be debilitating, and more Americans are experiencing this firsthand.
While it may seem like skin suddenly becomes hypersensitive overnight, Dr. Peredo points out that it typically transitions from normal to sensitive, and then hypersensitive as the skin barrier breaks down. “It’s a slow process, but it can happen more suddenly depending on the cause. Early warning signs include redness, tingling, itching and dryness, but if you catch it early, you can adjust your skin-care routine accordingly.
The Primary Causes of Sensitive Skin
According to Miami dermatologist Anna Chacon, MD, the increasing prevalence of pollutants, widespread use of products with harsh ingredients and growing exposure to blue light–emitting digital screens contribute to the proliferation of more extreme skin sensitivities. “Additionally, stress, environmental allergies and changes in diet can also exacerbate skin sensitivity,” she explains. Consuming too many inflammatory, sugary and processed foods, as well as insufficient hydration, can also affect skin health.
Washington, D.C. dermatologist Tina Alster, MD agrees, yet points to abrasive skin-care products as the primary driver of increased sensitivity. “With an ever-expanding market of personal care items, consumers often create skin-care regimens without understanding how certain ingredients or products interact,” she says. “This lack of knowledge can lead to a disrupted skin barrier, resulting in heightened skin sensitivity.” Constantly layering exfoliants and acids further compromises the skin. Additionally, overdoing in-office treatments like lasers and chemical peels can prevent the skin from retaining moisture and dilute its barrier’s functionality.
Additionally, stress, environmental allergies and changes in diet can also exacerbate skin sensitivity.
Anna Chacon, MD
Beyond an ill-functioning skin barrier comes impaired skin-microbiome function. Dr. Alster explains that the microbiome is imperative in maintaining a healthy skin barrier, and protecting against external pathogens and environmental stressors. “But, many topical skin-care products unintentionally lead to microbial misalignment and set the stage for inflammatory skin diseases such as skin sensitivities, acne and eczema.”
The natural aging process can also prompt mildly sensitive skin to become hypersensitive. Houston dermatologist Jennifer Segal, MD says increased sensitivities are expected with aging due to structural changes the skin undergoes, most notably in women experiencing menopause. A decline in estrogen, collagen, elastin and lipids causes skin to thin, making it drier and more susceptible to irritants and sensitivities. The most significant impacts are seen in the first five years post-menopause when the skin is most fragile. “There is also a decrease in oil, so moisture retention is compromised and cellular turnover slows, which makes the skin less efficient at repairing itself,” adds Dr. Alster.
The Role of a Strong Skin Barrier
Dr. Segal equates a healthy skin barrier to a first-line defense system that keeps damaging elements out. Anything that impairs it leaves the skin susceptible to damage and, therefore, change. “A compromised barrier leads to increased dryness, irritation, redness, itching, and even breakouts, eczema or dermatitis.”
To keep the skin barrier healthy, nourished and protected, Dr. Segal recommends using gentle cleansers that don’t overdry the skin, followed by a soothing, fragrance-free moisturizer, which are both suitable for more sensitive skin.
Restoring Balance to the Skin
To restore harmony to extremely sensitive skin, using gentle, fragrance-free products is the name of the game. “Avoid anything harsh or irritating, such as retinoids and mechanical or chemical exfoliants,” Dr. Alster says. Focus on rich, moisturizing products with ceramides to rebuild and reinforce the skin barrier, as well as humectants to attract and retain moisture. Dr. Chacon also endorses soothing ingredients like aloe vera, chamomile and oat extract, and always recommends patch-testing products.
Sun protection is key, too. “Patients with super sensitive skin should use physical sunscreens that contain zinc oxide and titanium dioxide, and keep away from chemical formulas that may be irritating,” Dr. Alster says.
Beyond a well-devised at-home skin-care regimen to reinstate healthy skin, in-office protocols can also help. Dr. Alster recommends hydrating facials to address dryness, as well as fractional lasers, microneedling, radio frequency and microfocused ultrasound to improve collagen and elastin production in the skin. “LED light therapy has been shown to reduce inflammation and promote skin healing, so we routinely administer it after laser treatments to minimize post-treatment recovery.” Similarly, Dr. Segal adds that some in-office peels, like those with alphahydroxy acids, can help hydrate the skin and reduce redness and sensitivity.
