Sensitive Skin

Sensitive skin affects millions of people, but the exact definition varies depending on who you ask. Dermatologist Leslie Baumann, MD, FAAD, director of the University of Miami's Cosmetic Medicine and Research Institute and professor of dermatology at the University of Miami Miller School of Medicine, reports that in her practice up to 50 percent of patients have some form of sensitive skin. Dr. Baumann explains that there are four distinct types of sensitive skin: acne, rosacea, burning and stinging, and contact dermatitis (this includes allergies and irritants). These skin types all have one characteristic in common: inflammation.

Background on skin care products for sensitive skin

Skin care products marketed for sensitive skin do not specify for which type of sensitive skin they work best — such as acne or rosacea. For example, a product for an acne patient is very different from a product for a rosacea patient. But, both products will be labeled for use with sensitive skin. Manufacturers of skin care products cannot make any specific drug claims for treating conditions such as acne or rosacea. Therefore, "sensitive skin" has become a catch-all category for these products. The U.S. Food and Drug Administration (FDA) issues monographs for ingredients used in products that allow manufacturers to make certain claims, but not every ingredient will benefit every type of sensitive skin. For example, the FDA monograph that covers oatmeal allows the manufacturer to claim that this ingredient protects and soothes skin. However, Dr. Baumann reported that oatmeal would not be the best treatment for all types of sensitive skin, but can help contact dermatitis.


Acne is caused by oily skin and high levels of the bacteria P. acnes. Some skin care products can clog pores, leading to whiteheads and blackheads. Treatments for acne involve anti-inflammatory ingredients and anti-bacterials, including antibiotics, benzoyl peroxide, salicylic acid and retinoids. One natural ingredient that is used to treat acne is tea tree oil. Other natural ingredients, such as coconut oil and avocado, can cause acne outbreaks. Dr. Baumann cautioned acne patients to be careful when selecting products labeled "natural" or "organic," and to ask your dermatologist if you have questions as to whether an ingredient will help your particular type of sensitive skin.


Rosacea is a common skin condition commonly marked by facial flushing, pimples and broken blood vessels on the face. The cause of rosacea is not completely known, but theories range from bacteria, genetic causes, side effects of sun exposure and vascular instability. Anti-inflammatory ingredients that do not cause irritation are the mainstay of treatment for this difficult condition. They effectively reduce the redness and inflammation caused by rosacea and prevent facial flushing. These ingredients include caffeine, sulfur, sulfacetamide, various antibiotics and natural ingredients such as feverfew, chamomile, green tea and licorice extract. Dr. Baumann advised that skin care products containing vitamin C and alpha hydroxy acids (AHAs) should be avoided, as they are acidic and can cause stinging.

Burning and stinging

The cause of burning and stinging is unknown. Dr. Baumann noted that there are no products that help burning and stinging sensations. That's because the mechanism of why they occur — such as what nerves or skin components are involved — has not been determined through scientific research. Ingredients that are known to cause stinging are lactic acid, azaelic acid, benzoic acid, glycolic acid, vitamin C and AHAs. Dermatologists gauge whether a person has this form of sensitive skin by taking a medical history of the patient, and certain tests can be performed to see if a patient has a positive reaction to the known stinging ingredients. For example, the lactic acid stinging test can be conducted to determine if a patient feels lactic acid when a small amount is placed on the skin. However, this test is complicated by the fact that not everyone stings to lactic acid. For example, some patients who test negatively to lactic acid may sting to benzoic acid.

Contact dermatitis (allergies)

There are two main types of skin irritations in this category. The first is allergens, which is when you are allergic to an ingredient. For example, when you are allergic to something, your immune system is making antibodies against the thing to which you are allergic and causing the allergic reaction. The second is irritants, where an ingredient is irritating but you are not truly allergic. For example, if bleach is poured on your skin you will get an irritation from that chemical — but it doesn't mean you are allergic to it. People who complain of frequent rashes to specific skin care products are most commonly allergic to fragrance, preservatives, colors or formaldehyde. Dr. Baumann noted that it is difficult to predict who will be allergic, and dermatologists gather clues and make a diagnosis by asking patients questions as to when they notice the appearance of a rash. For example, a patient may report that she notices a rash whenever she wears eye shadow. In order to be certain of an allergy to an ingredient, patch testing must be done. Dermatologists perform patch testing by applying a certain ingredient to the skin and look for a rash to develop within 24 to 48 hours. Impaired skin barrier (or defects in the protective outermost layer of skin) may increase susceptibility to skin allergies and irritations. Many organic products lead to contact dermatitis, because they contain essential oils and fragrances that can cause allergy. For example, patients with a ragweed allergy could develop rashes to organic products that contain chamomile, calendula (marigold extract) and fever few — as these ingredients are cross reactive ragweed allergies. Dr. Baumann said that it is a misnomer to call organic products healthier and advised patients to use caution before using products labeled natural or organic. Dr. Baumann anticipates seeing occasional cases of contact dermatitis to some botanicals found in skin care products. See your dermatologist for successful diagnosis and treatment of skin, hair and nail conditions.

For More information contact Copyright © 2011 American Academy of Dermatology. All rights reserved. Reproduced with prior written permission.

Chemically Safe Information

There has been a great deal of talk about "chemically safe" cosmetics. In California, Governor Arnold Schwarzenegger has signed SB484 the California Safe Cosmetics Act of 2005 - the Nation's first state law on chemicals in cosmetics. Companies will now have to notify the state when they use chemicals linked to cancer and birth defects.

There are two opposing views regarding "safe" chemicals in personal care products. Chemists believe that any chemical used in the correct concentration of a product will not harm you. Therefore when a product is developed, guidelines on percentages are followed to insure the safety of the product.

Hypoallergenic and Cosmetics Safety Information

Information for my clients about HYPOALLERGENIC COSMETICS from: US Food and Drug Administration Center for Food Safety and Applied Nutrition Office of Cosmetics and Colors Fact Sheet December 19, 1994; revised October 18, 2000

"Hypoallergenic cosmetics are products that manufacturers claim produce fewer allergic reactions than other cosmetic products. Consumers with hypersensitive skin, and even those with "normal" skin, may be led to believe that these products will be gentler to their skin than non-hypoallergenic cosmetics."

"There are no Federal standards or definitions that govern the use of the term "hypoallergenic." The term means whatever a particular company wants it to mean. Manufacturers of cosmetics labeled as hypoallergenic are not required to submit substantiation of their hypoallergenicity claims to the FDA".

"The term "hypoallergenic" may have considerable market value on a retail basis, but dermatologists say it has very little meaning." Cosemetic Safety Information from:
US Food and Drug Administration
FDA Consumer
November, 1991; revised May, 1995

Allergic Reactions

"Do the preservatives (in cosmetics) pose any safety risk?"

"According to a study of cosmetic reactions conducted by the North American Contact Dermatitis Groups, preservatives are the second most common cause of allergic and irritant reactions to cosmetics. Fragrances are number one. Although the study is more than 10 years old, the results can still be considered valid today, says Harold R. Minus, M.D., an associate professor of dermatology at Howard University Hospital. (for More information on this study, see "Cosmetic Allergies" in the November, 1986 FDA Consumer."

"People who have had allergic reactions to cosmetics may try hypoallergenic or allergy-tested products. These are, however, only a partial solution for some and no solution at all for others."

"'Hypoallergenic can mean almost anything to anybody,' says Bailey."

"'Hypo' means 'less than,' and hypoallergenic means only that the manufacturer feels that the product is less likely than others to cause an allergic reaction. Although some manufacturers do clinical testing, others may simply omit perfumes or other common problem-causing ingredients. But there are no regulatory standards on what constitutes hypoallergenic."

"Likewise, label claims that a product is 'dermatologist-tested,' 'sensitivity tested,' 'allergy tested,' or 'nonirritating' carry no guarantee that it won't cause reactions."

Safety Testing

"Whether driven by altruism, liability, or the bottom line, most companies see the need for safety testing. But safety testing can rarely be mentioned without bringing up the controversy surrounding the use of animals for those tests."

"Many companies have begun to label their products with statements indicating that no animals have been used in testing."

"As far as we know,' says Neil Wilcox, D.V..M., director of FDA's Office of Animal Care and Use, 'what these companies do is use, for the most part, old reliable ingredients that have proven safe (based on past animal data and a history of safe use) and then test the final product on people."

"There's kind of a fine point here; says CTFA's McEwen. 'These companies that say they don't test on animals are skirting the issue. Practically every ingredient that's used in cosmetics was at some point tested on animals. Probably a statement like 'no new animal testing; would be more accurate"

Beauty on the Safe Side

"Besides never putting on makeup while driving, consumers should follow other precautions to protect themselves and the quality of their cosmetics."

"* Keep makeup containers tightly closed except when in use."

"* Keep makeup out of sunlight; light can degrade preservatives."

"* Don't use eye cosmetics if you have an eye infections, such as conjunctivitis, and throw away all products you were using when you first discovered the infection."

"* Never add any liquid to bring the product back to its original consistency. Adding water or, even worse, salvia could introduce bacteria that could easily grow out of control. 'If it has lost its original texture and consistency,' says McEwen, 'the preservatives have probably broken down.'"

"* Never share."

"* Throw makeup away if the color changes or an odor develops. Preservatives can degrade over time and may no longer be able to fight bacteria."

"'We don't have a hard and fast rule on (when to throw cosmetics out),' says says McEwen. McEwen says makeup can be kept indefinitely as long as it looks and smells all right and the consistency doesn't change. 'It would be difficult to have any kind of bacterial growth and not have it noticeable,' he explains."

"However, Janice Teal, a microbiologist who heads the product and package safety divisions of Avon Products, Inc. disagrees. 'Even after the preservatives have stopped working, you may not be able to see or smell anything different,' she says."

"She agrees with McEwen that there is no absolute date for discarding various various products, but says Avon recommends that consumers throw mascara away after three months. They can keep other makeup products a few months longer."

"'Mascara is our biggest concern because of the wand,' she says. 'Normally, the eye is a good barrier to bacteria, but one slip and that wand can scratch the cornea and introduce all kinds of bacteria.'"

Skin Cancer Foundation and Sun Protection Information

Information for my clients about Year-Round Sun Protection taken from:
Skin Cancer Foundation website,

Copyright 2019 Dr Jonathan S. Sibson, D.C. all rights reserved.