How to care for sensitive skin

What does sensitive skin mean?

Sensitive skin describes reduced tolerance to cosmetics and personal care products, rather than a single medical diagnosis. Symptoms include stinging, burning and itching, with or without visible redness, dryness, peeling or bumps. Skin can feel irritated even when no rash is visible. The face, especially the eyelids, can react to a product that other parts of the body tolerate.1

Sensitivity is not automatically an allergy. Irritant contact dermatitis is inflammation caused by something touching the skin without an allergic response. Dry skin, eczema and rosacea can also cause sensitivity. Several mild irritants can add up: frequent washing, friction, sweat, heat, cold and low humidity can all contribute. Care means avoiding triggers and treating an underlying condition when one is present.1

How should you wash and moisturize your face?

Start with a fragrance free cleanser; a soap free cleanser is another option for sensitive skin. Water alone is less effective at removing oily particles. Choose by how your skin tolerates the cleanser, not just the adjective on the label.14

1. 1Wet your face with lukewarm water. Hot water can strip the skin barrier and increase dryness.
2. 2Massage cleanser gently over your face, jaw and neck with your fingertips. Washcloths, loofahs and scrubbing brushes can be harsh.
3. 3Rinse with lukewarm water until the cleanser residue is gone.
4. 4Pat gently with a clean cotton towel rather than rubbing.
5. 5Apply moisturizer while your skin is still damp to help hold water in the skin.

Limit face washing to twice a day and after sweating. Cleanse before bed and before applying skincare products. Moisturize after washing, including if your skin is oily. You can apply a plain emollient again whenever your skin feels dry; check the label because products containing medicines such as hydrocortisone have different directions.25

What should you look for in a moisturizer?

Emollients are ingredients that soften skin and help relieve dryness or irritation. Moisturizers can also contain humectants, which attract water, and occlusives, which help prevent water loss. Glycerin and hyaluronic acid are examples of humectants. Petroleum jelly is an occlusive. If you are prone to acne, heavy occlusive products can aggravate breakouts; look for a moisturizer labeled noncomedogenic, meaning formulated not to clog pores.5

Fragrance free face creams are a sensible starting point. Ceramides and glycerin are ingredients to look for in creams for sensitive skin, but the full formula and ingredient concentrations affect tolerance. Be cautious with "all natural" claims: plant ingredients can cause allergic reactions too. An appealing description does not replace testing the product on a small area first.6

How do you test a new product?

Introduce only one new product at a time. If you change several products and develop a reaction, identifying the cause becomes harder. For eczema prone skin, use this home test before adding a skincare product:5

1. 1Apply a quarter sized amount to the skin on the inside of your arm.
2. 2Repeat daily for 7 to 10 days.
3. 3If the area remains clear, begin using the product. Avoid continuing with a product that triggers irritation.

An arm test cannot predict every facial reaction, because facial skin can be more sensitive. Medical patch testing is different: a clinician uses it to identify substances responsible for allergic contact dermatitis. Repeated reactions deserve assessment rather than an expanding list of guessed allergies.1

Should you use acids or retinol?

Acid cleansers, including those containing glycolic or salicylic acid, can irritate sensitive skin. Retinol can also cause irritation and needs particular care. If you choose retinol, start with a very small amount three times a week and increase only as tolerated. These ingredients are not necessary for the basic cleansing, moisturizing and sun protection routine.246

If you use a prescription cream, follow your clinician's instructions about applying it with moisturizer. Some medicines or active products need to go on before an emollient. Regular emollient use can ease dryness, itching and discomfort, but a chronic skin condition that is not improving needs a review of treatment.5

How do you protect sensitive skin from the sun?

Use shade, protective clothing and sunscreen as part of daily care. Apply a broad spectrum sunscreen with SPF 30 or higher to skin not covered by clothing, and reapply every two hours or after swimming or sweating. A moisturizer with sunscreen can combine two steps, provided it meets those requirements. Sun protection helps prevent wrinkles, age spots and skin cancer.2

How should you care for sensitive skin on your body?

Use warm rather than hot water. For sensitive or eczema prone skin, soap only needs to be applied to the face, armpits and groin rather than all over the body. If you shower multiple times daily, use soap during only one shower to reduce drying. Avoid fragranced bubble baths; their foaming agents can be irritating and drying. Rinse afterward if you use bubbles or a bath bomb.7

What changes if you have eczema?

For eczema, keep baths or showers to 5 to 10 minutes. Apply a fragrance free cream or ointment, rather than lotion, immediately afterward while skin is damp. Moisturize again whenever skin feels dry. Choose "fragrance free" rather than "unscented": unscented products can contain masked fragrance that still triggers a flare.3

Clothing and laundry matter too. Wear loose cotton clothing, avoid wool against skin, and use fragrance free and dye free detergent. Wash new clothes before wearing them and remove irritating tags. Cold can dry the skin, while overheating and sweat can trigger flares. Identifying your triggers helps reduce flares; an eczema treatment plan can also include medication.3

Buying fewer products can reduce both costs and irritation from using several different formulas.2

When should you stop a product or get medical help?

Avoid a product that triggers burning, stinging or irritation. Contact a clinician for redness, itching, rash or wounds that will not heal. Seek emergency care for a rash with fever, widespread involvement, blistering, red streaks, yellow or green fluid, sudden rapid spreading, pain or warmth to the touch.15