A Complete Guide to Sensitive Skin Care

I’ve suffered from sensitive, dry skin my whole life. So when La Roche-Posay, a company that started as a Thermal Center hospital for dermatology conditions, and their partner Dermstore, asked me to join their sensitive skin #dermclass with celebrity dermatologist, Dr. Glynis Ablon, I was ecstatic. 

I had quite the list of questions for her.

What do I do when I have a skin reaction? Do I need an SPF 30 or higher? What even is broad spectrum sunscreen? What environmental factors are causing me to break out? I have a red rash on my face, now what? My skin care products are causing a sting or burn, now what? Can I just wear a mask full-time for extra protective layers? No one needs to see me, right? Do I need to do patch testing? Why does it look like the blood vessels are popping out of my face? 

Okay, I may be exaggerating just slightly on my questions. Bottom line: it’s unpleasant having easily irritated skin. People with sensitive skin have numerous things to think about for healing their skin.

Dr. Ablon’s expertise goes way beyond being one of The Doctors. She’s an Associate Professor at UCLA, training up the next generation of doctors, and has a plethora of research attributed to her name. After taking this class, I have to say, I wish I were training with her at UCLA full-time. I think when you read what she had to say below, you’ll be signing up for UCLA too!

So Dr. Ablon, what is sensitive skin? Are people just born with it?

I think [that’s] more of a cosmetic diagnosis. When people have reactive skin, an irritant reaction, they have damaged surface cells….Even a tan is a sign of damaged skin. Damaged skin doesn’t often react like baby new skin. [And] if you’re protecting yourself [by putting] a product on, and your skin does not have sun damage, it can actually be a little more sensitive to it, even though you don’t have sensitive skin.

 

What is the difference between an allergic reaction, allergic contact dermatitis, and an irritant?

A true allergy means that you were exposed to something, and then you were re-exposed to that same ingredient. Your body then actually has what’s called a delayed hypersensitivity. [Which] stimulates your immune cells (T helper cells) to react to that product…often times that means pimples, blisters, redness, itchiness…an allergy can appear up to four days after exposure.

Irritant dermatitis, which [is] much more common, means that you touch something, and your skin becomes irritated, and itching as soon as it touches your skin…if you have a reaction to something you’ve never tried before, that’s not an allergy. It has to be a re-exposure.

 

Is fragrance an irritant? Essential oils?

When you’re looking at ingredients, the more smelly and beautiful it is, often times, the more irritating it can be…before you try anything, put it on your wrist. If you want to be aggressive, put it behind your ear. If you have a reaction, I wouldn’t recommend that product.

 

But I love lavender!

I love it too, but it can be an irritant. And that’s why, if you’re someone with sensitive skin, we stay away from the really pretty smelling stuff.

 

What about parabens?

Things that make our products live on the shelves for years…there are preservatives there… Products that [are] chemical free, paraben free, [and without] stabilizers [are preferable]. If you just don’t feel good when you put it on, that’s something you should stay away from. For example, alcohol isn’t great for sensitive skin, but for acne, isn’t necessarily a bad thing.

 

What about other allergies, like pollen and food allergies? Does this affect the skin?

“[Allergies] can manifest with watery, itchy eyes, hives, rashes, all over your body. I really believe the environment is a big factor. People are being exposed to toxins in the environment, [which can cause] skin allergies to occur. 

All these things degrade your [skin] barrier. Anything you can do to help your barrier, to repair your barrier, is critical. That’s where topical products really can make a difference.

You keep saying protect the skin barrier! Why is this such an issue?

Our skin is getting damaged…and everyone’s into their scrubs and loofahs. As you get that really smooth skin you are also, often times, damaging the skin.…I try to be more gentle with my skin. 

 

Can I ask a dermatologist what the condition of my skin barrier is?

There is a measuring tool you can get on the internet. This is just going to measure your moisture content. The idea for me, is that, more barrier I create, (the greasier you keep your skin, the thicker it feels), the more protected your skin will be. So I like that! I’ll tell my patients the greasier the better! Especially if you’re having a reaction. This creates a seal on the skin. 

Will retinols help my skin barrier? What do you think about retinol for sensitivity?

Retinoic Acid, retinols and retinoids are products that will actually thicken your epidermis and stimulate the formation of collagen. The biggest drawback? They are drying. Someone with sensitive skin can be miserable! 

It’s a great product, but you need to know what you can tolerate. There are different levels of retinol. Everyone can tolerate a different amount of it. The biggest thing I like to use retinol for is acne scars. It can really change scars! 

But because everybody is different, I usually have my patients start with a small amount, like four little green peas to cover your entire face, and only twice a week. With infrequent use, you’ll get to the point when you can use it every day.

What do you think about plant-based retinol?

I like [it]! They typically are less concentrated and patients can tolerate them better.

 

What if I’m concerned about big pores and acne?

This is always a question! They’re constantly trying to work on machines to shrink pores. But the truth is retinoic acid, that vitamin A family, is one of the best things for pore size. Because, by thickening the epidermis, those pores do shrink in size. Things like pore strips, just temporarily take the keratin out of the pores and they fill right back up. It’s not a permanent fix, but it’s a nice temporary fix.

 

And dark spots?

Like dark spots from the sun? Typically we do lasers. If it’s a dark spot, as in hyperpigmentation, from a resolving pimple..we’ll typically do things like peels. For conditions like Melasma, we’ll typically use topical lightening agents, chemical peels or new lasers.

What is the best skincare routine for sensitive skin? What is the best way to take care of sensitive skin?

That’s where ceramides are important, because they create a barrier for your skin to your outside environment.You want to protect your skin also using mineral sunscreens, and avoid chemicals as much as possible as well as fragrances and drying alcohol in products.

The biggest mistake people make is taking a teeny little bit and say, ‘ok! I put it on!’ Sunscreen for example, it should be like a shot glass to cover your body one time! More is better!

But if I’m talking to someone with acne prone skin, my prescription might change. Everyone’s skin is slightly different. The idea is to find what works for you personally. I think [we should] get away from the chemicals, go more for preservative-free and chemical products.

I did a topic one time on the news, and we were talking about the cosmeceutical products out there that are endocrine disruptors. So these kids are putting products on there skin and their hormones are changing from it! So phthalates, parabens, phenols…are things that you really have to be careful of. Those of you who are young, or have kids, thinking of having children, those are things you really want to be careful of.

La Roche-Posay doesn’t have any preservatives in it. The pouch really helps with the preservation of the formula. Most parabens…, if you can get away from them, great! Then you’ll have less sensitivity.

Will my skin regimen always be the same throughout my life?

Our skin absolutely changes. What you used when you were 20, is probably not what you’ll use when you’re 30, it’s certainly not what you’ll use in your 40’s or 50’s.

You absolutely change over time due to a variety of factors. Environment, hormones, stress…which I wrote a book on!  It’s about finding the things that work for you at that age.

 

What about oily/combination/sensitive/acne-prone skin?

The first thing I actually talk about is diet. Then, I talk about cleansers with my patients. I may use one cleanser once a day, one in the am and a different one in the evening depending on their skin type. Every once and awhile I may use two different cleansers at the same time in different areas of the face. It just depends on the person.

[This] is a perfect reason why La Roche-Posay made these products! You want to stay away from as many chemicals and preservatives as possible. It’s also important, for your sensitive areas, to stay away from alcohol. And then [set] an acne treatment, which may include balancing hormones and [soforth].

 

Speaking of hormones, why does birth control get prescribed for acne?

Hormones change your sebum production and more. Birth control doesn’t change acne. They put in a medicine that’s a variety of spironolactone and that’s what changes the acne, but birth control can help you, or it can hurt you. It depends on what’s happening with your body.

 

What if you have eczema and acne at the same time? What moisturizer should you use to treat both at the same time?

There are different kinds of moisturizers that aren’t as greasy. There are serums, and gels, and things like that. Depending on that patient, they may get more of a gel to treat acne and a moisturizer or prescription creamy moisturizer for the eczema, and then work on the barrier once the acne is under control. It might be [treated] in stages.

 

What about rosacea? Is it really skin mites? How do you get back to a base line?

There is a form of rosacea called Demodex, that feels like…almost like a crawling sensation, and it actually is a crawling sensation. Because it’s little mites! You can scrape the skin and put it under the microscope and see their little arms. You would want to have that diagnosed by a physician. You can treat it. You change the pH and use topical [products].

 

What about photosensitivity? Can that be cured?

The question is what is causing your photosensitivity? Photosensitivity can be caused by an auto-immune disorder, can be related to eye color…if it’s something you’ve had ever since you’re a child it’s usually just due to how your eyes are set up. It can just be the eyes; it can be your skin. 

If you’re sensitive due to an underlying condition, then you would want to treat that condition and sometimes it can go away. If it came on suddenly, go get checked out. [Some] medication can also cause photosensitivity.

 

You talk a lot about diet and there are so many supplements out there for skin care. What do you believe works?

I have on my desk, 10 different bottles! I believe the majority you should get from your diet, but I do, for example, Vitamin D. I take 4000 IU’s a day. Studies show that Vitamin D protects against cancer, chemo protecting, if it’s above 40 IU’s. They used to think it was 20 [IU’s]. 

I think everyone over 25 should be on a calcium-magnesium supplement…Cal-Mag is something that people are often times missing. People forget that osteoporosis happens! As we age, it’s something we have to [think] about. If, at the age of 25 and over, you can get on a supplement of 1000mg a day and over [that’s great]. 

I don’t sell supplements in my office aside from menopausal supplements, because I love them! But I do give a list of supplements to my patients for different skin conditions.

 

Do collagen supplements work?

I think we need more data for me to be convinced that they’re really making a difference. To see if it makes a change, you’d probably have to be on it for 6 months and do some measurements to see if it’s truly making a difference.

My hope is that your nutrition is good enough that you are getting [collagen] in your diet. But if you aren’t really a great eater it might be something you’d like to try.

 

Personally, I’m against supplements because I believe you should get it from your diet. How did you arrive at supplements being important? 10 is a LOT.

Some of my supplements you might not even consider a supplement…like, I do a green juice every day. The better I am with my diet, I may decide to pull out a supplement because I don’t think I really need [it]. And remember all supplements are not the same. Look for organic ones.

Certain things aren’t going to be enough. Even with my healthy eating, sometimes I’m so busy, I won’t even drink! So, I know with me, what I may not be getting in there. Other than Cal-Mag, not everyone needs to be on what I’m on. It’s important to evaluate. What is your diet plan? What do you need?

Are there things you should definitely avoid? Definitely include in your skincare routine?

The skincare industry has had a giant boom. There are so many choices! I frequently will say, just like at the grocery store, if you see 472 ingredients on there, don’t buy it. 

The more ingredients, the less active ingredients you’re getting in there, and who knows what you’re getting. I love staying away from chemicals and preservatives. The more you can stay preservative-free, especially if you know you have sensitive skin, the better off you are. 

If you find a company that you like and you trust, that’s a good way to go! Take a look at the data and research. If there’s no research on it, I’d be a little concerned.

I won’t just put anything on my skin, and I’m not sensitive. I really research and look at what the ingredients are.

Because I do research, I get a lot of product. I read about 40 journals a month. When we’re doing skincare product studies, we’re talking 60-80 patients. It’s not a few patients. The idea is we’re really getting a broad scan. These patients are getting pictures, and doing diaries. They’re being asked if they’re having any weird reactions.

 

What about specific products you shouldn’t use for sensitive skin?

1. Toners
   If you have oily skin throughout the day, then I usually don’t mind toners, but, it does strip your skin typically of your natural oils. And I don’t like to do that.
2. Scrubs
   [They’re] okay with young individuals. Usually people over 25 or 30, can actually cause broken capillaries for men and women. I think it’s more damaging than helpful overall.

 

No Scrubs? How am I supposed to exfoliate!?

I like masks. When you’re rubbing on your skin, you’re breaking capillaries. That’s why sometimes we’ll see red lines around the face. I tend to do a mask that may have a hydroxy acid in it. Depends on the skin type. Masks are good because you aren’t mechanically disrupting the barrier. Sometimes there are buffers you can use [too for sensitive skin].

 

What do you think about microneedling?

It’s a great way to get products into the skin! It’s a nice way to deliver PRP. When combined with radio-frequency, it’s a great way to work on scars. By itself, it’s not the end all be all, but it’s a nice tool. 

Anytime you prick the skin, you are doing what’s called Collagen Induction Therapy. Really well done micro-needling…hurts. Go to a professional. Don’t go to the [random] clinic down the street. 

Everything has it’s place. Weigh your options and see what you’re trying to address.

 

What does treatment look like if you wake up with a reaction, like a rash or irritation?

If you are able to get in and see someone, that’s the best thing. Then you can find out what’s going on. 

The first thing I do is tell my patients is to immediately keep a diary. Sit down and write down the last 72 hours. 

• What did you do?
• What did you put on your face?
• What did you eat?
• Where were you?
• Were you traveling?

Really keep a list of what might have caused the rash or development that occurred. At that moment in time, you want to clean your face. Something really gentle, nothing harsh or acid cleansers or anything like that. 

Then treat it like a baby’s bum. A little hydrocortisone I don’t mind. A very low dose that gets put on twice a day; keep it moisturized. Pure moisturizer is a really good idea. If [the rash is] gone, you’re done! 

You can take an anti-inflammatory, you can take an advil, or, an aspirin, which will also help calm it. There are a bunch of homeopathic things you can do, but that’s another topic. 

The idea is that less is more. Clean that. Don’t put anything on it. Don’t put makeup on it because that’s the worst thing you can do. 

Once it calms down, again, take a look at your history and what you’ve done.

What exactly is SPF?

SPF15 doesn’t mean 15 minutes in the sun, or 15 times as strong versus 30 times as strong. 

It is the percentage of blockage you can get. When you get SPF 15 you are going to block out about 90% of the sun’s rays. When you go to 30, this is going up very slightly. it goes to about 94%. When you go to an SPF 50, you’re going to, like, 96%. When you go to 100 SPF, you’re getting, like 98%. 

[Most] of my patients, when they get an SPF of 30? They’re good. But someone that easily sunburns, this may not be enough. You wear sunscreen so you don’t get a sunburn or sun tan. 

If you go out and get a sunburn, or sun tan, with an SPF of 50, then 50 isn’t enough for you–you may need 100. If you go out and you’re fine with SPF of 15 with no tan, then it may be enough for you.

 

What’s the best SPF for sensitive skin?

The most important thing you can do [for your skin], I can tell you absolutely, is sunscreen. One of the things I like about La Roche-Posay is they have mineral sunscreen. I’m a big fan of mineral sunscreens.

Mineral sunscreens are physical blockers. They sit on your skin; they immediately block and protect your skin. Then you wash it off without any chemicals absorbing into your body. That’s what I like and it’s really the only thing I recommend my patients to use.

Chemical sunscreens have to be activated, which is about 20 minutes before it becomes active, and then it protects your skin. So if you throw it on and run outside, you’ve just gotten 20 minutes of sun exposure. I’m not a big fan of that. Doesn’t mean you can’t do that!

There are also new supplements that are oral sunscreens. And B vitamins work to be a little more photo protectant and anti-inflammatory as well.

 

Do mineral sunscreens last longer?

No. 80 minutes per application, even if it has a high SPF.

 

A lot of foundations have sunscreen in them. Is that enough?

[Whatever the source, sunscreen] has to be reapplied every 80 minutes. Sometimes really thick makeup adds a layer of protection as well, but it has to be reapplied to be effective.

 

If you’re trying to avoid sensitivity, what would be your 5 golden rules?

 

1. Always take care of yourself.
   Make yourself a priority. Do what you need to do to bring down the stress in your life.
2. Do what you love in life
3. Wear your sunscreen.
   Everyday! Even on cloudy days, you’re getting UV [rays] and sun damage.
4. See a skincare specialist  
   and find out what YOU need [for your skin]….Don’t think Google is your answer! I think a face-to-face is really important. Bring your bag of skincare products so you can go over what’s in your bag. Look at what’s in your products.Not every ingredient is what you need… And there’s a difference between natural and organic. Natural doesn’t necessarily mean it’s organic. It’s important to understand what you’re putting on your skin.
5. Look at what you’re putting in your body.
   Nutrition is everything! We’re just now seeing the data on [gut health]. When you treat your gut right, guess what else looks good? The outside is a manifestation of what’s going on inside.When you can eliminate the sugars and the things that don’t make your body the best it can be, you’ll feel better.

*Editorial Note: This post was sponsored by La Roche-Posay x Dermstore. The compensation received in exchange for placement on The Vanilla Plum is used to purchase props, hire a photographer, write/edit the blog post and support the team behind The Vanilla Plum. Thanks to La Roche-Posay, Dermstore, Dr. Ablon, The Huntley Santa Monica, and Hotel Pendry for bringing this post to life.

While compensation was received in exchange for coverage, all thoughts and opinions are always my own. Sponsored posts like these allow for the development of additional dynamic content to be produced, unsponsored. Thank you for supporting our partners!