Skin Sensitivity Explained - Rosacea, Eczema, Psoriasis
A truly sensitive skin condition is the result of a person’s genetics but sensitive and sensitized skin manifest the same way. Sensitive skin is genetically predisposed while sensitized skin is usually the result of environmental and lifestyle factors. Sensitive skin falls into a more general category referred to as the atopic triad but includes: rosacea, eczema, psoriasis, and dermatitis. Statistics show that 50-90% of the population perceives their skin as being “sensitive” Sensitive/sensitized skin tends to be thinner, highly reactive, prone to allergic reactions, and has a low tolerance for temperature changes. Regardless of the classification the common theme is burning, stinging, itching, and prickling skin sensations. Cosmetics, skincare ingredients, diet, and climate changes can all trigger skin sensitization and worsen a genetically sensitive skin condition.
Rosacea Overview
Rosacea is a very common skin condition characterized by redness and flushing usually in the centro-facial region. https://www.rosacea.org/. It can also manifest on the neck and triangle of the upper chest. As rosacea worsens a person may develop telangiectasia (distended capillaries), retention hyperkeratosis (dead skin cell build up), and inflammatory lesions that will closely resemble acne vulgaris. Rosacea is more common in lighter skin tones and is three times more common in women than in men. Most cases of rosacea fall into one of the five subtypes.
Rosacea subtypes
Subtype I (erythematotelangiectatic rosacea): primarily vascular manifestations only. Persistent redness (erythema) especially in T-zone. Dilated blood vessels are often visible, flushes easily. Skin tends to be dry and prone to burning/itching. Triggers can include; stress, alcohol, spicy foods, rigorous exercise, and climate changes.
Subtype II (papulopustular rosacea): some permanent redness, usually very pronounced in t-zone and cheeks. Inflammatory lesions present, very often confused with acne. Telangiectasia may also be visible. Papulopustular lesions can occur.
Subtype III (phymatous rosacea): characterized by thickening of the skin and nodule-like lesions. Most commonly associated with rhinophyma, a skin disorder characterized by a large, red, bulbous nose. Can also affect chin, forehead, ears and/or eyelids.
Subtype IV (ocular rosacea): red, irritated eyes and lids. Eyes tend to feel gritty and sensitive. Ocular rosacea can develop before any other subtypes. May include some skin sensitivities and erythema.
Subtype V (neurogenic rosacea): caused by neurogenic inflammation characterized by dramatic facial redness, burnings, stinging, pain, tremors, depression, and OCD. Thought to be attributed to abnormalities in neurovascular homeostasis.
Currently there is no cure for rosacea but it can be treated with a variety of different approaches. Changes in lifestyle and home care products can be hugely impactful in treating and controlling the symptoms of the disorder. If rosacea is left untreated it worsens with time and is known to be a chronic, long-term skin condition. Natural remedies can be used alongside most medical treatments and add additional support in healing and controlling inflammation. It’s important to work directly with your healthcare team to develop an effective treatment for your rosacea.
Eczema Overview
Eczema is a blanketed term referring to skin inflammation and is sometimes referred to as dermatitis. https://www.niams.nih.gov/health-topics/atopic-dermatitis. The skin becomes dry, itchy, and prone to skin fissures and weeping. In more severe cases plaques and rashes can occur especially on the face, hands, elbows and knees. As with most sensitive skin issues, the root cause is not known but experts believe that it’s caused by both genetic and environmental factors. Eczema symptoms can improve or worsen over time but is a long-term skin disorder that needs careful management.
The most common form of eczema is atopic dermatitis, which is more common in babies and young children, but we’ve seen a growing number of adults suffering with it as well. The treatment for eczema and sensitive skin conditions as well as the triggers are fairly universal and discussed in more detail below.
Psoriasis Overview
Psoriasis is an inflammatory skin condition, which results with an inappropriate immune response and increase proliferation of skin cells. Although there is a genetic predisposition, environmental influences play a huge rule. UV radiation, smoking, skin flora, and stress are all key players in the manifestation and treatment of psoriasis.
Facial psoriasis is a chronic skin condition characterized by persistent red and dry patches https://www.webmd.com/skin-problems-and-treatments/psoriasis/face#1. Psoriasis can manifest anywhere on the body and is commonly seen on the face, eyelids, hairline, and ears. It is rare to have psoriasis solely on the face; most sufferers experience it in other places as well.
Patients with facial psoriasis suffer even more due to the plaguing being in highly visible areas. Because facial skin is so thin, treating psoriasis plaguing can be challenging so it’s advised to follow the general rules for treating skin sensitivities.
Main Factors/Triggers
The actual causes of sensitive skin disorders is still unknown however there are several factors that play key roles in this complex skin condition.
Genetics: individual that have a family history of rosacea are more likely to develop the condition.
H. pylori bacteria: bacteria found in the gut, it stimulates a polypeptide known to cause blood vessels to dilate.
Light skin tone: fair skinned people are much more likely to develop rosacea than darker skin tones.
Abnormalities in facial blood vessels-abnormalities in the blood vessels of the face cause flushing, persistent redness, and visible blood vessels. The root causes are still unknown but some possibilities include prolonged inflammation and UV damage.
Diet- alcohol, spicy food, sugar, medications, and dairy are all known triggers for inflammatory flare-ups. There is no evidence that diet factors into the initial development of skin sensitivities but can significantly worsen the condition.
Inflammation- inflammatory skin conditions as well as autoimmune disorders can contribute to or even worsen compromised skin.
Skin Flora- malassezia is a group of yeast that has multiple different species and is associated with dermatitis. It is believed that the metabolites of the yeast are responsible for skin irritation.
Environmental damage- environmental damage may include UV radiation, climate changes, and chemical exposure. Some experts believe that environmental changes are the initial trigger for vascular changes and skin breakdown.
Skin matrix degradation- rosacea skin has an increase in degradation of the skin matrix which includes; collagen, elastin, and glycosaminoglycans (GAG’s). Unknown whether this is a cause or factor.
Demodex folliculorum-tiny mites that live in the epidermis and hair follicles and are present on all humans. Overgrowth of demodex triggers an immune response that perpetuates skin inflammation.
Skin irritants- skin irritants can cause or worsen symptoms of sensitive skin. Improper product usage is a key factor, usually the over use of exfoliating products.
Treatments For Sensitive/Sensitized Skin
Medical:
Topical medication to reduce inflammation, treat bacteria, and heal lesions
Azelaic Acid
Metronidazole
Retinoids
Sodium sulfacetamide
Sulfur
Steroid creams
Eucrisa https://nationaleczema.org/fda-approves-treatment-for-atopic-dermatitis/.
Oral medication to treat inflammation and lesions
Azathiorine
Ciclosporin
Steroids
Methotrexate
Mycophenolate
Lasers, electrocautery, and IPL to reduce visible erythema and telangiectasia
Surgical procedures to reduce skin thickening
Holistic:
Consume a whole foods based anti-inflammatory diet that maximizes nutrient density.
Stress often manifests itself through various skin issues. Stress reduction can be a helpful compliment to any rosacea treatment.
Topical preparations using plant/botanical ingredients to help calm and heal the skin.
LED light therapy can be very useful in reducing bacteria, erythema, inflammation, and can accelerate wound healing.
Supplements- various herbs such as ginger and turmeric are effective in reducing inflammation and gamma-linoleic acid and Vitamin B have been shown to improve overall skin health. https://www.thehealthyhomeeconomist.com/gamma-linolenic-acid-weight-loss-fat-with-anti-inflammatory-benefits/. As with any nutritional supplement, it’s important to work directly with your healthcare team to target your unique nutritional needs.
Functional medicine- deeply science based, personalized healthcare with an emphasis on individuals genetic and biochemical uniqueness. Supports natural healing mechanisms of the body versus attacking the illness. Functional medicine can be highly useful in both the treatment and prevention of disease. https://www.evanbrand.com/.
Skincare:
No harsh rubbing, scrubbing, or exfoliating the skin
Use only gentle cleansers with cool water, never hot
No harsh ingredients, alcohols, known skin irritants
Apply antioxidants to reduce inflammation and boost SPFSkin appropriate moisturizer- light weight for oily/acneic, heavier weight for dry/dehydrated/sensitive
Spray Hydrators to increase moisture level and maximize product penetration
Daily SPF protection with a mineral based sunscreen. Formulations will include titanium and/or zinc oxides
High quality, mineral based cosmetics can be used on even the most delicate of skin. https://janeiredale.com/us/en/mineral-makeup/product-testing.htm Mineral based cosmetics also provide additional SPF protection and don’t degrade quickly on the skin. If applied correctly, the skin is protected for up to 8 hours
Protect skin in the wintertime with scarves or a skin mask. Cold weather depletes the skin of moisture further increasing sensitivity
Regardless of the classification of skin sensitivity the common thread amongst them is inflammation. Addressing inflammation both topically and internally is critical for the treatment and management of skin sensitivities.
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