Find out more or book a one to one video consultation

The difference between sensitive and sensitised skin

Your skin may be reactive, but is it sensitive or sensitised?

If your skin seems to react to absolutely everything, it’s all too easy to think that you should be switching your entire skincare regime for products labelled 'for sensitive skin' or 'hypoallergenic.'  

But before you bin everything and rush out to restock, it’s worth working out what’s really going on first.

Is your skin sensitive or sensitised?

While a dermatologist is unlikely to use these terms as they’re not medical jargon, they can be a helpful way for the person on the street to understand what’s happening with their skin.

From an appearance perspective, sensitive and sensitised skin can look the same: you might get erythema (redness), scaliness, or some other form of dermatitis or skin irritation with both.

But as Dr Ifeoma Ejikeme, Founder & Medical Director of London’s Adonia Medical Clinic and EV Editorial Panel member explains, specific products tend to be the culprit if your skin suddenly seems to be sensitive overnight, which means it’s probably sensitised, rather than sensitive.

“Sensitised skin describes irritation in the skin usually as a result of using certain cosmeceuticals, such as retinoids, salicylic acid or glycolic acid,” she says.

“It tends to occur when lots of different active products are started at once, which disrupts the barrier function of the skin and prevents it from tolerating any products. Redness, pustules and even dermatitis can be seen.

The key difference between sensitive and sensitised skin is with sensitised skin, once the products causing the issue are stopped and the barrier function of the skin is restored, the irritation, sensitivity and any other changes go away.”

On the other hand, if you’ve got sensitive skin, sorry, but a) you’re probably stuck with it for life, and b) you’ll probably find that you don’t have to use stronger products to get exactly the same extreme reaction.

Even a basic moisturiser that all your friends can use without a second thought might provoke a reaction. This is because your skin is simply more prone to inflammation or adverse reactions, often from ingredients such as colourings and fragrances that don’t cause an issue for most people.

What’s causing the reaction?

Whether you’ve got sensitive or sensitised skin, the first thing you need to do is work out what’s caused the reaction.

In the case of sensitised skin, it will probably be easy to pinpoint the culprit — it’s likely to be a retinoid or an acid that you’ve started using recently, or that you’ve used too frequently so — for the moment, at least — put down the active ingredients.

If you’ve got sensitive skin, you might have to do a bit more detective work. In just the same way that people with food allergies have different triggers, so do people with sensitive skin. There are some ingredients that are more likely to provoke reactions — “certain fragrances, preservatives, and occlusive oils” are some of the common troublemakers for those with sensitive skin, says Dr Ejikeme. UV filters and essential oils can also cause issues.

The key to working out what your skin doesn’t like is to scrutinise the ingredients list. Every time you get a reaction to something, note down the whole list of ingredients and, over time, you should be able to pinpoint the common denominator, and avoid any products that contain it.

Will hypoallergenic products help sensitive skin?

Terms such as 'hypoallergenic' and 'for sensitive skin' are just marketing terms — legally they don’t mean anything at all, and there are no specific tests that products making these claims have to pass.

It may mean that they don’t contain fragrance or artificial colourants, but there are no guarantees, so if you’ve got sensitive skin, you’re far better off reading the label. Avoid anything that includes the words 'fragrance' or 'parfum,' and, to make your life easier, opt for products with as few ingredients as possible.

The simpler the product – and the fewer ingredients – the less likely it is to cause a reaction, and the easier it is to pinpoint the problem ingredient if it does.

So what does work?

Whether you’ve got sensitive or sensitised skin, when it comes to repairing the damage, Dr Ejikeme has a similar priority for both: "stop any offending agents and repair the barrier function of the skin.”

To do this, she recommends gentle cleansers, followed by products with ingredients like ceramides, hyaluronic acid, niacinamide and non-occlusive emollients.
Once you’ve got your skin back on an even keel, if it was temporarily sensitised, hopefully you’ve learnt your lesson and will be a little bit less gung-ho when using those actives. To avoid this kind of thing happening in the future, only introduce one active ingredient into your routine at a time, and gradually ease yourself in.

For example, if you’re using a retinoid, use it no more than twice a week at first. Don’t increase the frequency or start using another ingredient such as glycolic acid, until your skin feels like it is tolerating it well and you’re not getting any adverse reactions.

For those with sensitive skin, don’t panic that you won't be able to address other skin issues, you just have to do it carefully.

“For patients with sensitive skin, I look to follow a plan to address their underlying skin concerns, such as pigmentation, redness or age management,” says Dr Ejikeme.

“Whatever their concern, I would choose ingredients that are more suitable for sensitive skin such as lactic acid, azelaic acid and retinaldehyde, rather than stronger actives. I would opt for gentle cleansers, limited toning and add in moisturisers and a moisturising sunscreen that they are able to tolerate.”