How to Treat Acne on Sensitive Skin
When it comes to curing acne, sensitive skin requires sensitive treatment1. Acne remedies that work well on resistant skin can make acne on sensitive skin worse, especially ingredients that are added to make a formula seem organic, herbal, and natural.
- Sensitive skin responds to harsh treatment by making oil.
- The wrong acne treatment on sensitive skin can make acne worse.
- You can tell whether you have sensitive skin by reactions of your skin to fragrances, sun, laundry products, and alcohol.
- If you have sensitive skin, it is very important to use only very mild concentrations of benzoyl peroxide.
- If you have sensitive skin, you will have probably have more problems with brown spots left after acne heals than you will have from acne itself.
- Certain lightening products can make brown spots darker if used on sensitive skin.
- Certain common acne treatments can make pimples worse if used on sensitive skin. This article lists alternatives that work.
Sensitive skin is a type of skin that is highly reactive to2 stress. When we undergo mental or physical stress3, the pituitary gland in the brain releases a hormonal messenger known as corticotrophin stimulating hormone to activate the adrenal glands. When the skin undergoes stress, it also releases corticotrophin stimulating hormone to sebum glands.
Sensitive skin responds to stress by making oily sebum4. Corticotrophin stimulating hormone also instructs mast cells in the skin to release histamine. This is the same chemical that causes allergies. In sensitive skin, it’s possible to have an allergic reaction without coming in contact with an allergy-inducing substance. Sensitive skin is “allergic” to stress5. And it responds to stress by becoming red, itchy, irritated, and oily.
How to Tell Whether You Have Sensitive Skin
How can you know whether you have sensitive skin6. Here are some reliable indicators:
- You get bright red pimples on your face.
- Makeup, toners, astringents, exfoliants, and sunscreen sting or burn when you put them on your face.
- Any kind of jewelry other than 14-karat gold makes you break out (anywhere you place it on your body).
- You have been diagnosed with rosacea.
- Your friend tell you that you must have rosacea.
- Using bubble bath, moisturizer, shampoo, or massage oil with fragrances added makes your skin feel dry or itchy or makes you break out.
- Using scented laundry sheets or static control sheets in your dryer makes you feel itchy or makes your skin break out.
- Coming in from cold air to a warm room makes your skin break out, especially in the middle of your face.
- Drinking hot beverages or eating spiced food makes your skin break out.
- You get pimples instead of sunburn when you are out in the sun, or when your skin gets hot.
- Anger and embarrassment make your face and neck red.
- People ask you if you are sunburned, even if you are not. Or you really are sunburned all the time (which is not a good thing).
If three or more of these characteristics apply to you, chances are that you have sensitive skin. And it’s also possible that you can have rosacea.
The Difference Between Rosacea and Common Acne
Rosacea is a condition of skin inflammation that begins in blood vessels, not in pores7. People who have rosacea tend to have weak capillaries, especially in the skin of the face over the cheeks, on the nose, and around the eyes. When these tiny blood vessels expand to cool the blood, they begin to leak. This makes the skin red in tiny dots around the leak. If this happens enough times (usually over a period of years) the skin can develop lumpy scar tissue around repeated leaks, giving the skin, especially the skin of the nose, a bumpy, lumpy kind of disfigurement known as rhinophyma.
Trying to get oil out of your pores won’t do you any good if you have rosacea8. But trying to get oil out of your pores won’t do you any good if you have common acne on sensitive skin, either. All you will accomplish by harsh chemical or detergent treatment of either rosacea or common acne on sensitive skin is stimulating even more redness and even more sebum production. It’s possible to have both common acne and rosacea—which is the likely result of treating rosacea with the methods used to treat acne on resistant skin. Sensitive skin requires sensitive handling.
How to Take Care of Sensitive Skin
Many people who have sensitive skin have a problem with acne, but they are more likely to be concerned about spots left behind once acne heals9. If you have sensitive skin, your skin overreacts to inflammation. The melanin pigment that darkens the skin also protects it against free radicals and inflammation10. If you have sensitive skin, chances are you will have brown spots in your skin left over from its fight against inflammation long after the acne inflammation goes away. The darker your skin, the more prominent the spots.
Minimizing inflammation minimizes discoloration of the skin11. Here is what you need to to prevent lasting reminders of acne flares long after they have healed:
- If a product makes your skin tingle, itch, turn red, or burn, just don’t use it. This means you may not be able to use any prescription strength benzoyl peroxide formulas at all, although you may be able to use up 2.5% benzoyl peroxide in an over the counter product.
- If a product contains scents, fragrances, herbal essences, or essential oils, just don’t use it. Almost any botanical ingredient can irritate sensitive skin.
- Avoid frequent sun exposure. Tanning the skin builds up melanin, which concentrates into spots to fight inflammation that comes with either common acne or rosacea.
- Don’t bother with alpha-lipoic acid (often used to treat raised acne scars) or diethylaminoethanol (DMAE, often used to treat indented acne scars). Your skin won’t tolerate them, and they will at best replace acne scars with brown spots. It is easier to conceal scars than spots.
- Don’t use skin lighteners that contain hydroquinone or vitamin C. These may cause unintended spotting of the skin. Use skin lighteners that contain arbutin and/or kojin acid. These will not cause unintended spotting of the skin.
And what about day-to-day skin care if you have active acne on the skin12?
A good product for keeping the skin clean is Neutrogena Oil-Free Acne Wash, Redness Soothing Facial Cleanser. If (and only if) you don’t experience any kind of redness, irritation, or peeling of the skin after using the product, you may use up to 10% benzoyl peroxide gels as a spot treatment for pimples, but you should not use more than 2.5% benzoyl peroxide over your entire face. Chances are you should not use tea tree oil over your whole face, but a dot of 10% tea tree oil cream (it has to be about 10% to do you any good, just smelling like tea tree oil is not enough) will often take the red out of pimples while it kills acne bacteria.
Whatever you do, don’t place hot steamy washcloths or ice cubes on a pimple. Heat and cold damage blood vessels and can make redness worse13—and permanent.
You can cover up pimples with concealer you apply with a feather brush to the skin. Place a tiny bit of yellow concealer, less than the size of a pea, on the back of your recently washed hand. Add a tiny amount of:
- Neutrogena On-the-Spot Acne Treatment, Vanishing Formula, or
- ProActiv Advanced Blemish, or
- Kinerase Clear Blemish Remover
and work them together. Apply the mixture of concealer and pimple treatment to the pimple with the brush, and then use your clean fingers to smooth out the edges of concealer on the skin around your pimple. Be sure to remove the concealer at night to help pores stay open.
- InformedHealth.org. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Skin care for acne-prone skin. 2013 Jan 16.
- Rodan K, Fields K, Majewski G, Falla T. Skincare Bootcamp: The Evolving Role of Skincare. Plast Reconstr Surg Glob Open. 2016 Dec 14;4(12 Suppl Anatomy and Safety in Cosmetic Medicine: Cosmetic Bootcamp):e1152.
- Zari S, Alrahmani D. The association between stress and acne among female medical students in Jeddah, Saudi Arabia. Clin Cosmet Investig Dermatol. 2017 Dec 5;10:503-506.
- Yosipovitch G, Tang M, Dawn AG, Chen M, Goh CL, Huak Y, Seng LF. Study of psychological stress, sebum production and acne vulgaris in adolescents. Acta Derm Venereol. 2007;87(2):135-9.
- Chen Y, Lyga J. Brain-skin connection: stress, inflammation and skin aging. Inflamm Allergy Drug Targets. 2014 Jun;13(3):177-90.
- Duarte I, Silveira JEPS, Hafner MFS, Toyota R, Pedroso DMM. Sensitive skin: review of an ascending concept. An Bras Dermatol. 2017 Jul-Aug;92(4):521-525.
- Mikkelsen CS, Holmgren HR, Kjellman P, Heidenheim M, Kappinnen A, Bjerring P, Huldt-Nystrøm T. Rosacea: a Clinical Review. Dermatol Reports. 2016 Jun 23;8(1):6387.
- Buddenkotte J, Steinhoff M. Recent advances in understanding and managing rosacea. F1000Res. 2018 Dec 3;7:F1000 Faculty Rev-1885.
- Connolly D, Vu HL, Mariwalla K, Saedi N. Acne Scarring-Pathogenesis, Evaluation, and Treatment Options. J Clin Aesthet Dermatol. 2017 Sep;10(9):12-23. Epub 2017 Sep 1.
- Cobb C. Dark spots on the skin: Causes, treatments, and remedies [Internet]. Medical News Today. 2019.
- Werschler WP, Herdener RS, Ross VE, Zimmerman E. Critical Considerations on Optimizing Topical Corticosteroid Therapy. J Clin Aesthet Dermatol. 2015 Aug;8(8 Suppl):S2-8.
- Del Rosso JQ. The role of skin care as an integral component in the management of acne vulgaris: part 1: the importance of cleanser and moisturizer ingredients, design, and product selection. J Clin Aesthet Dermatol. 2013 Dec;6(12):19-27.
- Narang I, Sardana K, Bajpai R, Garg VK. Seasonal aggravation of acne in summers and the effect of temperature and humidity in a study in a tropical setting. J Cosmet Dermatol. 2018 Sep 20.
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