Collection: Sensitive, reactive skin with atopic dermatitis

Do I have sensitive skin?

I think there isn't a person in the world who hasn't experienced any issues with their skin. Hypersensitivity and reactivity of the skin can appear during certain periods of our lives and can be either a brief episode or a chronic condition. It involves subjective or objective signs of irritation: skin tension, tightening, itching, burning, redness, stinging, flaking, and dryness. There isn't a single definition of sensitive skin, but it can unequivocally be stated that such a skin condition involves a decreased tolerance to various factors.

Skin irritants can be the ingredients in cosmetics, contact with chlorinated water or sunlight, and can also react after consuming spicy food or having a glass of wine. Sometimes even a morning shower turns out to be an unpleasant experience. Frequent sensations of burning, itching, or redness after applying a new cream make us very cautious when testing a new product. We fear that our reactive skin won't tolerate another attempt to find a safe cream. To avoid further disappointment and find the right path to improving our sensitive skin, let's understand the basic principles of selecting appropriate skincare.

Causes of skin sensitivity

Sensitive skin is increasingly reported by patients in medical offices. The issue affects approximately 50% of women and 40% of men. It accompanies various dermatoses - atopic dermatitis, rosacea, contact eczema, psoriasis. But we don't necessarily have to be diagnosed with any dermatological disease to experience skin hypersensitivity. Even though our association with an excessive skin reaction to external factors (cosmetics, water, radiation, etc.) usually involves an allergic reaction, the basis of skin hypersensitivity is not unequivocally linked to immunological mechanisms. Burning and suddenly appearing redness after applying a new cream doesn't necessarily mean an allergy to one of its components; it might be a symptom of sensitivity.

Skin sensitivity can arise when:

  • The skin barrier is damaged - the skin is dry and flaking.
  • Irritation and inflammatory conditions of keratinocytes (skin cells) occur.
  • Inflammatory conditions develop in the skin, leading to the secretion of so-called pro-inflammatory mediators (especially substance P - strongly dilating blood vessels).

As a result, nerve endings in the skin are stimulated, leading to inflammatory conditions at different levels and/or sudden dilation of blood vessels. We feel this as unpleasant skin tension, itching, pain or tenderness, sudden redness, warmth. Subjective sensations may appear without clear visual symptoms, meaning we might not see redness on the skin, although we feel a strong burning sensation. Skin hypersensitivity can also arise due to chronic dysbiosis, an imbalance in the skin's microbiome. An improper balance of different bacterial and fungal strains leads to increased transepidermal water loss, a rise in skin pH, and damage to the hydrolipidic barrier. This leads to the appearance of blackheads, and when inflammation develops within them, also papules and pustules.

What criteria must a cosmetic for sensitive skin meet?

  • Free from common allergens and irritants
  • Free from pollutants with allergenic potential and enriched with appropriately selected antioxidants to neutralize free radicals
  • Without strong penetration enhancers that could favor the penetration of irritating substances
  • With carefully chosen auxiliary substances such as emulsifiers and surfactants
  • With low-irritation preservative substances

Environmental factors contributing to skin sensitivity:

  • Alkaline soaps
  • Perfumes
  • Skincare products containing alcohol
  • Prolonged exposure to air-conditioned environments
  • Topical corticosteroid use
  • Excessive or inadequate daily skincare - when exfoliating too often or forgetting night cream."

Atopic Dermatitis

Atopic dermatitis (AD) is a non-infectious, chronic inflammatory disease that occurs in both children and adults. It is highly distressing due to symptoms such as intense itching and dry skin, inflammatory, reddish skin changes (eczema), and a predisposition to bacterial, fungal, and viral skin infections. It follows a pattern of flare-ups and remissions (reduction of symptoms). In chronic phases, it can involve thickening of the epidermis and visible flaking.

The affected areas typically include the folds of the knees and elbows, facial and neck skin, and can also affect the skin across the entire body (known as erythroderma). Skin is not the only organ associated with the immunologic reactions characteristic of AD. Research confirms the link between AD and other atopic diseases related to immunoglobulin E, such as allergic rhinitis, conjunctivitis, bronchial asthma, and food allergies.

The primary approach in treating AD involves using emollients and anti-inflammatory measures, as well as avoiding irritants. When a concurrent bacterial, fungal, or viral infection appears, additional antimicrobial treatment should be initiated. Patients are also educated on an elimination diet that excludes potential food allergens triggering atopic symptoms. Such allergens may include cow's milk and dairy products, eggs, soy, fish, cereals, some fruits, and vegetables. At certain stages of the disease, proactive therapy is applied, involving the use of local anti-inflammatory preparations and phototherapy.

Distinctive changes in the epidermal barrier of atopic skin involve abnormal formation of structural proteins, high levels of proteases (protein-degrading compounds), and simultaneously low concentrations of their inhibitors (substances that inhibit the action of proteases). As a result, the skin becomes more susceptible to the penetration of allergens and external irritants, considered the cause of eczematous skin changes in atopic dermatitis. Interestingly, visible skin symptoms are not necessary to detect such changes in the epidermal barrier of atopic skin—this type of skin is termed "apparently unchanged."

Atopic dermatitis is associated with the concept of the "itch-scratch cycle," which appears as follows:

What is most essential in the treatment of AD is patient education and the understanding of how to manage the disease during different periods. Understanding the disease and adhering to the recommendations of specialists (dermatologists, allergists, dietitians) are crucial in effectively managing the distressing symptoms and improving the quality of life for individuals with AD.

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