Sensitive skin is one of those terms that’s thrown around frequently and, often, haphazardly. We hear it in advertisements for all sorts of lotions and creams; we see it on the packaging for nearly every skin-care product on our roster; and sometimes, we even hear it from our dermatologists and aestheticians when discussing treatment plans. We understand it as “skin that easily becomes red, irritated, or inflamed,” explains Dr. Hadley King, a board-certified dermatologist in New York City, but with such a broad definition, the popularity of multistep regimens, and the pull to always try the next big thing, you’d be hard-pressed to find someone whose skin hasn’t been reactive at one point or another.
There are, however, certain telltale signs that you might have sensitive skin, and it’s important to pay attention to them, if they arise. “Your skin will become inflamed or irritated when exposed to things like synthetic fragrance or too-hot or too-cold temperatures, and you will be prone to redness,” says Dr. Dennis Gross, a board-certified dermatologist in New York City. “You may also have complexion problems, including rosacea and eczema, and when using products with high concentrations of active ingredients, you will feel a burning or stinging sensation.” He also notes that sensitive skin tends to be on the dry side.
These reactions can occur at home or after an in-office treatment. After undergoing a treatment that was too harsh on your sensitive skin, “you will typically see immediate redness, and you might even feel a burning sensation,” Dr. Gross explains. “In the worst-case scenario, you might see a rash, a breakout, rosacea, or a contact dermatitis flare-up.” A number of popular in-office treatments are known to irritate sensitive skin, but advances in technology and chemistry have given us great alternatives. These are the treatments to avoid—and those to try instead.
Instead of radiofrequency microneedling, try just radiofrequency
A big trend over the past few years, microneedling is a regular offering in dermatology offices everywhere. The treatment involves penetrating the skin with tiny needles, to create micro injuries that produce a wound-healing response and stimulate collagen production. Combining microneedling with radiofrequency ups its effectiveness, because the thermal damage helps further with cell regeneration. But radiofrequency with microneedling could be too irritating for those with sensitive skin, says Dr. King. “It’s rare, but occasionally, microneedling can cause lingering bumps in sensitive skin that take time to resolve.” Even if they are not long-lasting, tiny bumps or dots where the needles pierced the skin are fairly common universally post-treatment, so if you are prone to reaction, you might do well to avoid microneedling. Instead, Dr. King suggests opting for regular radiofrequency treatments (she likes Thermage and Pellevé) without the microneedling, but it’s important to keep in mind that your skin sensitivity may require adjusting the level of intensity.
Instead of an alpha hydroxy acid chemical peel, try a polyhydroxy acid peel
Chemical peels are among the most popular in-office treatments. They’re easy and quick to administer, and they can deliver dramatic results. For many patients, a salicylic acid or retinol peel takes just a few minutes and causes only minimal redness that subsides shortly after. Yet, as we know from Samantha Jones’ memorable chemical peel in Sex and the City, these treatments are not without the risk of a truly awful reaction. Many chemical peels are formulated with alpha hydroxy acids, or AHAs—which, according to Dr. King, can be too irritating for sensitive skin, depending on their concentrations and formulations. If you know you have sensitive skin and want the luminous results of a chemical peel without the irritation, she suggests opting for a polyhydroxy acid base instead. “In general, it will be more difficult to tolerate acids in the setting of sensitive skin, and PHAs may be the best choice.”
Similar to AHAs in that they exfoliate by breaking down the bond that holds dull or dead skin cells to the surface of the skin, PHAs differ in their larger molecular size, which prevents them from penetrating as deep. “This ensures that they work on the skin’s surface, without affecting the layers underneath, making them less irritating, and you can still achieve the benefits of skin renewal, without the irritation,” Dr. King explains. “And clinical studies have even shown that people with rosacea and eczema can usually tolerate polyhydroxy acids.” Popular PHAs include lactobionic acid, gluconolactone, and galactose, but your provider will be able to discuss all your peel options after analyzing your skin.
Instead of Fraxel, try Clear + Brilliant
There’s nothing quite like the look of skin after a Fraxel laser treatment: clear, smooth, and free from sun damage and dark spots, it can take years off a person. But with these amazing results comes lengthy, harsh recovery time—and that’s for even the most tolerant of skin. While there are a few different versions of Fraxel lasers, available as ablative and non-ablative, they all tend to be too harsh for sensitive skin. So if you’re prone to bad reactions, Fraxel lasers of any kind are definitely not for you. Instead, try Clear + Brilliant. Affectionately dubbed “the baby Fraxel,” Dr. King says, “Clear + Brilliant uses lower energy compared to more intense resurfacing lasers, so there is a lower risk for adverse reactions.” Unlike other, harsher lasers, Clear + Brilliant tends to require multiple treatment sessions to see results, but you will be able to return to work and your normal activity immediately afterward, whereas Fraxel can keep you inside for weeks.
Instead of a YAG laser, try Vbeam laser
When it comes to reducing redness and evening out skin tone, there are a number of effective laser treatments available to patients. Long-pulsed YAG lasers, one of the most popular options for addressing redness, use wavelengths to lightly penetrate skin’s surface and send heat that is absorbed by blood vessels to stimulate collagen production in damaged regions. For anyone who suffers from sensitive skin or rosacea though, Dr. Gross says there’s no better choice than the Vbeam laser, a pulsed-dye laser. “The Vbeam is used to target anything ‘red’ or ‘blood-related,’ meaning rosacea, broken capillaries, overall redness, scarring, and more. This is a great option to help sensitive skin look less irritated while stimulating collagen, to tighten at the same time.” Vbeam is also considered the most long-lasting solution for rosacea and birthmarks known as port-wine stains.
Instead of lasers, try Ultherapy
If you’re interested in skin tightening but hoping to avoid lasers and their associated risks of reactivity, Ultherapy—a noninvasive treatment that uses ultrasound technology to lift and tighten—is a great alternative. “Despite what some people may think about Ultherapy being invasive or painful, it actually does not see the surface of the skin at all, meaning it would not have any interaction with sensitive skin,” explains Dr. Gross. “Ultherapy uses ultrasound technology to look into each individual’s skin, to understand the depth and layers of the dermis and visibly tighten the skin.” Although the treatment itself can sometimes be uncomfortable, there is no downtime.
