Sensitive skin is a common condition that affects a majority of people and commonly has predisposed factors such as ethnicity. Factors such as an impaired skin barrier, a weakened immune system, inflammation, and digestive health can also contribute to the skin’s sensitivity. The skin is constantly going through a repair process, so it is necessary to strengthen the function of the stratum corneum in order to strengthen sensitive skin.

There are numerous exfoliation options for strengthening sensitive skin, with physical exfoliation being the least effective. Physical exfoliation can actually irritate the skin and cause the skin to become even more sensitive. With sensitive skin, chemical exfoliation is a much better option and can actually have multiple benefits. In the case of hydroxy acids, some are chemically compounded and have properties that can benefit and strengthen sensitive skin. Chemical compounds that have a large form molecule, such as lactic acid, penetrate the skin at a slower rate and are less irritating to the skin. Lactic acid has great moisture binding properties and prevents evaporation of moisture in the skin. Lactic acid may have multiple benefits for aging and oily skin conditions, darker skin phototypes, and clients who have sensitive skin conditions.

MANDELIC ACID

Hydroxy acids, such as mandelic acid, have a large form molecule, as well, and cause less irritation to the skin. Mandelic acid has numerous benefits to the skin and can be used to manage various skin conditions such as acne, aging, hyperpigmentation, and rosacea. With acneic conditions, mandelic acid has powerful antibacterial properties, which makes this an ideal acid to treat rosacea or acneic skin conditions. As a lipophilic and hydrophobic agent, mandelic acid is ideal for exfoliating the sebaceous follicle and retaining moisture in the skin, therefore, reducing oil production by the sebaceous glands. Ideally, mandelic acid has the ability to inhibit tyrosinase, which is an enzyme located in melanocytes that converts the amino acid tyrosine into melanin. As a tyrosinase inhibitor, mandelic acid is ideal in lightening and preventing hyperpigmented conditions such as melasma, post-inflammatory hyperpigmentation, and sun damage. In clinical studies, mandelic acid has proven results which are comparable to and often better than topical prescription strength hydroquinone. Mandelic acid has multiple benefits when treating skin conditions and is ideal for dark skin phototypes or those who are prone to hyperpigmented conditions.

POLYHYDROXY ACIDS

The latest in chemical exfoliation includes the discovery of polyhydroxy acids. With polyhydroxy acids, the process of desquamation differs from alpha hydroxy acids. Polyhydroxy acids are not traditional keratolytic agents that nonspecifically dissolve skin’s bonds from the top downward. Instead, polyhydroxy acids affect the process of keratinization and help to normalize the thickness of the stratum corneum. Unlike most alpha hydroxy acids, polyhydroxy acids are powerful humectants and have potent antioxidant abilities. Larger polyhydroxy acid compounds include bionic acids such as lactobionic acid and maltobionic acid, which are derived from natural sugars. Bionic compounds have a large form molecule that penetrates gradually into the skin and are gentle and non-stinging. Polyhydroxy acids are less irritating than alpha hydroxy acids and their chemical composition make them ideal for all skin types, especially those with compromised, sensitive, or dark skin phototypes.

ENZYME EXFOLIATION

Enzyme exfoliation is another ideal option for exfoliating sensitive skin types. Enzymes are natural compounds commonly composed of digestive fruit acids, such as papaya, pineapple, or pumpkin, and are proteolytic agents that work differently than alpha hydroxy acids. Enzymes work by dissolving cellular material in the stratum corneum and are optimized in a neutral or alkaline pH. Proteolytic agents are ideal to manage aging, couperose, inflamed acne, rosacea, or sensitive skin types and can be safely used on dark skin phototypes. Ideally, enzyme exfoliation can be synergistically combined with hydroxy acids for optimal results.

When treating sensitive skin conditions, the professional should consider and address numerous factors, such as predisposed ethnicity, an impaired skin barrier, a weakened immune system, digestive health, inflammation and diet, vitamin and mineral deficiencies, and underlying health conditions and medications, which can contribute to the sensitive skin condition. Sensitive skin conditions commonly have internal factors that exasperate the condition and should be addressed along with strengthening the skin barrier and function of the stratum corneum by reducing transepidermal water loss.

Exfoliating dead, keratinized cells contained in the stratum corneum and retaining moisture in the skin is key to improving the skin barrier and strengthening sensitive skin types.

Linda Gulla is a NSPEP physician-endorsed master aesthetician and is a published writer in cosmetic dermatology, whose material has been reviewed and endorsed by dermatologist Dr. Eric Schweiger, as well as the renowned Dr. Abdala Kalil. As a published writer, Gulla’s expertise can be found in the Milady Advanced Esthetics 2nd Edition. Gulla has shared her expertise with family physicians and dermatologists as an adjunct instructor with the National Procedures Institute, where her material was reviewed by over seven medical review boards and was ACCME accredited. Gulla is founder of the Institute of Advanced Aesthetics and Health Sciences and is recognized as an approved provider with the NCEA COA. Her online self-study program can be found at iaahs.com.