I have written and rewritten this many times, overcome with my concern for listing facts, statistics, and the latest research. After all, I am writing to the industry’s best and brightest, and I don’t want to disappoint. But, as someone with panic disorder and complex post-traumatic stress disorder, I recently had the opportunity to speak publicly to doctors and mental health care professionals treating those like me. To humanize my experience and remind doctors that while I am a patient and there is a medical aspect to it, this is also my life. It’s my family living through it, my body suffering through the symptoms, and I who permanently navigates life with this diagnosis once I leave the doctor’s office. 

This reminded me how important it is to recognize the person on the other end of the table as more than just a case number, another client, or another patient. And so, I’ve concluded that what I want to say in here has more to do with the human experience of it all, than the facts and figures. I want to appeal to the professional skin care and aesthetics industry by writing about my experience as an anxious soul with sensitive skin in this big machine we call the skin care service industry. 

I preface this article by fully recognizing that with the alarming increase in chronic stress and anxiety levels, the aesthetics landscape has changed. Aesthetics professionals, spa owners, and beauty professionals deal with more than just skin care and cosmetic elements, often fulfilling the role of therapist, counselor, and friend. This takes an emotional toll on providers which can lead to their own emotional fatigue and burnout. It is not my aim to place blame or add pressure and responsibility. Each of us must take ownership of our struggles and path to healing. I stand by this and live by this principle. This blog does, however, paint a picture of my experience as a client, and I don’t seek to offer recommendations, advice, or judgment.

For brevity, when I refer to “spa,” I am referring to any aesthetics or professional skin care experience in a calm and luxurious setting, meant to relax, rejuvenate, and restore both skin and soul. I am not referring to massages and body therapies, but only the holistic experience of a rather basic relaxing facial. I am also not speaking about medical aesthetics treatments and procedures involving injections or complicated devices. Just the age-old facial with good products, a cleanse, mask, heated towels, soft music, cucumber slices, and perhaps a targeted treatment. All caveats being seen to, I now begin my tale. 

I have always had temperamental, sensitive skin. After my panic disorder diagnosis and my breaking of mind, body, and soul in 2015 – my skin went into sensitive overdrive. Over the years, I have learned all about the effects of anxiety on my skin1 and why I struggle with burning, itching, severe stinging at times, cystic breakouts (which were never an issue), redness, flaking, and the feeling of my skin literally “burn-crawling.” It’s an intense burning sensation on skin combined with the feeling that your skin is moving, buzzing, or crawling. It’s incredibly distracting and uncomfortable.2 

In my early diagnosis days, I was blessed with an amazing spa and aesthetician. She understood me and worked with my skin, and my ever-changing needs based on my current anxiety levels. I had access to my favorite sensitive ingredient, South African rooibos extract. Most importantly, she was open to avoiding the spa’s preferred line if my skin could not tolerate it at that moment. 

When I moved to Europe in 2020, I was lost. Finding a spa with professionals like my fairy godmother, I soon realized, was utterly impossible. If you live with a constant panic shadow like I do, you are willing to invest in any small element of self-care that will bring you even a moment’s reprieve. You also start to identify the trivial things in your healing journey you can actively control to ensure it does not trigger you and start accepting the things you cannot control and learn to work with them. Skin care and self-care moments were things I could control. 

I went from spa to spa, one highly recommended medical aesthetic clinic to the next, spending thousands in the process only to end up with the same problem: skin in total agony, defeated emotionally, and recognizing that this was yet another small reprieve I no longer had access to. Since my business brings me to the United States every few months, I continued this expedition in the great 50 states, with the same outcome. 

What I felt, was that my voice did not matter. My view on my sensitivity was just that: my uneducated view. There was always an explanation on how I may be misinterpreting it, questions about anything else changing in my life, followed by the recommended spa product for sensitive skin filled with all the common ingredients I know upset me. I have yet to find a spa willing to offer me a truly fragrance-free skin care experience, with no fancy “soft” or “light” exfoliators that are “excellent for sensitive skin,” or clever irritant replacements that still cause issues for my sensitive skin. A common example? Essential oils as natural alternatives to synthetic fragrances. 

When I enter a spa and give my take on my skin, noting my sensitivity, I am most often met with a polite eye roll. Funnily enough, I understand and sympathize with this. There is so much unnecessary fearmongering in our industry, especially related to ingredients that consumers often don’t understand the complexities of. This, combined with the fact that everyone seems to self-identify as a sensitive skin type, must be very frustrating to navigate. I feel the same about the use of the word “anxiety” in pop culture or as a slang word for having a grueling day. Anxiety is not just stress; it’s not a joke. And by treating it trivially, it makes it difficult for us who truly struggle to be taken seriously. I feel the same way about my sensitive skin declaration.

After the complimentary consultation and exploration into whether my skin truly is sensitive, I am always told that the spa has the perfect product, especially for sensitive souls like me. In the excitement and sincere hope that this is the golden goose I’ve been looking for, I trust their professional opinion and head through to the treatment room. My first sign that this is going to end badly is usually when the first step of the facial starts: the cleanser is uncapped. A waft of smells floats toward me and my skin starts crying out, almost like it is trying to remove itself from my body to run away. I know how this will end. I am so nervous about what’s about to ensue that I have no sensory connection to the delicious smells wafting over me in any event. When I ask, again about fragrance, I am reassured this is for sensitive skin and it’s very gentle. I am also often told that spas generally do not carry fragrance-free, simple formulas because clients expect the sensory experience during their much-needed downtime, and it won’t sell well. Another popular comment is that the skin care was specially designed by a doctor or skin care professional and is truly gentle. 

When I ask about a burning sensation, I am often told my skin doesn’t look red or it will soon pass, or that my skin is dry and that’s why it’s stinging. When I ask to read the ingredients before application, I am re-educated on why it will not upset my skin, even though I have my certification in cosmetic chemistry and have made it my life’s goal to understand the facts and science behind ingredients and how the cake is made. Most importantly, I am the one keeping a diary of what seems to upset my anxiety-driven sensitivity. 

Without fail, the professional or “medical-grade” sensitive skin care presented to me always has at least one of the following ingredients that I now know upset my skin: some synthetic fragrances, essential oils as a replacement to synthetic fragrance (which often have a healthy natural occurrence of linalool and limonene),3 and certain fruit extracts that I know upset me. These have all been proven to have a higher possibility of upsetting sensitive skin types4 and my dermatologist will always recommend I avoid these in my skin care routine. While I understand the conversation is much more complex than this with hundreds of kinds of fragrances used for assorted reasons from smell to preservative to a stabilizer, I have also learned on my journey that these are common ones to avoid. This makes it so hard to understand why I cannot access these options in my sacred space of rejuvenation and relaxation. Instead, I feel cast out to the drugstore aisle, the home remedy, and “maybe facials are not for you.” 

My facials always end in two ways: 1) I request the process to be stopped mid-mask because my skin is uncomfortable and on fire. 2) I leave after the facial, rush home, and try to scrub whatever was placed on my skin clean. Weeks of agony usually follow. 

The summary is that I haven’t had a facial in three years. It was so hard to let go of this little pleasure. This small little reprieve when the world fades away, and I get to be taken care of for an hour. My needs are so simple: an hour in a calm space, with cozy towels, relaxing music, someone taking care of my skin for me, and a gentle facial massage while I relax with a truly calming product. I don’t need all the bells and whistles, just the calming experience of quiet solace. 

I am here to say that I am willing to pay for simpler, nonsensory, and “boring” options if it means I get my beloved facial back in my monthly calendar. There are other ways that I can be included in the indulgence without the factors that irritate me or to be pigeonholed because I speak the words “sensitive skin.” I just want to be heard and understood. I want to gladly pay for options that cater to me and support this wonderful industry that is so pivotal in our selfcare journeys. Just because I am sensitive does not mean I am no longer open to, or able to, enjoy luxury experiences of self-care indulgence.

In a world so consumed by catering to the needs of everyone, I know it can seem overwhelming to add yet another request. But, from my side of the window, I often feel like little Curly Sue longingly staring into the restaurant at patrons enjoying their delicious meal while I can only look on, mouthwatering. Could you perhaps find a seat at the table for sensitives like me? 

References

1. 1. Folk J Folk M “The Stress Response” The Anxiety Centre Online 2022 available at https://www.anxietycentre.com/anxiety-disorders/symptoms/stress-response/. Folk J Folk M “Skin symptoms caused by anxiety” The Anxiety Centre Online 2021 available at https://www.anxietycentre.com/anxiety-disorders/symptoms/skin-symptoms-anxiety/#
2. Sun C Ren Y Wanhong Z “Association between skin disease and anxiety: a logistic analysis and prediction” Annals of Translational Medicine 2023 11(2) at 6-8 available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9929807/pdf/atm-11-02-115.pdf. 

3.Opinion of the Scientific Committee on Cosmetic Products and Non-Food Products intended for Consumers concerning Linalool (9 December 2003) SCCNFP/0760/03 European Commission available at https://ec.europa.eu/health/ph_risk/committees/sccp/documents/out248_en.pdf. 

4. De Groot AC “Fragrances: Contact Allergy and Other Adverse Effects” Dermatitis 2020 Jan/Feb 31(1) at 15-16 available  https://www.contactderm.org/UserFiles/file/Fragrances__Contact_Allergy_and_Other_Adverse.3-1.pdf. 
5. Opinion of the Scientific Committee on Cosmetic Products and Non-Food Products intended for Consumers concerning Fragrance Allergy in Consumers: A Review of the Problem & Analysis of the Need for Appropriate Consumer Information and Identification of Consumer Allergens (8 December 1999) SCCNFP/0673/03 European Commission available at https://ec.europa.eu/health/ph_risk/committees/sccp/documents/out98_en.pdf. 

Dr. Jeanne Retief is a highly sensitive person (HSP) and anxious overachiever with panic disorder. After her breaking in 2015, she left behind her beloved career in international human rights to fully take ownership of her diagnosis and help others struggling on the anxious path. She is the founder of FIGGI Beauty and The Anxious Calm Online offering for those seeking to peacefully coexist with their unique wiring.