Reactive skin is a term that has been used to describe sensitivity to external stimuli. This external stimuli can be in the form of physical type of manifestations, such as changes in temperature heat, cold, or even the presence of wind on the skin, or it can be chemically induced wherever whereby the skin reacts to topically applied skincare and all these factors. Subsequently, lead to inflammation in the skin. The key here is most individuals are able to tolerate environmental changes. However, in a certain group of individuals who has sensitive skin, they actually have an impaired skin barrier function which means that these external stimuli tend to cause skin reactions.
Causes of Reactive Skin
Reactive skin can be due to multiple different dermatological diagnosis, whereas sensitive skin in general, is used to refer to individuals with a form of eczema. These individuals have dry skin and have inherited a deficient molecule that leads to barrier dysfunction. Reactive skin can be due to a condition known as hives, also known as urticaria. There is a Cholinergic type of urticaria which is a type of hives that reacts to heat. And also, even to water in a type of urticaria known as Aquagenic urticaria for individuals who develop hives in response to water. After being exposed to wind or air conditioning, they most likely have a form of physical urticaria.
If you’re familiar with images of individuals who seem to have writing on their skin. This is actually a phenomenon known as Dermatographia and is part of this constellation of diagnosis that fit under the reactive skin umbrella. Individuals with urticaria can have concomitant eczema sensitive dry skin. They could also have a normal skin barrier, and only react specifically to the stimuli. It is very common to have both diagnosis together.
In addition, one may also have a condition such as rosacea whereby the skin reacts to extremes of temperature, in particular heat, as well as UV radiation. This sort of reactivity actually causes long term skin damage because of persistent inflammation. The excess blood flow can cause skin thickening over a period of time, leading to the appearance of enlarged pores and irregular skin texture.
Reactive Skin vs Sensitive Skin
It is important to differentiate in an individual between reactive versus sensitive skin. For example, if you are just trying to treat reactive skin with moisturizers alone, you are very likely going to have a sub optimal result. In addition, another possible mistake is treating rosacea with the treatment meant for sensitive skin as a form of eczema, usually in the use of anti inflammatory topical steroids. The steroids itself is inappropriate treatment for rosacea. This can in fact lead to worsening of the rosacea because it can cause steroids induced rosacea flare ups.
Furthermore, it is critical to appreciate the underlying pathophysiological processes that cause reactive and sensitive skin. Sensitive skin itself may be synonymous with dermatitis or eczema, dry skin conditions, and is primarily due to barrier dysfunction. Reactive skin, on the other hand, is a lot more complex because, in and of itself, reactive skin is not used as a medical term. This includes also the term sensitive skin, as both of these terms were coined by laypersons to describe certain symptoms of the general population.
Role of Probiotics
Some advances in our understanding of skin sensitivity and reactivity have been in the form of topical probiotics, in particular, by bifidobacterium longum extract, which was proven in a clinical trial and published in the Journal of Experimental Dermatology, to improve sensitive skin. Specifically, the results of this study demonstrate that this bacterial extract has a beneficial effect on reactive skin, and that new approaches based on bacterial lysate could be developed for treatment and/or prevention of symptoms related to sensitive skin.
Let’s talk a little bit more about what probiotics. Probiotics can be in the form of fermented or non fermented food products. They are actually part of our intestinal microflora and have a beneficial outcome by exerting an anti-inflammatory biologic effect. This is the reason why doctors tend to prescribe them as a part of functional food diets. It is interesting that live probiotics, not just regulate the intestinal health, but can also have beneficial immunomodulatory effects on skin. This has been evidenced in a study, which has also showed that an ingested probiotic was able to reduce skin sensitivity in patients who have eczema.
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