How to Tell If You Have Sensitive Skin

January 29, 2025

by Sarah Villafranco, MD

What is sensitive skin? Despite how it may feel if you’re dealing with it, sensitive skin is not a medical diagnosis. You can find some cool medical terms related to sensitive skin, like Sensitive Skin Syndrome, Cosmetic Intolerance Syndrome, or, my favorite, “status cosmeticus.” (Cue the medical resident screaming “Someone remove this woman’s toxic mascara STAT!!!”) You can have subjectively sensitive skin, where you report burning, tingling, or discomfort without visible changes in your skin, or objectively sensitive skin, where it’s possible to observe signs like dryness, redness, dermatitis, or acne. But if you go to a doctor about your sensitive skin, you won’t come away with a diagnosis of sensitive skin, because no such thing exists. And yet, surveys report up to 50% of women and 30% of men believe that they have sensitive skin. So whether it’s got its own ICD code or not, it’s a real problem for a lot of people. I should know—I’m one of them.

Sensitive skin is a condition in which skin is more reactive to its environment. This reactivity can show up as a sensation, like burning or itching, or as a physical sign like redness or a rash. And while it’s not an official diagnosis, people usually know if they have sensitive skin, because it either feels bad or looks bad. Let’s dig in to what it means to have sensitive skin a little more deeply.

Causes of Sensitive Skin

Because sensitive skin is such a broad, vague condition, it’s hard to come up with a complete list of the possible causes of sensitive skin. In general, women tend to have sensitive skin more than men, as their skin is thinner than men’s skin. Underlying medical conditions that result in increased levels of inflammation can cause sensitive skin. Ongoing medical treatments like medication or radiation therapy can cause sensitive skin. Extreme temperatures or fluctuations in humidity can cause sensitive skin. But the single biggest cause of sensitive skin, in my substantially educated opinion, is sodium lauryl sulfate (SLS) or its ethoxylated little cousin, sodium laureth sulfate (SLES).

SLS was allegedly developed as an engine degreaser in World War II. Eventually, SLS found its way into almost every product in our homes, from dish soap to shampoo to laundry detergent, and most of us have been using it every single day for many years. If you have not actively tried to remove SLS from your life, then you’re using it, often even when you’ve switched to cleaner brands. It can be biodegradable and plant-derived, but it’s still a skin irritant. In fact, it’s the main skin irritant used in medical studies to create skin irritation so that companies can test out their soothing skin products. Granted, it’s used in much higher concentrations to create the irritation in medical studies, but with chronic, low-level, cumulative use, it still creates chronic, low-level irritation (also known as sensitive skin?) by damaging your skin’s barrier function over time. Here’s a guide to getting rid of SLS in your life, which I recommend you do immediately if you have sensitive skin.

Common Signs of Sensitive Skin

The most common skin sensitivity symptoms (these are subjective things that you feel):

itching
burning
tightness
stinging

The most common signs of sensitive skin (these are objective things that can be seen by others):

redness
rashes
flaking
dryness
breakouts

How to Know If You Have Sensitive Skin

If you’re afraid to try new products on your skin because of reactions you’ve had in the past, you probably have sensitive skin. If you experience regular itching, tightness, burning, or stinging when you use certain products, you definitely have sensitive skin. If you have any form of dermatitis or eczema, you likely have a side-dish of sensitive skin to go with it, since those conditions also involve reduced skin barrier function. In short, if you think you have sensitive skin, you probably do. But remember, it’s not a diagnosis, and that’s a good thing. It’s just a situation for you to educate yourself about and learn how to manage.

Tips for Managing Sensitive Skin

I’ll start by saying that I see a LOT of people get hyper-focused on the following question: Why is my skin so sensitive??? And, while it’s a super frustrating condition, and can often feel unfair, especially when it shows up out of the blue, I suggest moving past that question quickly (likely without a very satisfactory answer) and asking instead what steps you can take to support your sensitive skin.

People often want to focus first on the best skin care routine for sensitive skin. While I’m all for switching to products that are suited for sensitive skin—we make plenty of them—I prefer to start by zooming out to look at all the possible reasons your skin could be acting sensitive.

What products in your home could be causing sensitive skin, and have you eliminated SLS/ SLES and synthetic fragrance in EVERYTHING?
What foods and drinks are you consuming that could be increasing inflammation in your body? Since nutrition is the most essential factor to consider when it comes to your health, it’s worth making changes in your daily intake to reduce things like added sugar, highly-processed foods, and microplastics in your life.
How is stress playing a role in your sensitive skin? Stress can mess with your skin in a big way, and adding an active form of stress management like meditation can be a total game changer.
Are you using too many products or overexfoliating?? I see it all the time, because people with sensitive skin often want to do more for their skin, but doing less might be the better medicine.

Why Natural Skincare Is Best For Sensitive Skin

Well, let’s qualify this section by saying that not ALL natural skincare products are good for sensitive skin. Any skincare product for sensitive skin, natural or not, needs to have the right ingredients at the right concentrations. A New York Times article from a few years ago talked about how essential oils might be wreaking havoc on your skin, and then went on to list examples that made me literally cringe; I would never formulate a facial product with peppermint or cinnamon essential oil, and the maximum total concentration of all essential oils in facial products should be much lower than it is in body products. So, having the right person at the wheel when it comes to natural skincare formulations for sensitive skin is critical.

Most dermatologists will not recommend natural products for… well, for anything. They have no education about natural skincare products, and articles like the one above have left them terrified to learn more. If they recommend any bar soap for sensitive skin, it’s likely a grocery store brand, and those bars often contain synthetic detergents, fillers, fragrance, and other non-soap ingredients that can leave your skin dry and itchy. But there are much better choices when it comes to bar soap for sensitive skin—handmade, cold-process soap that contains nourishing natural oils and butters, naturally-occurring glycerin, and little to no fragrance.

When it comes to natural skincare for sensitive skin, again, formulation is key. Some natural brands are using the wrong ingredients at the wrong concentrations, and that can definitely make things worse. But if you have the right ingredients (aloe, jojoba oil, glycerin) at the right concentrations, natural skincare can be amazing for sensitive skin, and comes without many of the irritating ingredients found in conventional products. Putting my own sensitive skin and my medical degree to work, I have been able to formulate products to help people whose skin is as sensitive as my own. We have over 500 glowing reviews that specifically mention sensitive skin on our website, and I actually feel grateful to my sensitive skin for helping me understand what it means to have sensitive skin, and, more importantly, what it means to find relief.

With love from the proud owner of some extraordinarily sensitive skin,

Resources:

Willis CM, Shaw S, De Lacharrière O, Baverel M, Reiche L, Jourdain R, Bastien P, Wilkinson JD. Sensitive skin: an epidemiological study. Br J Dermatol. 2001 Aug;145(2):258-63. doi: 10.1046/j.1365-2133.2001.04343.x. PMID: 11531788.

Farage MA. Does sensitive skin differ between men and women? Cutan Ocul Toxicol. 2010 Sep;29(3):153-63. doi: 10.3109/15569521003774990. PMID: 20443651.

Duarte I, Silveira JEPS, Hafner MFS, Toyota R, Pedroso DMM. Sensitive skin: review of an ascending concept. An Bras Dermatol. 2017 Jul-Aug;92(4):521-525. doi: 10.1590/abd1806-4841.201756111. PMID: 28954102; PMCID: PMC5595600.

Misery L, Ständer S, Szepietowski JC, Reich A, Wallengren J, Evers AW, Takamori K, Brenaut E, Le Gall-Ianotto C, Fluhr J, Berardesca E, Weisshaar E. Definition of Sensitive Skin: An Expert Position Paper from the Special Interest Group on Sensitive Skin of the International Forum for the Study of Itch. Acta Derm Venereol. 2017 Jan 4;97(1):4-6. doi: 10.2340/00015555-2397. PMID: 26939643.