Allergies are complicated. Why? Well, you can be allergic to anything—including hypoallergenic things. While navigating skincare for “sensitive skin” (a non-medical term often used to describe skin that negatively reacts to many topicals) is never easy, having an allergy to certain products/ingredients can make it more difficult.
It can be challenging to tell the difference between having a reaction due to an allergen versus having a reaction due to an irritant. If you think you may be experiencing an allergy, you might want to contact a medical provider for assistance. If you're curious about how to tell between the two skin concerns, we’re here to help clarify.
So what should you make of a skincare product labeled hypoallergenic? Many dermatologists consider “hypoallergenic” a marketing buzzword, and the FDA doesn’t regulate the term.¹ Most of the time, it means a product was designed to be less likely to cause allergic reactions. Maybe it’s free of more common potential allergens like added fragrance or certain preservatives.
That said, hypoallergenic skincare can be a good starting point, especially for those who feel they have “sensitive skin.” Read your product label for seals of approval from independent organizations you trust, such as the National Eczema Association. If you’re concerned about reactions, you may want to patch test new products—more on this in a bit!
“Sensitive skin” isn’t a one-size-fits-all categorization. If anything, it’s a spectrum of experiences people have had when applying various personal skin products. Sensitive skin tends to be subjectively “hyperreactive” to environmental triggers,² and it has been reported to manifest in many ways:
Dryness. Dry, delicate skin that is easily damaged or irritated.
Tight tingling. A tingling or tightening sensation may occur.
Triggered by climate. Reduced tolerance to cold, heat, wind, or temperature changes
Allergic skin reactions are different. If you’ve had an allergic reaction to your skin, it has specific triggers that can cause these reactions. A big tell of an allergic reaction is a red, itchy rash that often has distinct borders (although it can spread in some cases). It’s a type of contact dermatitis, of which there are two types: irritant and allergic contact dermatitis. We’ll dive deeper in a bit, but here’s a brief introduction:³
Irritant contact dermatitis (which is not considered an allergy) can manifest as a painful or itchy red rash that comes on quickly in response to an irritant. Common irritants include detergents, soaps, and cleaners. But introducing a new skincare product (such as a moisturizer) can also cause irritant dermatitis.
Allergic contact dermatitis is an allergic reaction to something (an allergen). It is an immune-mediated response, and it can take about 24-48 hours for the rash to develop after exposure. Allergic contact dermatitis will not develop on the first exposure to the allergen (aka a molecule that activates and primes the immune system), but it can occur after repeated exposure. Common allergens include jewelry (metals like nickel), beauty products, and fragrances.
Even well-researched or highly regarded ingredients can irritating. Sometimes your skin experiences an adjustment period when you introduce a new product to your routine. For example, tretinoin is an amazing ingredient used to treat acne and skin aging. It may cause some skin irritation at first, but that’s often part of the adjustment process—and your Curology dermatology provider likely has given you the heads up!
Anything can trigger an allergic skin reaction, although there are some allergens that are more common than others. If you have a true allergy to an ingredient or product, they won’t do you any favors. Here’s an example: aloe has well-researched skin benefits, making it a popular ingredient in skincare products. But for people with aloe allergies, touching aloe to their skin sends a signal to their body to produce an immune response and…boom! An allergic reaction occurs.
Head’s up: If you experience lip or mouth swelling or have trouble breathing, it’s important to see an in-person healthcare provider without delay. If your reaction doesn’t improve as expected or worsens, you may need to see an in-person dermatologist or allergist for a specific diagnosis and treatment.
An allergic skin reaction is a medical diagnosis that causes visible signs, in most cases, a rash. “Sensitive skin” is a subjective experience.
An allergic skin reaction manifests after initial exposure to an allergen. It can happen on repeat exposure. The technical name for this is allergic contact dermatitis (ACD). Acute ACD can take 24-48 hours before any physical symptoms appear.⁴ Once symptoms show up and the allergen has been removed, it can take a few weeks for them to go away—even with treatment.⁵
“Sensitive skin,” on the other hand, may not show any visible signs. Symptoms can feel like pulling, prickling, burning, or stinging on the skin.
Allergic reactions often show up as a red rash. But there are other symptoms to look for, including swelling, blisters, itching, and hives. The itching can be intense. But as hard as it is, don’t scratch!
If you suspect you’re having an allergic reaction, do some investigative work to find what may be causing it. Paying attention to where the rash appears can offer some clues:
Around your eyes or lips can be indicative of certain skincare products, cleansers, or makeup. Or less obvious offenders like the metal in tweezers, eyelash curlers, doorknobs, or keys. Metals are a common allergen—if you use a metal tweezer and it touches the skin around your eyes, guess what? And for your lips, if you play a wind instrument, you might need to consider a plastic mouthpiece.
If you wear latex gloves, a rash on your hands might indicate a latex allergy.
Depending on the severity of your symptoms, you might consider seeing an allergist or dermatologist.
The good news is that once you’ve identified the allergen, eliminating it will solve the problem. Unfortunately, it can take a couple of weeks to completely go away once the allergen is removed, but treatment will usually calm down the symptoms quite quickly!
Identifying potential triggers that evoke reactions in sensitive skin can be a little tricky. It can vary from person to person since “sensitive skin” is subjective (and not an official medical diagnosis!). Potential external triggers stem from outside the body. Examples may include:
Pollution. Environmental irritants may elicit a negative reaction for those with “sensitive skin.”
Temperature changes. Temperature changes can have a magnifying effect on those with sensitive or hyper-reactive skin.
Skincare products. This is probably the most common one. Stick with simple, gentle, non-clogging ingredients in your skincare products and moisturizers.
Potential internal triggers come from inside the body. For example:
Stress. The pathophysiological link between stress and the skin is not fully understood. However, research shows that chemical mediators are released during stress that may contribute to skin sensitivity.⁶ Research also shows that a link between inflammatory skin conditions and stress may also exist.⁷ Those with certain inflammatory conditions (e.g. rosacea and atopic dermatitis) often feel that their skin is sensitive.
Hormonal changes. Some of us know all too well how hormonal changes can affect the skin—acne! As we age, hormonal changes can also affect our skin in other ways. For example, the American Academy of Dermatology states that fluctuating hormones during menopause can result in dry, itchy skin and adult acne.⁸ These changes may make you feel like your skin is more “sensitive.”
Lastly, sometimes we inadvertently do things as part of our regular routine that can irritate sensitive skin—like waxing. There are alternatives to facial hair removal that don’t involve wax.
Technically, a patch test is something a dermatologist or allergist does in-office (or you do it at home, while under the supervision of a dermatologist).⁹ It might go without saying, but just in case: If you want to be assessed for allergic skin reactions, ask your dermatologist for an in-office patch test. What we’re talking about here is a way to vet a new skincare product from the comfort of your home, which is different, and of course, will not be as accurate as one performed in-office. But it’s a good first step. Here’s how to do it:
Apply a product to your inner arm according to the product’s directions once or twice daily. Repeat this step for up to two weeks, and watch for a reaction. Just make sure you’re applying the product to the same spot on your arm each time!
If there’s no itchiness, redness, or flaking, repeat step 1 by applying a small amount of product on your face, following the product’s directions as far as frequency of application and time of day.
At this point, if there’s still no reaction, you can start using the product—with a caveat. Apply on just one part of your face, and consider using the product just a few times a week at first.
Remember, allergies may develop after repeated exposure. So even if your previous patch tests were fine, there’s still a chance you might have a reaction.
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We briefly mentioned irritant and allergic contact dermatitis, but let’s dive deeper to better understand the difference. First, contact dermatitis is when something comes in contact with your skin that causes an inflammatory skin reaction. The two types of contact dermatitis—irritant and allergic—can manifest differently. In general, both can be avoided by eliminating whatever is causing the irritation or allergy.¹⁰
Irritant contact dermatitis occurs when a substance actually damages the part of the skin it comes in contact with. It can result in the first exposure to a substance and can manifest as a painful, itchy, or burning rash with a more severe reaction occurring with longer or repeated exposure. Irritant contact dermatitis can happen anywhere, including in the workplace through repeated exposure to chemicals or soaps. It’s often found on the hands, although it can be found anywhere on the body.
Allergic contact dermatitis is less common. It’s your body’s immune response to an allergen. A common example is poison ivy, which creates an allergic reaction on the skin. Other typical allergens include fragrances, metals, and other plants. The symptoms can be similar to irritant contact dermatitis, except that allergic reactions typically don’t appear until at least 24-48 hours after contact. They also don’t appear on the first exposure to the allergen, only on repeat exposure.
If you’re struggling with sensitive skin, we feel you. But give yourself props! If you’ve read this far, that means you’re taking steps to educate yourself, and knowledge is power.
If you’re dealing with a potential skin allergy, know that we don’t manage skin allergies at Curology—we recommend seeing an in-person dermatology provider for that—but if you need help getting common skin concerns like acne, hyperpigmentation, or rosacea under control, then let Curology do the busywork for you. Curology members are paired with an in-house licensed dermatology provider, who can prescribe you a custom cream with a mix of three active ingredients for your unique skin.
We also have a whole line of skincare products to complete your routine, each designed by dermatologists to be non-comedogenic, dye-free, paraben-free, and hypoallergenic—made to keep your skin happy and healthy. Interested? You can get a free month of Curology—just pay $4.95 (plus tax) to cover shipping and handling on your first box. After that, you can cancel at any time or choose the subscription plan that works for you.
Most of the time, it means a product was designed to be less likely to cause allergic reactions. Maybe it’s free of more common potential allergens like added fragrance or certain preservatives.
Sensitive skin tends to be “hyperreactive” to environmental triggers, and it has been reported to manifest in many ways: dryness, tight tingling or triggered by climate. Allergic skin reactions are different. A big tell of an allergic reaction is a red, itchy rash that often has distinct borders.
An allergic skin reaction manifests after an initial exposure to an allergen; it can happen on repeat exposure. “Sensitive skin,” on the other hand, may not show any visible signs. Symptoms can feel like pulling, prickling, burning, or stinging on the skin.
U.S. Food and Drug Adminstration. "Hypoallergenic" Cosmetics. (n.d.).
Berardesca, E., et al. Sensitive skin: an overview. International journal of cosmetic science. (2013).
Novak-Bilić, G., et al. IRRITANT AND ALLERGIC CONTACT DERMATITIS - SKIN LESION CHARACTERISTICS. Acta clinica Croatica. (2018).
Novak-Bilić, G., et al. IRRITANT AND ALLERGIC CONTACT DERMATITIS - SKIN LESION CHARACTERISTICS. Ibid.
American Academy of Allergy, Asthma, and Immunology. Allergic Skin Conditions. (n.d.).
Chen, Y., & Lyga, J. Brain-skin connection: stress, inflammation and skin aging. Inflammation & allergy drug targets. (2014).
Arck, P.C., et al. Neuroimmunology of Stress: Skin Take Center Stage. Journal of Investigative Dermatology. (August 2006).
American Academy of Dermatology. How to Care for Your Skin During Menopause. (n.d.).
Mowad, C. M., et al. Allergic contact dermatitis: Patient diagnosis and evaluation. Journal of the American Academy of Dermatology. (2016).
Usatine, R. P., & Riojas, M. Diagnosis and management of contact dermatitis. American family physician. (2010).
This article was originally published on November 20, 2020, and updated on July 18, 2022.
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Meredith Hartle, DO