Q: How do I know if I have rosacea or sensitive skin?

A: While sensitive skin and rosacea may share similar skin symptoms, these conditions are different and best diagnosed by a physician or skin professional. Sensitive skin is a skin condition (also called a skin type due to its prevalence) that involves an alteration (thinning) of the protective skin barrier and an exaggerated response by the nerve endings in the epidermis. Individuals who suffer from sensitive skin may react to stimuli that would typically not affect those with a healthy skin barrier. Otherwise, when the skin is not exposed to any irritating stimuli, it can appear practically normal. Rosacea is a chronic skin disorder that is much more complex, involving factors that extend beyond the skin surface, like anatomical dysfunctions, overgrowth of a skin mite, and even gastric bacteria, to name a few. Rosacea tends to evolve and worsen over time if not addressed early or properly (causing an acne-like rash, nose enlargement mostly in men, and even ocular problems) and usually requires medical treatment. However, that can be effectively supported with high-quality targeted skincare.

Both conditions cause the skin to become visibly red, irritated, and sometimes itchy or burning, yet the triggers can be different. For example, for sensitive skin, the reactions are caused mainly by irritating products that affect the surface directly, dry air, skin manipulation, heat, cold, etc. These reactions can happen almost anywhere on the face where the skin barrier is affected and tend to be temporary. In the case of rosacea, the triggers for the skin reaction not only come from the surface but also from the inside, as in the case of drinking hot beverages and eating spices and hot meals. However, the reactions tend to appear during bouts of flushing and blushing on circumscribed facial areas such as the cheeks, nose, chin, and forehead. Moreover, individuals with rosacea tend to suffer from long-term erythema (redness) in those reactive areas, which constantly feel warm due to permanent capillary dilation (visible blood vessels).

My recommendation for someone with sensitive skin is to use high-quality skincare products formulated specifically for sensitive skin types. That means products that contain soothing and calming ingredients while at the same time helping protect and rejuvenate the skin barrier (aloe, bisabolol, lavender, safflower, etc.) And, of course, avoid unprotected sun exposure and any irritating stimuli as much as possible. Additional useful recommendations can be obtained from an esthetician, skincare specialist during a visit to a spa. For rosacea, I would recommend an evaluation by a dermatologist first and then supportive treatment with high-quality targeted skincare products that do not contradict doctor's orders and contain ingredients that are calming and soothing (green tea, allantoin, chamomile, etc.) and can assist with capillary dilation (dipotassium glycyrrhizate, for example). Next, seek professional spa treatments aimed at intensively cooling and repairing to help improve the condition "from the ground up." Of course, sunscreen will always be a great ally for optimal skin health.


Q: Why do I have more wrinkles on one side of my face than the other? How can I treat it?

A: It is very common to see asymmetrical symptoms when lifestyle habits are the culprit. Putting aside any physical or health disorders that may require further evaluation from a physician, often simply sleeping on that side of the face more than the other, may accentuate the lines, wrinkles, and folds one may develop. In addition, dynamic movements and manipulation of those skin areas through gestures, resting the hand on that side of the face, biting the inside of that cheek or grinding, and constantly touching and scratching the concerned area can cause the skin to become irritated or inflamed, looser, overly stretched, etc.

Other possible causes include chronic cell phone use, as these devices emit blue light and heat and press against the skin, causing micro-inflammation with loss of elasticity and fat displacement. And finally, overexposure to the sun on unprotected skin, as in the case of driving and getting sunlight on half of the face or sitting near and parallel to a window where the sun hits all the time. To solve this problem, the first thing to do is change those habits, as their recurrence will only continue the cycle of skin symptoms, even with customized treatment. Simultaneously, the best approach will be receiving professional skincare treatments (synergistically complemented with specialized self-care) that focus on stimulation, repair, and protection.

For a basic approach, using ampoules, targeted massage, and masking can prove very beneficial. A more advanced approach with the application of device modalities, chemical peels, and high-performance treatments can offer even greater, more expedited benefits. Of course, the entire face will be addressed, but a more concentrated effort will be on specific areas of concern for outstanding results. And don’t forget your sunscreen!


Q: What are those bumps on the back of my arms and legs?

A: Most likely, those elevations or “bumps” on the skin surface result from a benign condition called keratosis pilaris. Keratosis pilaris is simply a buildup of keratin (dead cells) on and around the hair follicle openings. This causes pores to become clogged, and sometimes, fine vellus hairs remain trapped inside. Some people suffer more than others from this condition, especially if they are fair skinned, predisposed to eczema or dermatitis, have a vitamin A deficiency, are overweight, or have metabolic or endocrine disorders. The most affected body areas are the upper arms, buttocks, thighs, back, and even the face. Although there is no cause for concern, this condition can cause discomfort to the touch. As the skin becomes rough and prickly, it may feel itchy and dry/scaly; plus, there is a visual component as you may see discoloration of the affected areas, sometimes with redness or patchy brownness. Usually, this condition tends to disappear on its own; however, when it is actively showing symptoms, the affected individuals may seek treatment in the form of exfoliation with scrubs, alpha-hydroxy acids, retinols, etc. It is crucial to use high-quality moisturizers that do not contribute to further pore clogging and protect the skin with non-comedogenic sunscreens during sun exposure. Advanced therapies may include lasers and other exfoliation modalities.