Tirantez, incomodidad, picor, rojeces… Aproximadamente un 30% de las personas se queja de tener la piel sensible o reactiva, una condición cutánea que no es fácil de diagnosticar -debido principalmente al importante componente de percepción personal que implica- y cuyas causas no están del todo definidas, pero de la que sí se sabe que empeora cuando hace mucho frío (o mucho calor) y, también, que la mejor forma de aliviar sus síntomas es hidratarla “como si no hubiera un mañana”.
“La piel sensible es aquella que produce sensaciones no placenteras o desagradables tras estar sometida a estímulos que normalmente no provocan esa reacción o efecto. Por eso, el término académico más adecuado para referirse a este tipología es el de piel reactiva, aunque la mayoría, incluida la comunidad científica, alude a ella como piel sensible”, explica la doctora Lorea Bagazgoitia, del Servicio de Dermatología del Hospital Ruber Juan Bravo, de Madrid, quien destaca también que “se calcula que en España, el 30% de las personas sufre esta condición cutánea (no se puede considerar una enfermedad), que es predominante en mujeres, aunque es cierto que la frecuencia de casos masculinos está al alza”.
No es lo mismo…
La doctora Bagazgoitia señala que no siempre resulta fácil determinar que una piel es sensible, y que tampoco lo es diferenciarla de otras tipologías cutáneas, como por ejemplo, del concepto de piel sensibilizada, “entendiendo como tal aquella piel de una persona sana en general, pero que ha desarrollado una sensibilización o alergia a un determinado ingrediente. El más frecuente es el níquel, pero también pueden producir esta reacción algunos conservantes de los cosméticos, ciertos colorantes o los perfumes. Estas personas no tienen una piel sensible o reactiva sino una alergia o sensibilización a un componente. También conviene diferenciarla de una piel irritada, que es aquella que también presenta molestias (picor, rojeces) pero en la que no hay ninguna alergia detrás. Es un tipo de piel frecuente, por ejemplo, en personas de la tercera edad y también en aquellas que usan tratamientos cosméticos como los exfoliantes de forma abusiva o inadecuada”.
Causa difusa, sintomatología concreta
“Concretar las causas de la piel sensible sigue siendo, en cierta medida, un enigma, y el diagnóstico también es complicado, ya que hay un elevado componente de percepción y subjetividad por parte de la persona que padece esa sensación de sensibilidad”, comenta Lorea Bagazgoitia.
En cuanto a los síntomas, la dermatóloga señala que los más característicos son calor, escozor, ardor, picor… “En definitiva, todo se resume a un malestar de la piel, que a veces va a acompañado de rojeces más o menos súbitas o que pueden durar unos días, pero en aproximadamente la mitad de los casos ni siquiera hay rojez. Lo normal es que los especialistas, a simple vista, no notemos nada, ya que se trata más bien de una percepción que abordamos a partir de lo que la persona nos cuenta”.
La edad no es en sí misma un factor determinante para desarrollar una piel sensible “y, de hecho, son frecuentes los casos de personas de cierta edad que, de repente, se dan cuenta de que su piel se ha vuelto reactiva”.
Bagazgoitia explica también que hay ciertos ambientes que favorecen especialmente esa sensación de piel sensible, como son las temperaturas muy altas, los climas muy secos, el frío intenso o el viento muy fuerte. “En cuanto al efecto de la polución, ahora sabemos que la contaminación puede influir en la sensibilidad de la piel (al no estar intacta la barrera cutánea, es lógico que sea más susceptible a la entrada de agentes dañinos de la polución) y también en un mayor envejecimiento, ya que implica cierto estrés oxidativo. Sin embargo, sus efectos en relación con la piel sensible no son un motivo concreto de consulta, ya que se trata de un factor silente que nos va “atacando” sin que nos demos cuenta”.
La experta destaca también la importancia causal que, en las mujeres, tiene la influencia hormonal, especialmente la menstruación, “pero sin ninguna duda, el desencadenante de los síntomas por excelencia es el uso de determinados productos cosméticos”.
Cuidar la piel sensible: “operación ladrillo”
Tal y como explica la doctora Bagazgoitia, cuando se trata de una piel sensible, esa “pared de ladrillos” que es el manto hidrolipídico está defectuosa, de ahí la necesidad de restaurarla y reconfigurarla con los cuidados adecuados, entre los que destaca, por encima de todos, la hidratación. “Es fundamental hidratar la piel sensible con ingredientes como el ácido hialurónico o la glicerina, que aportan niveles elevados de agua. También es importante reponer la hidratación con aceites vegetales y ceramidas, así como limitar los ingredientes irritantes y potencialmente alergénicos; minimizar la cantidad de perfumes y conservantes y, en general, utilizar fórmulas con pocos ingredientes”.
Uno de los errores más extendidos respecto al cuidado de este tipo de piel se refiere a la forma de limpiarla: la “recomendación” de hacerlo con jabón tipo “Lagarto” (debido principalmente a su composición 100% natural) es todo un clásico que pervive incluso entre la población más joven: “Este tipo de jabones y en general los surfactantes no están recomendados, ya que pueden llegar a resultar agresivos. También hay que evitar las exfoliaciones muy intensas y procurar secar siempre la piel de forma suave, con golpecitos y sin frotar”, dice la dermatóloga.
Bagazgoitia insiste en que la clave de los cuidados de este tipo de piel es reponer el manto hidrolipídico: “para ello hay en el mercado muchas gamas específicas para la piel sensible. En cuanto al maquillaje, resulta menos agresivo utilizar las texturas en polvo que las cremas. Tampoco hay que olvidar la protección solar, siendo más recomendables los filtros físicos o minerales (los solares que incluyen óxido de titanio o de zinc presentan menos riesgo para este tipo de pieles). Y en cuanto a los tratamientos antiedad, hay que tener mucho cuidado al utilizar ingredientes como el retinol, y aplicarlos siempre bajo supervisión dermatológica”.
Estrategias de refuerzo cutáneo
Por su parte, Eva Raya, cosmetóloga y co-creadora de la firma Alice in Beautyland (www.aliceinbeautyland.com), aporta algunas claves para manejar y controlar la piel sensible y evitar que su sintomatología vaya a más:
- Limpieza con “sentido y sensibilidad”. La experta coincide con la doctora Bagazgoitia en señalar a la limpieza en general y ciertos jabones en particular como uno de los gestos con mayor implicación en la sensibilidad cutánea y con los que, por tanto, más cuidado hay que tener: “los jabones agresivos pueden alterar el manto hidrolipídico natural de la piel. En este sentido, también es recomendable evitar maquillajes tipo waterproof, que requieren limpiadores especiales para eliminarlos”.
- Ojo con el maquillaje. Asimismo, y respecto al maquillaje, Eva Raya señala que ingredientes como el oxicloruro de bismuto, que proporciona un aspecto perlado a los maquillajes, suele ser bastante irritante y oclusivo para las pieles delicadas, pudiendo provocar escozor, sobre todo en la zona de los ojos, cuando está presente en productos como delineadores o máscara de pestañas. “También algunos conservantes o el exceso de perfumes, tanto químicos como naturales, pueden aumentar el número de alergenos de forma considerable. Y emulsiones muy ácidas o alcalinas como el retinol o los protectores solares químicos tampoco son los mejores amigos de las pieles sensibles”.
- Hidratación atemporal (y en todas las estaciones). Respecto a la hidratación, Raya aconseja no bajar la guardia incluso durante el invierno, ya que la piel pasa mucho tiempo al aire libre (especialmente si se practican actividades como el esquí). “Siempre hay que optar por los productos más suaves y emolientes, es decir, aquellos que eviten la pérdida de agua y que contengan ingredientes hidratantes naturales testados dermatológicamente para pieles sensibles”.
- Hábitos bajo control. Según Eva Raya, hay que evitar gestos como tocar excesivamente la cara, “ya que puede empeorar la situación de la piel sensible y, en casos extremos, llegar a producir una infección de acné”. Otra de sus recomendaciones es lavar la piel con agua a una temperatura templada, y prestar especial atención a la caducidad de los cosméticos y a la mezcla de distintos productos no compatibles, “que son la causa de muchas de las reacciones que se producen en las pieles sensibles”.
- Medicina estética adaptada. En cuanto a los tratamientos de medicina estética, la cosmetóloga afirma que algunos AHAs pueden resultar muy irritantes para este tipo de piel: “Por ello, en el caso de, por ejemplo, hacerse un peeling, hay que recurrir a un profesional que recomiende tanto el ácido como la concentración más adecuados para esa piel en concreto. También hay que tener precaución con los láseres”.
Rojeces: manual de uso
Aunque, como ha comentado la doctora Bagazgoitia, las rojeces no siempre están presentes en la piel sensibles, cuándo aparecen son sin duda uno de los síntomas más antiestéticos de esta condición cutánea que, además, también caracterizan otro problema de la piel directamente relacionado con ella: la rosácea. “Aunque muchas personas piensan que su piel, de repente, ha cambiado, la realidad es bien distinta, ya que tanto las rojeces como la sensibilidad cutánea no aparecen inesperadamente, sino de forma progresiva y, a veces, este estado de la piel es incluso imperceptible”, explica la doctora Montserrat Salleras, dermatóloga y directora de la Clínica Dermatológica Salleras (www.clinicasalleras.com), de Barcelona, quien, en colaboración con Bioderma, ofrece algunas pautas para tratar este síntoma: “cuando la rojez acompaña a la sensibilidad cutánea, a la alteración del sustrato córneo característico de ésta se une la vasodilatación (conocida como eritema facial), característica de la rojez y que tiene su origen en distintos factores tanto genéticos como ambientales (viento, frío, ejercicio al aire libre, exposición solar). Esta ‘apertura’ y posterior ‘cierre’ de los capilares y vénulas de la cara va dejando una cierta dilatación permanente, que no se recupera y que es el origen de la piel con rojeces y con tendencia al enrojecimiento”.
La doctora Salleras también advierte respecto al efecto agresivo que determinados cosméticos pueden tener en este tipo de piel: “exfoliaciones, peelings y dermoabrasiones son totalmente desaconsejables en una piel sensible y con rojeces, ya que provocan vasodilatación de la circulación y enrojecimiento. Lo ideal sería realizar tratamientos que impliquen masajes suaves, que favorezcan el drenaje linfático de la zona y eviten la tendencia al edema”.
Asimismo, señala que para calmar y tratar la piel con rojeces y/o rosácea es necesario aplicar cosméticos formulados con principios activos específicos para este tipo de piel: “Incluso hay algunos con efecto maquillaje que consiguen que la piel luzca totalmente uniforme y permiten difuminar las rojeces en un solo paso”.
Piel, mente y emociones: señales a interpretar
Para Eva Raya, más allá de una cuestión estética, la sensibilidad cutánea es una señal del cuerpo que hay que saber interpretar: “Las incómodas expresiones de la sensibilidad suelen aparecer ante situaciones de estrés. De hecho, en su libro The Telomere Effect, la bioquímica Elisabeth Blackburn (premio Nobel de Medicina en 2009 por su descubrimiento de la telomerasa) explica sus investigaciones acerca de cómo nuestros hábitos de pensamiento y emociones influyen decisivamente en el estado de los telómeros de nuestras células. De esta forma, si realizamos el ejercicio consciente de percibir ese estímulo estresante como un desafío en lugar de como una amenaza, los niveles de cortisol (la hormona del estrés) se equilibran y reducen, protegiendo la producción de queratinocitos, fibroblastos y colágeno de la piel. Y todo ello, además de mejorar su aspecto, evita o minimiza la sensibilidad”.
En la misma línea, en su charla “Piel sana desde dentro”, celebrada en el marco de la VIII Feria de la Salud en la Piel, organizada por la Fundación Piel Sana de la AEDV, el doctor Leopoldo Borrego, vicepresidente de la sección canaria de la AEDV, destacó la importancia de prestar atención a los factores biológicos, emocionales y psíquicos para asegurar el buen estado de la piel, adoptando en este sentido hábitos como el control del estrés, junto a otros como el ejercicio moderado, la abstención del tabaco y una alimentación adecuada. “La ausencia de enfermedad dermatológica no implica necesariamente que nuestra piel esté sana. De hecho, los cuidados deben ser constantes para que la piel cumpla adecuadamente sus funciones como órgano barrera de defensa inmunológica, activador de vitamina D, productor de melanina o regulador de temperatura”, señaló el doctor Borrego.
1.470 comentarios
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Lo ideal sería realizar tratamientos que impliquen masajes suaves Snow Rider, que favorezcan el drenaje linfático de la zona y eviten la tendencia al edema
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