How to diagnose and establish skin type

Ksenia Kazimirova, MD, dermatologist, cosmetologist

Oily skin test

This test is indicative for young skin, up to 30 years. Those with mature, aged or dehydrated skin are advised to determine their type by other criteria.

In the morning, the face is cleansed with a mild product. No matting wipes, makeup, or creams are applied. After at least two hours, a thin napkin is applied to the face and light pressure is applied to the forehead, nose, chin and cheeks. The test result is assessed by the presence of greasy stains on the napkin.

• Negative: no oily spots - dry skin;
• mild spots in the T-zone - normal skin;
• positive: oily spots on the forehead, nose and chin - mixed;
• strongly positive: five oily spots in the T-zone and in the cheek area - oily.

Unfortunately, this gradation of types does not take into account one of the most important characteristics of the skin - the peculiarities of its renewal process over time. If, according to this classification, you begin to intensively nourish dry skin with a rich cream, then the glued horny scales will interfere with the normal renewal of the skin surface, and the growth of a worn-out layer will lead to a deterioration in its color, clogged pores and the appearance of a rash. On the contrary, if we take it as an axiom that only low-fat cream is indicated for oily skin, then we can disrupt the lipid structure, depriving it of important fats necessary to ensure normal barrier properties of the skin. As a result, despite all its oiliness, the skin will become dehydrated. And if you start lubricating it with alcohol solutions, you can make it as reactive as dry skin.

Skin turgor test

Dividing the skin only according to the characteristics of sebum and sweating does not take into account such important conditions as firmness, elasticity and fullness, which in cosmetology is called skin turgor, for which the state of its connective tissue is responsible. Therefore, to more accurately determine the condition of the skin, it is necessary to conduct an additional test, which must be repeated periodically, since, unlike skin type, turgor changes with age.

To assess skin turgor, you need to grab an area of skin with two fingers (thumb and forefinger), hold for a couple of seconds and release. With this test you can check the elasticity of the skin on any part of the body. And on the face, skin turgor is determined by capturing the fold in the side under the cheekbones.

Test results evaluation:

• the skin resists and it is difficult to form a skin fold - the turgor is excellent;
• a skin fold forms, but immediately straightens - turgor is slightly reduced;
• the fold is easily formed and does not straighten out immediately, and in some places the skin itself forms folds - the turgor is significantly reduced.

Skin condition

The condition of the skin is not a cosmetic constant; it changes under the influence of the following factors:

• lifestyle;
• disturbances in sleep and rest patterns, in particular lack of sleep;
• bad habits: alcoholism disrupts skin pigmentation, blood vessels constantly dilate - the skin turns red and inflamed, loses tone and becomes sluggish. Cigarettes are even more destructive: the skin of the face and neck dries and irritates, becomes yellowish-gray - the cells do not have enough oxygen. Then red spots and wrinkles appear, blood flow slows down: the cascade reaction of free radicals is activated;
• sedentary work: the muscles of the collar zone are overstrained, the vessels are pinched, and blood circulation is disrupted - the skin turns pale and dull;
• fad diets cause a lack and deficiency of necessary substances, this causes skin cells to lose moisture, which leads to dehydration and lethargy;
• gastrointestinal pathologies and nutritional disorders, for example, consumption of spicy foods, foods containing large amounts of fats and carbohydrates;
• season or sudden climate change, with excessive insolation, the skin becomes dehydrated, tired, and pigment spots appear;
• changes in hormonal levels, including during pregnancy and lactation, overweight;
• internal aging;
• stress and psycho-emotional states;
• bad environment;
• improper care.

What changes are observed in the skin?

The amount of sebum may change due to hormonal changes (pregnancy, taking oral contraceptives, thyroid disease, etc.)

Dehydration is a skin condition of any type with disturbed water balance. Signs include tightness, flaking, increased sensitivity, skin elasticity decreases, sagging and wrinkles appear. It is not true that if the skin feels tight, it means it is dehydrated and needs hydration. In this case, dry skin occurs from a lack of sebum, not water. Air conditioning, heating, wind, cold, sun, and fat-dissolving cosmetics contribute to moisture loss. Dehydration can occur with any type of seborrhea, especially the thick form and mixed state due to dissonance in the functioning of the sebaceous and sweat glands. In any case, repeated use of a fortified and mineralized spray with thermal water throughout the day and correction of the condition of the water-lipid mantle will be beneficial for the skin.

Tone is the state of tension/elasticity of muscles and tissues. Tone decreases with age due to a decrease in the quality of elastin in connective tissues. Massages can partially correct the situation.

Turgor is a state of fullness/elasticity of the skin, which depends on the presence of moisture in the cells and their ability to retain this moisture. Turgor becomes worse from exposure to UV rays and due to biological aging.

Inadequacy of the renewal process, leading to the formation of uneven skin texture.

Skin imperfections (comedones, acne, redness, peeling, etc.).

From the above, it is important to understand that:

• skin type is constant, rarely changes, usually with age;
• skin condition - temporary;
• oily, dry skin - these are the types;
• thick, thin, mixed - these are the subtypes of oily skin;
• and dehydration, sensitivity, problematic and impaired epidermal barrier are skin conditions.

Classification of skin taking into account the slightest nuances

So, the generally accepted classification cannot remain relevant, since cosmetology has moved far forward, and the arsenal of professional cosmetics allows specialists to select programs for their clients more accurately, based on the individual characteristics of the skin. And for the concepts “oily reactive skin”, “wrinkled, with a high degree of pigmentation”, “dry dehydrated”, a more precise classification was required, taking into account the slightest nuances (Table 1). And it was suggested by the founder of the Miami Cosmetic Research Institute, professor of dermatology Leslie Baumann:

1. dry or oily skin;

2. sensitive (hyperreactive) or resistant (not prone to irritation);

3. pigmented or non-pigmented;

4. wrinkled or without wrinkles (smooth).

Explanation of the abbreviation:

• C - D (dry) - dry;
• F - O (oily) - fatty;
• N - N (nonpigmented) - without pigmentation;
• P - P (pigmented) - pigmented;
• P - R (resistant) - not prone to irritation (resistant);
• Ch - S (sensitive) - sensitive (hyperreactive);
• G - T (tight) - smooth;
• M - W (wrinkled) - wrinkled.

Thus, cosmetologists, according to the Baumann classification, can specifically select correction methods, taking into account the individual needs of 16 possible skin types.

Correction methods

Happy owners of normal skin think that they do not need to take care of their face is a mistaken opinion. If you leave the process to its own devices, over time the skin will become more sensitive, especially to temperature changes. Therefore, you should regularly take care of normal skin type. And for complete care, products that contain more moisture than fat are suitable.

Dry skin, as a result of low activity of the sebaceous glands, can be caused by a disruption of the endocrine system, but more often the cause is improper care, for example, the regular use of alcohol-based products. Dry skin can look rough due to cracks, fine lines may be visible, and if it is powdered with talc-based products without first using a cream, it will become even drier. For all skin types, especially dry skin, regular care, protection from sun rays, as well as methods and preparations that deeply moisturize and nourish are important. At the same time, exfoliating agents must be gentle with small and soft abrasive particles for gentle cleansing without harm to the epidermis. Dry skin needs nourishing and moisturizing masks 2 times a week.

Persons with dry, smooth, sensitive and non-pigmented skin need procedures to restore the water-lipid mantle, eliminating foaming agents that remove lipids from the surface of the skin. It is necessary to use cosmetics with ceramides and allantoin, thoroughly moisturize the skin using preparations based on hyaluronic acid and urea.

When choosing a skin care regimen, the amount of melanin, the skin pigment, is taken into account. The darker the skin, the better it is protected from the damaging effects of sunlight, and the lighter it is, the more thorough protection it needs. Then you need to consider the specific problem. Patients with heavy pigmentation and signs of photoaging on the face require the use of sunscreens with a high protection factor (SPF), as well as whitening and deep moisturizing of the skin with preparations based on natural moisturizing factor and hydrolyzed collagen. For lightening, depigmenting agents are used, both direct and indirect, which include: substances that reversibly inhibit melanin synthesis in melanocytes (hydroquinone, ascorbic acid and its derivatives, azelaic acid); tyrosinase enzyme inhibitors (arbutin, kojic acid). Herbal preparations based on bergenia, bearberry, yarrow and licorice also have a whitening and safe effect.

If the skin takes on a dull, unclean appearance, then you need to use exfoliating products with fruit acids to even out the skin color and its texture. The type of peeling is chosen exclusively pathogenetically, and is carried out at least once a week. Toning masks and massages are also recommended.

Oily skin is susceptible to contamination, so when caring, it is necessary to cleanse twice a day using water-soluble products, including cosmetic soap or foam. More washing is possible, but without cleansing, as too much oil may be removed from the skin and the sebaceous glands will produce additional sebum. Oily skin is prone to acne formation and is often sensitive. The most important thing is to identify the cause of irritation and contamination of the sebaceous glands, follow a diet, regular cleansing and use of products that normalize keratinization and activity of the sebaceous glands, as well as increase the skin’s resistance to infection. According to indications, retinoids (isotretinoin, tazarotene, tretinoin) and agents with anti-inflammatory activity are prescribed: tinctures of sage, calendula, oak bark, chamomile, essential oils and fruit acids. Moisturizing and nourishing creams are applied more generously to the sides of the face, while the T-zone is not overloaded. Such creams should contain a lot of moisture and little fat, moreover, properly selected. When exposed to silicic acid, the skin becomes dull, zinc oxide absorbs sebum, and alcohol-containing preparations disinfect the skin and dry out inflammatory elements. However, you should not abuse alcohol-containing substances. Cleansing masks are recommended twice a week. Masks with aloe vera relieve irritation and inflammation well, and trigger cell renewal processes.

Sometimes there is a sensitive skin type, which is the most difficult to determine, reacting to all kinds of irritants. In fact, any skin can be sensitive, regardless of age or type. This is one of the additional characteristics. The skin becomes excessively dry and tightens even at the slightest contact with water, from weather and climate influences, or oily, and reacts to contact with clothing with the appearance of a rash. This increased skin sensitivity can be temporary: caused by health problems, menopause, and certain cosmetic procedures, such as peels. As a result, redness forms on it and a rash appears. High sensitivity can also be permanent - due to certain genetic characteristics of the skin and blood vessels.

Leslie Baumann notes four subtypes of sensitive skin:

• skin type with a tendency to develop acne;
• skin type with rosacea (prone to the formation of telangiectasia and redness);
• irritated skin with a permanent burning sensation;
• allergic skin type with peeling, itching and redness.

These sensitive skin subtypes require individual treatment and special care. All four subtypes have one common inflammatory problem, so therapy should include cosmetic preparations that eliminate inflammation. For the care of sensitive skin, it does not matter whether it is congenital or acquired. In any case, such skin should be spared and products with active soothing substances (panthenol, calendula oil, licorice extract, bisabolol) should be used. Cosmetics labeled “for sensitive skin” are not always suitable for all subtypes. This type of skin does not like frequent changes of medications. It is very important to refresh your face with thermal water and use a light moisturizer (containing hyaluronic acid, urea, amino acids, glycerin).

Every cosmetologist is well aware of the term that includes the entire range of existing problems in cosmetology: skin prone to acne, allergic reactions, rosacea and rosacea is called “problematic”. But in Leslie Baumann’s classification there is no such type, since each problematic condition of sensitive skin requires an even more individual approach. For example, skin with acne is characterized by hypersecretion of the sebaceous glands with pathological accumulation of fat. The vicious circle that occurs as a result of the action of pathogenic bacteria that provoke inflammation is quite difficult to break. If lesions constantly appear on oily skin, it becomes oily and problematic. But oily skin is not always problematic. Treatment of this condition should be carried out in four directions:

• normalization of sebum secretion (retinoids, oral contraceptives, etc.);
• cleansing pores of sebaceous plugs (mechanical cleaning, antibacterial agents);
• elimination of pathogenic elements;
• elimination of inflammation (use of antibiotics and antiseptics);
• correction of post-acne (salicylic, azelaic, kojic peelings).

Cosmetic imperfections such as telangiectasia, post-inflammatory congestive spots, and “red nose” are of vascular origin. The shallow location of the capillaries leads to moisture loss. The rate of skin renewal and the speed of wound healing depend on the intensity of blood circulation, so many cosmetics and procedures are aimed at stimulating blood circulation, toning and strengthening the walls of skin blood vessels. For good results, the composition of care products should include extracts of plants rich in bioflavonoids (gingko, kupena, arnica, witch hazel, horse chestnut), menthol as a tonic. Preparations with vitamin K and C are effective.

Treatment for skin with rosacea includes anti-inflammatory drugs to narrow dilated blood vessels and reduce the permeability of their walls. Such a calming effect is provided by drugs that contain bisabolol and azulene, pycnogenol, and beta-glucan. Whey and a number of plant extracts (green tea, witch hazel, lavender, cola, blueberry, willow, red grapes, turmeric, aloe) have a powerful antioxidant effect. Creams with allantoin and oils rich in linolenic acid (fish oil, rapeseed oil, flaxseed oil, black currant oil) are used as an antiseptic and irritation-relieving agent. Omega-3s reduce the production of arachidonic acid metabolites, which have a pro-inflammatory effect, while increasing the synthesis of those prostaglandins that reduce inflammation. Couperosis and rosacea often occur in people with pigmented skin. The sun is the biggest enemy of superficial blood vessels. It is mandatory for all skin types to use sunscreens that do not disappear from the skin very quickly, but form a film on the surface of the skin.

Skin with irritation and burning is very sensitive and especially reacts to the ingredients of cosmetics, although most often it does not have signs of an inflammatory nature and is the result of a non-allergic reaction in response to a number of environmental factors.

An allergic skin condition is more often observed in persons with chronic dermatological diseases, in particular with atopic dermatitis, and can react acutely with a general allergic reaction of a delayed or immediate type to fragrances and preservatives included in cosmetic compositions. Such skin should be regularly moisturized with neutral moisturizers, as it is characterized by excessive dryness.

No matter how hard we try, there comes a time when the skin becomes mature and begins to gradually fade. She is considered young until she is 27 years old. The rate of wilting depends on external factors, genetics and care. And if you are lucky with genetics and the environment, with careful care, the first signs of old age appear only after 35-40 years in the form of:

• decreased elasticity and firmness, the appearance of sagging and sagging skin - collagen and elastin fibers are destroyed;
• dryness, peeling, tightness, discomfort, hypersensitivity, red spots, burning, itching due to gradual atrophy of the sebaceous glands;
• dehydration, which is a temporary condition in other skin types, with aging skin becomes a permanent condition due to a decrease in the synthesis of hyaluronic acid;
• the appearance of wrinkles - small and large, the formation of “crow’s feet” around the eyes, etc.;
• the oval of the face changes with the formation of “jowls”;
• age-related pigmentation is characteristic;
• there is increased permeability of the vascular wall in the form of spider veins and meshwork;
• a damaged epidermal barrier is quickly restored with proper care.

A cosmetologist has a lot of methods and means of anti-aging therapy in his arsenal. And the prescribed programs for correcting signs of aging are very personalized.

The right choice of funds

The origins of beauty are found in the depths of the skin, which accurately reflects the state of our health and, often there, originate diseases that destroy beauty. Accordingly, many skin problems are solved only by influencing its deep layers. However, the condition can be improved by starting systematic care as early as possible. With the help of cosmetics, you can protect the skin from harmful factors, strengthen its protective structures and deliver necessary substances. Therefore, the key to the success of cosmetology is an understanding of what processes are the cause of certain external changes and what technique will allow you to restore, preserve and increase beauty without causing damage.

An interesting situation is taking place in cosmetology, a peculiar stage of development, which is not at all in favor of science. First, methods and means are created that somehow change the skin: this is the destruction of the stratum corneum, epidermis, supposedly for better penetration of active ingredients, muscle relaxation, filling wrinkles with all kinds of substances, embedding mesothreads into the skin, immunostimulation and changing the hormonal balance, burning dermal structures and their cooling, etc. And only after active implementation in cosmetic practice, after millions of testing, scientists begin to think about what happens in the skin during all these manipulations and what long-term consequences this can lead to.

Unfortunately, many things do not receive the attention of scientists at all, primarily because cosmetic procedures are not methods of treating or preventing any diseases. Therefore, if some effects used in modern cosmetology, which came from classical medicine, have been studied in some detail, then almost nothing is known about others, and the result of thoughtless intervention in such a complex living system as the skin can be difficult to predict.

Our main task is to assess the merits of the skin and the correct selection of a care program, correcting deficiencies (redness, swelling, wrinkles, acne, rashes), bringing the skin to a normal, healthy, comfortable and attractive state. For thin skin, you need to worry about preventing aging earlier, and be more attentive to the choice of cosmetics, taking into account the risk of irritation. And if the skin is oily, then this means that all the factors that increase the secretion of sebum will manifest their effect especially strongly in it. Well, if you have normal skin, then you just need to be careful not to disturb its harmony with rash actions.

When choosing skincare products, you should remember one unshakable rule: the skin after applying a cosmetic product should feel not overloaded and comfortable. High-quality skin care products often turn out to be more effective than medicinal drugs, but they help only temporarily, therefore, taking into account not only immediate needs, but also the time of year, cosmetics need to be changed at certain intervals, choosing each time more precisely and individually.

Reducing negative factors affecting the skin is a necessity. For example, if it is not possible to normalize sleep and rest, drainage cosmetics are used to relieve swelling, restore tone and elasticity to the skin, remove toxins, and improve metabolic processes and facial contours. Products with herbs and algae are good; Citrus extracts perfectly restore and tone the skin.

Physical activity, visiting the pool, and regular massage eliminate tension in the neck muscles and help restore a fresh color to the face.

The diet should be light, but at the same time include all the necessary foods rich in vitamins and minerals.

During diets, you need to cleanse your skin as thoroughly as possible—toxins are removed through it.

Skin can become dull and gray under the influence of poor ecology: lack of oxygen and “excessive” amounts of exhaust gases, and on top of that, chlorinated water ages the skin ahead of time. It is good to use filtered tap water at “room” temperature, adding soda (for dry skin) or boric acid (for oily skin) 1 tsp. per liter

It is especially important to maintain a drinking regime so that toxins do not settle in the cells, but are safely removed from the body. People have not yet come up with a better way to cleanse the body inside and out.

With proper care, the skin remains fresh, young, elastic and radiant for a long time. The art of a cosmetologist lies in choosing the most effective method and product with minimal harm to health. In this case, the result should last for a long time. The main thing is that everything has common sense and functionality.