The Best (and Worst) Spa Treatments for Sensitive Skin – Real Simple

With these tips in your robe pocket, you’ll be a regular spa goer in no time.
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Reader question: What are some good spa treatments for people with sensitive skin and allergic to practically everything? – @iluvbroadwaymusicals
Just wanted to say that I totally relate—my skin is also allergic to everything! 
The struggle is real. As a beauty editor, I have the privilege of being invited to facials frequently. Although I'm more than eager to jump on hairstyling events and makeup sessions, I was terrified of anything that involved strangers touching my skin (still am, TBH) because of how sensitive it is. 
After many good—and some awful—experiences, I can now say that I've become pretty confident of walking into a spa and picking a treatment that is compatible with my complexion. The key is—and I can't stress this enough—communication.  
"Your facialist should be taking the lead in assessing your skin's needs, but it's always a good idea to bring in a list of what you're currently using for skincare, as well as a list of the skin concerns you'd like to address," says Candace Marino, celebrity esthetician known as "The LA Facialist" for her star-studded clientele. Additionally, be sure to list all the medications you're using as there may be contraindications to the treatment due to increased sensitivity, says Loretta Ciraldo MD, FAAD, board-certified dermatologist in Miami, Fla. "For example, you shouldn't get waxed if you use a prescription Tretinoin in this area."
Once you have an idea of what you want, use this list to reference what questions you should be asking.
As for the treatments you should be getting, skincare treatments that are soothing, reparative, and strengthening are going to be best for sensitive skin and those with compromised barriers. "In my practice, we use Biologique Recherche products on our most fragile skin types, as they help to rebuild the epidermis while calming inflammation and working on secondary skin concerns," says Marino. 
Dr. Ciraldo doesn't advise TCA or AHA peels above 30 percent, and says to make sure any microneedling needles have a shorter needle length (0.5mm). "I advise getting a gentler 'lunchtime' type peel, preferably with a low concentration AHA that is a buffered product," she says.
And this is a general rule of thumb as your facialist's assessment is more valuable, but for most, suction-based exfoliation (like microdermabrasion) is generally not a great idea on ultra-sensitive skin or for those who have thin skin, broken capillaries, or rosacea. 
Marino adds that you should avoid overexposure to heat and/or steaming, which is definitely not ideal for rosacea, melasma, or acne. "Heat induces more inflammation, which is a causing factor to these types of skin concerns," she explains. "While I'm not going to tell someone to never go in a hot tub ever again, I'd keep your skin concerns in mind and keep soaking time to a minimum. Once out, rinse off and apply a good strengthening and nourishing body cream."
If you do opt for a quick steam, never pair it with a spa treatment that involves harsh scrubs. "Heat will increase blood flow to the skin, so facial redness and sensitivity will be aggravated by heat of any kind during a spa treatment," says Dr. Ciraldo. "Also, since heat increases the penetration of topical products, if you have a potentially irritating product like a retinoid or AHA, the likelihood of inciting sensitivity when applied to skin exposed to steam or heat is much greater."
However, sometimes all that communication isn't enough, so confirmation is the last step. At my worst facial, an esthetician told me to "relax" and that "some irritation is natural," despite my face slowly swelling in angry hives. Turns out, she was using a product with milk-derived lactic acid when I had told her I'm allergic to dairy. 
My point being, if you have sensitivities to any ingredients, ask your esthetician to show you the ingredient lists of all the products he/she plans to use. You know your skin best, so always advocate for yourself and never be scared of confrontation. If something is burning during treatment, ask for it to be removed immediately.
RELATED: Ask a Beauty Editor: How to Know Your Skin Type

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