What are the 4 skin types?
The four main skin types are normal, dry, oily and combination. They correspond to different patterns of skin function and notably influence appearance, feel, pore visibility and the tendency to produce more or less sebum.
• Normal skin has a satisfactory balance between sebum, hydration and barrier function. It is generally supple, comfortable and less prone to shine or tightness.
• Dry skin produces fewer lipids and less sebum. Its skin barrier retains water less effectively, promoting discomfort, roughness and sometimes peeling.
• Oily skin is mainly characterised by substantial sebum production. It often shows shine, more visible pores and a greater tendency to comedones and acne lesions.
• Combination skin combines several characteristics on the same face. The T-zone — forehead, nose and chin — is generally oilier, while the cheek skin is normal or dry.
This classification is useful for guiding skincare, but does not describe the skin's condition entirely on its own.
How can you recognise normal skin?
Normal skin is balanced: it is neither particularly oily nor particularly dry. It generally has even texture, barely visible pores and little discomfort.
“Normal” does not mean “perfect”. Normal skin may occasionally have a spot, redness or a slightly dry area. Its main characteristic is the absence of persistent imbalance.
After cleansing, it generally does not feel tight. During the day, it neither becomes shiny nor shows peeling.
Its hydrolipidic film and skin barrier perform their protective function properly. Skincare therefore mainly aims to preserve this balance rather than change how it functions.
An overly harsh routine can, in fact, turn initially balanced skin into irritated or dehydrated skin.
How can you recognise dry skin?
Dry skin is mainly recognised by insufficient lipid production and a skin barrier that retains water less effectively. It may be thin, rough, uncomfortable and show scaling or tightness.
Lack of lipids weakens the barrier function of the stratum corneum. Transepidermal water loss then increases more readily, worsening dryness.
The patient may feel that the skin “pulls”, particularly after showering or cleansing. Certain areas may become rough, and superficial fine lines are sometimes more visible when the skin also lacks water.
Cold weather, dry air, repeated cleansing, certain harsh cosmetics and age can accentuate these signs.
Management mainly relies on gentle cleansers and products containing agents that limit water loss and support the skin barrier, particularly humectants and physiological lipids.
However, dry skin is not necessarily dehydrated skin: the two concepts are related but different.
How can you recognise oily skin?
Oily skin is characterised by excessive sebum production, called hyperseborrhoea. It generally shows persistent shine, particularly on the forehead, nose and chin, and pores may be more visible.
Sebum is produced by the sebaceous glands. It has a physiological function: it contributes to the hydrolipidic film protecting the skin surface. The problem is therefore not its presence, but excessive production or a change in its composition.
Oily skin is more prone to blockage of pilosebaceous follicles. Open or closed comedones may appear and, in some people, accompany inflammatory acne lesions.
However, oily skin and acne-prone skin are not synonymous. Skin may produce plenty of sebum without acne, while acne results from several mechanisms beyond hyperseborrhoea alone.
Trying to eliminate sebum completely through repeated cleansing, strongly degreasing products or excessive exfoliation can damage the skin barrier and cause irritation and dehydration. Oily skin should be regulated and properly cleansed, not stripped.
How can you recognise combination skin?
Combination skin has excess sebum in the T-zone — forehead, nose and chin — while the cheeks are normal or dry. This difference between facial areas distinguishes it from oily skin.
In the T-zone, sebum production is greater, shine more frequent and pores may be more visible. The cheeks produce less sebum and may show dryness or discomfort.
This distribution is explained, in particular, by differing sebaceous gland density between facial areas.
Skincare must therefore be adapted to each area. A strongly degreasing product may suit the T-zone but dry out the cheeks. Conversely, a rich texture suitable for dry areas may be too occlusive for oily areas.
Combination skin therefore needs a routine balancing excess T-zone sebum without drying normal or dry areas.
How can you identify your skin type?
To identify your skin type, observe its usual behaviour rather than its appearance at a single moment.
Skin that remains generally comfortable and balanced is probably normal. Tightness, roughness and a tendency to peel point more towards dry skin. Widespread persistent shine with substantial sebum production suggests oily skin. When these signs mainly affect the T-zone while the cheeks are normal or dry, the skin is more likely combination.
Products used can distort the impression. A strongly degreasing routine may make oily skin uncomfortable and give the impression that it is dry. Conversely, very rich cosmetics can temporarily increase shine.
Skin type must therefore be assessed in the context of its usual function and the products applied.
Can skin type change with age?
Yes. Skin type is not necessarily identical throughout life. Sebum production and barrier function evolve under the influence of age, hormones, the environment and certain treatments.
In adolescence, sebaceous gland activity frequently increases under hormonal influence. Skin that was relatively balanced during childhood may then become oilier.
With age, sebum production instead tends to decrease. Changes in the skin barrier and epidermal lipids may also promote drier, more fragile skin.
Hormonal changes, certain medicines, climate or a substantial change in cosmetic routine can also alter skin behaviour temporarily or permanently.
Someone may therefore have had oily skin at 20 and have drier skin several decades later. A routine effective at one age is not necessarily suitable indefinitely.
Sensitive skin: is it a fifth skin type?
No. Sensitive skin is generally considered a condition or characteristic rather than one of the four skin types. Dry, oily, combination or normal skin can be sensitive.
Sensitivity notably manifests as burning, tingling, itching or discomfort in response to stimuli that are normally well tolerated.
It may be associated with an impaired skin barrier and increased neurosensory reactivity. Excessive use of irritating active ingredients or certain skin disorders may also contribute.
This distinction is essential when choosing a routine. Someone may, for example, have oily, sensitive skin: treating excess sebum alone with harsh products risks worsening irritation.
Skin type therefore describes general function, while sensitivity provides additional information about reactivity.
What is the difference between skin type and phototype?
Skin type and phototype are two completely different classifications.
Skin type — normal, dry, oily or combination — mainly describes hydrolipidic balance and sebum production.
Phototype describes how the skin responds to ultraviolet exposure, particularly its tendency to develop sunburn and tan. The Fitzpatrick classification traditionally distinguishes six phototypes, from I to VI.
A person can therefore have oily skin with a fair phototype, dry skin with a dark phototype or any other combination.
This distinction becomes particularly important when medical treatment using light energy or a laser is considered. Skin type informs certain skincare needs, while phototype contributes to assessing treatment parameters and the risk of certain pigmentation complications.
Can you have several skin problems at the same time?
Yes. Skin type describes only part of its condition, and several problems can coexist.
Oily skin can be dehydrated and sensitive. Dry skin may have pigmentation spots. Combination skin may be acne-prone. Normal skin may occasionally develop irritation or a skin disorder.
The relatively stable skin type must therefore be distinguished from skin conditions and disorders, which can arise independently.
This distinction notably avoids choosing an entire routine based on a single sign. Spots do not automatically mean “oily skin”, tightness does not always mean “dry skin”, and redness alone does not define “sensitive skin”.
Which skincare should you choose for your skin type?
Skincare choices should take skin type into account, but also the condition of the skin barrier, any disorders and the intended objective.
Dry skin generally benefits from products that limit water loss and restore the skin barrier's lipid components. Oily skin instead needs suitable textures and a routine controlling excess sebum without irritation. Combination skin may need different products for different areas.
Sun protection is necessary regardless of skin type. Sunscreen texture should be adapted: a lightweight formulation is often more comfortable on oily skin, while a more emollient texture may better suit dry skin.
Retinoids, exfoliating acids, vitamin C and other active ingredients address specific objectives, and their tolerability depends, in particular, on skin barrier condition.
Which aesthetic medicine treatments should you choose according to skin type?
Skin type can guide aesthetic medicine treatment choice, but is not enough to determine an indication.
Dry, oily, combination or normal skin may have very different needs depending on hydration, sensitivity, phototype, age and the problem being treated: uneven complexion, visible pores, fine lines, loss of radiance, sagging or changes in skin quality.
For dry skin, the priority is generally to avoid treatments that could further damage an already fragile skin barrier. Mesotherapy and Skinboosters may be offered when the aim is to improve hydration, elasticity and skin density. PRX-T33 is indicated to improve radiance and skin quality without the substantial peeling of a conventional medium-depth peel.
For oily skin, superficial peels are particularly useful when excess sebum accompanies visible pores, comedones or superficial irregularities. The choice of acid and its concentration depends on the indication.
Combination skin often needs a more personalised strategy. A superficial peel may benefit areas with hyperseborrhoea and visible pores, while mesotherapy or a Skinbooster may address dehydration or skin quality.
For normal skin, treatment choice depends on the intended objective. Mesotherapy, Skinboosters or PRX-T33 may be indicated to improve hydration, radiance and skin quality.
Medium-depth peels and fractional ablative lasers address more specific indications, including certain photoageing changes, texture irregularities or certain scars. These treatments are not performed as simple maintenance skincare.
Sculptra may be offered when the skin gradually loses firmness and density. It stimulates collagen production, gradually improving tissue quality and support. Its indication does not depend on skin type — dry, oily, combination or normal — but on collagen loss associated with skin ageing.
Fractional ablative lasers and medium-depth peels require a more comprehensive medical assessment. Their indication depends, in particular, on phototype, pigmentation spots, skin quality, healing ability and current treatments. These factors also help assess the risk of pigmentation disorders after treatment.
The choice of a laser or peel therefore does not rest on having dry, oily, combination or normal skin. It depends above all on the problem being treated and the skin's characteristics.
Article written by Dr Valeria Romano
Dr Valeria Romano supports each patient through a comprehensive approach to facial, body and intimate aesthetics, as well as skin and hair quality. Every treatment is based on a personalised medical assessment.
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