Pathophysiology and management of sensitive skin: position paper from the special interest group on sensitive skin of the International Forum for the Study of Itch (IFSI)

Miséry, Laurent; Weißhaar, Elke; Brenaut, E.; Evers, Andrea W. M.; Huet, F.; Ständer, Sonja; Reich, Adam; Berardesca, Enzo; Serra‐Baldrich, E.; Wallengren, Joanna; Linder, Dennis; Fluhr, Joachim W.; Szepietowski, Jacek C.; Maibach, Howard; Honari, Golara; Gall‐Ianotto, Christelle Le; Takamori, Kenji; Richters, R.J.H.

doi:10.1111/jdv.16000

Cited by 53 publications

(63 citation statements)

References 75 publications

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“…Patients who report a presumed allergy to cosmetics may in fact suffer from “sensitive skin.” This is a separate entity defined as “the occurrence of unpleasant sensations (stinging, burning, pain, pruritus and tingling sensations) in response to stimuli that normally should not provoke such sensations.” 2 It is not immunologically driven and should not be confused with allergic contact dermatitis (ACD).…”

Section: Introductionmentioning

confidence: 99%

Developing a cosmetic series: Results from the ESSCA network, 2009‐2018

et al. 2020

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Background There is considerable variability across European patch test centres as to which allergens are included in local and national cosmetics series. Objectives To propose a standardized, evidence‐based cosmetic series for Europe based on up‐to‐date analysis of relevant contact allergens. Methods We collated data from the European Surveillance System on Contact Allergies (ESSCA) from 2009 to 2018 to determine which cosmetic allergens produce a high yield of contact allergy. Contact allergens with a prevalence of >0.3% that were considered relevant were included. Rare contact allergens were excluded if deemed no longer relevant or added to a supplemental cosmetic series for further analysis. Results Sensitization prevalences of 39 cosmetic contact allergens were tabulated. Thirty of these allergens yielded >0.3% positive reactions and are therefore included in our proposed European cosmetic series. Six were considered no longer relevant and therefore excluded. Three were included in a supplementary European cosmetic series. An additional nine allergens were included in either the core or supplemental European cosmetic series following literature review. Conclusion We have derived a potential European cosmetic series based upon the above methods. This will require ongoing investigation based upon the changing exposure profiles of cosmetic allergens as well as new and evolving substances.

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Section: Introductionmentioning

confidence: 99%

Developing a cosmetic series: Results from the ESSCA network, 2009‐2018

et al. 2020

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“…A systematic review of the literature showed that the levels of epidermal pH, sebum production and skin hydration were inconsistent [53]. Consequently, dry skin and sensitive can be associated, but sensitive skin cannot be reduced to being a manifestation of dry skin, and its management does not consist of the only application of emollients [12]. Nonetheless, it does not mean that there is no role of keratinocytes in sensitive skin and there are complex interactions between neurons and keratinocytes in sensitive skin [54].…”

Section: Arguments For Neuro-keratinocytic Interactionsmentioning

confidence: 99%

“…The IFSI special interest group on sensitive skin published a position paper on the pathophysiology and management of sensitive skin [12]. A multifactorial origin was suggested after the discussion of many putative mechanisms.…”

Section: Introductionmentioning

confidence: 99%

Sensitive Skins May Be Neuropathic Disorders: Lessons from Studies on Skin and Other Organs

Miséry

2021

Cosmetics

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Sensitive skin can be considered a neuropathic disorder. Sensory disorders and the decrease in intra-epidermal nerve ending density are strong arguments for small-fiber neuropathies. Sensitive skin is frequently associated with irritable bowel syndrome or sensitive eyes, which are also considered neuropathic disorders. Consequently, in vitro co-cultures of skin and neurons are adequate models for sensitive skin.

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“…Sensitive skin affects approximately half of the population and is more frequent in women than in men (2,3). The pathophysiological mechanisms have been debated, and several hypotheses exist (4). Sensitive skin can be considered a result of a decrease in the skin tolerance threshold, which thereby impairs barrier function and leads to abnormalities in the cutaneous nervous system, making the skin hyperreactive (4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

“…The pathophysiological mechanisms have been debated, and several hypotheses exist (4). Sensitive skin can be considered a result of a decrease in the skin tolerance threshold, which thereby impairs barrier function and leads to abnormalities in the cutaneous nervous system, making the skin hyperreactive (4)(5)(6). Sensitive skin can therefore be the clinical expression of neurogenic inflammation and can be modulated by many factors (7).…”

Section: Introductionmentioning

confidence: 99%

Sensitive Scalp: A Possible Association With the Use of Hair Conditioners

et al. 2021

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A sensitive scalp is defined by the occurrence of unpleasant sensations (tingling, burning, pain, pruritus) triggered by stimuli that should not cause such sensations. Environmental factors, particularly cosmetics, can be triggering factors. The aims of this study were to assess hair cosmetic product consumption in subjects with sensitive scalp and to perform a clinical evaluation of sensitive scalp. After a dermatological examination, women between the ages of 18 and 65 years with or without a sensitive scalp completed different questionnaires. Their use of hair cosmetics (frequency, amount per application) was recorded. A total of 160 women with a mean age of 41 years were included. Twenty-seven subjects presented with seborrheic dermatitis or psoriasis, so only 133 were included in the analysis. Five percent of the subjects declared they had a very sensitive scalp, 25% had a sensitive scalp, 38% had a slightly sensitive scalp, and 32% had a scalp that was not sensitive. The mean sensitive scalp score (3S) score was 3.7 ± 1.6 in the very sensitive scalp group, 3.6 ± 2.1 in the sensitive group, 1.2 ± 1.2 in the slightly sensitive group and 0.1 ± 0.4 in the non-sensitive group. Two groups were analyzed: the 56 subjects with a sensitive scalp (3S ≥ 2 score) and the 56 subjects with a null 3S score. In the sensitive scalp group, 89% suffered from itch, and 45% suffered from tingling. No parameter (hormonal status, smoking, age, phototype, BMI) was associated with the 3S score. No differences in the exposure to shampoos and masks between the two groups were noted. The exposure to hair conditioners was significantly higher in the sensitive scalp group than in the group without sensitive scalp. Itch is the main symptom of a sensitive scalp. The frequency of a sensitive scalp was lower than that previously described when the subjects with scalp dermatosis were excluded. The amount of hair conditioners used was significantly higher in subjects with sensitive scalp than in those without sensitive scalp, suggesting a possible link.

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Pathophysiology and management of sensitive skin: position paper from the special interest group on sensitive skin of the International Forum for the Study of Itch (IFSI)

Cited by 53 publications

References 75 publications

Developing a cosmetic series: Results from the ESSCA network, 2009‐2018

Developing a cosmetic series: Results from the ESSCA network, 2009‐2018

Sensitive Skins May Be Neuropathic Disorders: Lessons from Studies on Skin and Other Organs

Sensitive Scalp: A Possible Association With the Use of Hair Conditioners

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