Sensitive skin: closing in on a physiological cause

Abstract

The phenomenon of 'sensitive skin' is a relatively recent complaint in which certain individuals report more intense and frequent adverse sensory effects than the normal population upon use of cosmetic (personal-care) products. Originally defined as a minority complaint, sensitive skin is now claimed by a majority of women in industrialized countries and nearly half of men. Sensitive skin is self-diagnosed and typically unaccompanied by any obvious physical signs of irritation, and the number of individuals who claim sensitivity has risen steadily with the number of consumer products targeted towards this supposedly uncommon group. Believed by many dermatologists, therefore, to be a 'princess and the pea' phenomenon, the problem of sensitive skin has largely avoided focussed research. Over the last few years, however, the evidence of documentable biophysical changes associated with the largely sensory symptoms of this disorder has accumulated, including some gained by improved methods of identifying subclinical signs of skin irritation. Although the understanding of the aetiology of this phenomenon is as yet incomplete, existing research now supports a biophysical origin for this disorder. Effective methods of diagnosis, intrinsic and extrinsic contributors to exaggerated neural sensitivity, and the specific mechanisms of the discomfort associated with the compliant are required, as are appropriate means of prevention and treatment.

The Association Between Perception of Sensitive Skin and Objective and Subjective Measures in Women with Urinary Incontinence

“…Prevalence of self-perceived sensitive skin in this population of majority postmenopausal women with frequent UI was 62% (74 subjects out of 120), which is similar to that reported in the literature [8]. The majority of subjects in this study had long standing perceived sensitive skin (more than 10 years) with a consistent level of severity over time.…”

“…Rough female population prevalence estimates range from 5% to 69% globally [8]. Cultural differences, willingness to report, and methodological research differences are factors impacting the variation.…”

What Is Sensitive Skin? A Systematic Literature Review of Objective Measurements

“…Factors that impede the detection of sensitive skin are the heterogeneity of symptoms [17], the subjectivity of sensory discomfort [29] and the absence of visible clinical features [17,21]. Updates have been published recently, but a systematic approach and a critical appraisal of published studies is still lacking [19,22,30,31]. …”

“…Various exogenous factors such as cosmetic ingredients and environmental conditions have been indicated to trigger sensitive skin reactions. Many provocations used in experiments resulted in sensory skin reactions [19,21,22,24]. However, susceptibility to one provocative agent does not predict susceptibility to another [25,26,27,28].…”

“…To define the symptom profile and to address exogenous and endogenous factors which may elicit skin reactions, nonuniform questionnaires have been conducted in different populations [12,13,14]. Furthermore, various chemical and electrical provocations followed by noninvasive measurements of biophysical parameters of the skin have been widely appraised in persons having sensitive skin perceptions to quantify sensory irritation and to reveal the underlying mechanisms of sensitive skin [9,19,21,22,23]. Various exogenous factors such as cosmetic ingredients and environmental conditions have been indicated to trigger sensitive skin reactions.…”