The complex problem of sensitive skin

Abstract

There exists within the population subsets of individuals who display heightened skin reactivity to materials the majority find tolerable. In a series of investigations, we have examined interrelationships between many of the endpoints associated with the term 'sensitive skin'. In the most recent work, 58 volunteers were treated with 10% lactic acid, 50% ethanol, 0.5% menthol and 1.0% capsaicin on the nasolabial fold, unoccluded, with sensory reactions recorded at 2.5 min, 5 min and 8 min after application. Urticant susceptibility was evaluated with 1 m benzoic acid and 125 mM trans-cinnamic acid applied to the volar forearm for 20 min. A 2 x 23-h patch test was also conducted using 0.1% and 0.3% sodium dodecyl sulfate, 0.3% and 0.6% cocamidopropyl betaine and 0.1% and 0.2% benzalkonium chloride to determine irritant susceptibility. As found in previous studies, increased susceptibility to one endpoint was not predictive of sensitivity to another. In our experience, nasolabial stinging was a poor predictor of general skin sensitivity. Nevertheless, it may be possible to identify in the normal population individuals who, coincidentally, are more generally sensitive to a range of non-immunologic adverse skin reactions. Whether such individuals are those who experience problems with skin care products remains to be addressed.

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

“…However, 66.7% of nonsensitive subjects also experience this reaction. Moreover, several studies have shown that sensitivity to one substance seems not to predict sensitivity to another [28,35,39], questioning the validity of the LAST as a reliable diagnostic test for sensitive skin.…”

“…Therefore, the assessment of erythema in skin irritation has been widely investigated, either by visual assessment [28,37,41,59,60] or by quantitative methods such as tristimulus reflectance colorimetry (a* value) [20,50,51,52], reflectance spectrophotometry (erythema index) [38,53,59] or laser Doppler flowmetry (cutaneous blood flow) [20,41,48,50,51,53,61]. Increased vascular reactivity has been emphasized in the literature as a key player in sensitive skin pathophysiology.…”

“…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]. …”

Quantitative study of stratum corneum ceramides contents in patients with sensitive skin

“…In general, SS is a functional term used by individuals who show reduced tolerance to frequent or prolonged use of cosmetics and toiletries with sensitive reactions such as intolerable burning or itching sensation. 1,2 Tests for diagnosing SS include subjective testing, which involves determining the degree of skin irritation by applying stimulants and evaluating the subject's opinion, and objective testing, which involves visual or mechanical observation. However, there is no standardized method for diagnosing SS.…”

Supplementation of Flaxseed Oil Diminishes Skin Sensitivity and Improves Skin Barrier Function and Condition

“…Patients usually report an itching, stinging and burning sensation. Often it is not possible to identify a single cause for the symptoms, since they are not specific [2,7] .…”