Laurent Misery

Disclosures

Expert Rev Dermatol. 2013;8(6):631-637. 

In This Article

Abstract and Introduction

Abstract

Sensitive skin could be defined as the occurrence of erythema and/or abnormal stinging, burning and tingling sensations (occasionally pain or pruritus) in response to multiple factors, which may be physical (UV radiations, heat, cold and wind), chemical (cosmetics, soaps, water and pollutants) and occasionally psychological (stress) or hormonal (menstrual cycle). The diagnosis, pathophysiology, epidemiology and treatment are still under debate. Sensitive skin is most likely due to neurogenic inflammation after the enhanced activation of sensory proteins in keratinocytes and nerve endings. Skin sensitivity is a very frequent condition because it can be detected in approximately half of the population. The treatment is likely a cautious use of cosmetics or the use of cosmetics without preservatives and surfactants or containing inhibitors of neurogenic inflammation.

Introduction

'Sensitive skin' is commonly used to describe a number of unpleasant sensations of varying intensity that are transient in nature. Although the existence of sensitive skin has been challenged in the past, it is now admitted that sensitive skin can be defined clinically[1–6] as the occurrence of abnormal stinging, burning, pain, pruritus and tingling sensations in response to multiple factors, which may be physical (UV radiation, heat, cold and wind), chemical (cosmetics, soaps, water and pollutants) and occasionally psychological (stress) or hormonal (menstrual cycle). Erythema is not a regular feature but may occur often. Nonetheless, a consensus definition is still lacking since the initial descriptions of this syndrome.[7,8]

Sensitive skin is also known as reactive or over reactive skin, intolerant skin or irritable skin. The term 'reactive skin' seems preferable to 'sensitive skin', which may induce confusion with sensitized skin due to an allergic disorder. Although the pathophysiology of sensitive skin remains unclear,[9] the underlying mechanism is not immunological or allergic.

Tests that may help to establish the diagnosis include the stinging test, heat sensitivity test and capsaicin test. However, the diagnosis relies on history taking, which is obviously the most reliable method given that, by definition, skin sensitivity occurs in response to a variety of factors.

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