Laurent Misery


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

In This Article

Anatomic Site

Skin reactivity is not confined to the face.[47] For example, a study showed that 70% of patients reporting reactive facial skin exhibited involvement of extrafacial sites, such as the hands (58%), scalp (36%), feet (34%), neck (27%), torso (23%) or back (21%).[48] Genital involvement is also likely underestimated.[47] Another study found 77% of people with sensitive facial skin, 61% with sensitive body skin and 56% with sensitive genital skin.[47]


The face is the most common site of skin sensitivity, and most spontaneous complaints of sensitive skin are related to the face. The nasolabial fold is considered as the most sensitive region, and tests are usually performed in this area. This area is followed by the malar eminence, chin, forehead and upper lip.[32]


The frequency of a sensitive scalp is approximately 44% in the French population.[18] On the scalp, the symptoms are slightly different;[17,18] itching and prickling are the most frequent symptoms (corresponding with burning and erythema on the face). Dandruff cannot be considered as a symptom of a sensitive scalp. The main triggering factors are also different: heat, emotion and shampoos. No other area of skin sensitivity is specifically associated with scalp sensitivity. Sensitive scalps are increasingly frequent with age. A new assessment scale, the 3S questionnaire, allows discrimination between subjects with slightly sensitive, sensitive and very sensitive scalps.[17]

Scalp pruritus is frequent in people with or without dandruff.[49] The high frequency of scalp pruritus and sensitive scalps is related to the complex neuroanatomy of the scalp, with an abundance of sensory neural end organs in the pilosebaceous unit.[50] From a physiological point of view, the scalp could be considered as an organ with aberrant C nerve-fiber function.[51]

Genital Area

Skin/mucosal sensitivity in this area is poorly characterized in men but well known in women. The role of feminine hygiene products is still controversial.[25] It is difficult to separate hyperreactivity, irritation and immunological sensitization in this area.