In brief

Scalp sensitivity exists and occurs frequently. The Sensitive Scalp Score, 3S, based on the grading of sensitive skin sensations, is a convenient and effective tool. The Sensitive Scalp Score allows the discrimination between slightly sensitive, sensitive scalp, very sensitive scalp, or not sensitive scalp.

Introduction

Patients with sensitive skin exhibits subjective symptoms (pricking, burning, pain, pruritus…) to stimuli, which, alone, are non‐pathogenic by themselves (wind, heat, cold, water, cosmetics, stress…). Sensitive skin occurs frequently and can be reported on the face, hands, scalp, feet, neck, torso, back, genitalia.
Scalp sensitivity exists and the symptoms appear to be different from those of facial skin sensitivity. Scalp sensitivity is more often associated with scalp diseases, hair loss, greasy or dry scalps. The main triggering factors are pollution, heat, emotive factors and shampoos. However, scalp sensitivity scoring was lacking.

The Sensitive Scalp Score, 3S

In order to grade scalp sensitivity, a sensitivity score, The Sensitive Scalp Score or 3S, was developed. It comprises grades (0-20) for tightness, burning, prickling, itching or pain sensations in terms of their impact on quality of life. 3S is obtained from the sum of the grades given to each type of sensation.

Scalp sensitivity score was assessed in a representative sample of the French population

A survey was conducted on 2117 people representative of the French population aged 15 or older. Interviewees replied to 14 questions concerning scalp sensitivity and other items.
A total of 682 (32.22%) declared suffering from a sensitive scalp. 
Women were more affected than men (35.56% in women and 29.10% in men). The proportion of people declaring having a sensitive scalp increased with age (Figure 1).

Figure 1. Proportion of people declaring sensitive scalp according to the age.

Among those with a sensitive scalp, 186 of the 682 (27.27%) reported a very sensitive scalp, 347 (50.88%) a sensitive scalp and 146 (21.41%) a slightly sensitive scalp. Mean 3S scores were different among these three populations and correlated to the severity: 1.69 (±1.76) for subjects with slightly sensitive scalp, 2.06 (±1.89) for those with sensitive scalp and 3.53 (±3.39) for those with very sensitive scalp (Figure 2).

Figure 2. Scores of scalp sensitivity.

The number of symptoms (tightness, burning, prickling, itching or pain) varied according to whether the scalp was considered slightly sensitive, sensitive or very sensitive. Itching was very frequent (about 60%) in subjects with sensitive scalp, whereas prickling was less frequent (about 30%) and tightness, burnings or pain were rarer (between 10 and 15%). The association of scalp diseases increased with the severity of scalp sensitivity. However, most individuals with scalp sensitivity (even very sensitive scalp) did not have any associated scalp disease.

Conclusion

The 3S score is a simple and effective tool for investigating the severity and symptomatology of the sensitive scalp.