What is a sensitive skin?

  • 10min
  • May. 2022
  • Supported by
    • La Roche-Posay

Sensitive skin is a syndrome defined by the occurrence of unpleasant sensations (stinging, burning, pain, pruritus, and tingling sensations) in response to stimuli that normally should not provoke such sensations.1

Although sensitive skin is highly prevalent, there is no consensus on its definition or pathomechanism.


Despite its heterogeneous presentation, few research groups have focused on developing objective approaches to identifying differences in the condition of sensitive skin.

Various potential causal pathways are hypothesized to lead to a response pattern commonly observed in sensitive skin : sensory hyperreactivity, impaired barrier function, inflammatory or vascular responsiveness and atopic predisposition.2

Only a few provocative methods such as SLS (irritant patch testing with sodium lauryl sulfate), vasodilators and capsaicin may trigger the sensitive skin mechanism as these agents enhanced differences between subjects with sensitive and non-sensitive skin. The strongest evidence refers to an impaired skin barrier function. It may trigger both vascular hyperreactivity and sensory perceptions, suggesting different mechanisms for different discomfort presentations.2

Subjective scoring scales (Like the questionnaire of Jourdain3 or the Sensitive Scale of Misery4) could be adequate diagnostic tools to detect subjects with sensitive skin and, when combined with consistent biophysical measurements (stinging tests with lactic acid (or capsaicin), occlusion tests, behind-the-knee tests, washing and exaggerated immersion tests), which may highlight significant differences between subjects with sensitive and non-sensitive skin; adding consistent results.

This would situate sensitive skin within knowledge on skin disease pathology and provide a basis for developing solutions to individual skin reactions in clinical practice. The ultimate goal of identifying underlying mechanisms is to develop optimal interventions for every individual with sensitive skin, implementing personalized medicine.2

Bibliography

  1. Richters R, Falcone D, Uzunbajakava N, Verkruysse W, van Erp P, van de Kerkhof P. What is sensitive skin ? A systematic literature review of objective measurements. Skin Pharmacol Physiol. 2015;28(2):75–83.
  2. Misery L, Loser K, Ständer S. Sensitive skin. J Eur Acad Dermatol Venereol. 2016 Feb;30 Suppl 1:2–8.
  3. Jourdain R, Bastien P, de Lacharrière O, Rubinstenn G. Detection thresholds of capsaicin : a new test to assess facial skin neurosensitivity. J Cosmet Sci. 2005;56:153-166.
  4. Misery L, Jean-Decoster C, Mery S, Georgescu V, Sibaud V. A new ten-item questionnaire for assessing sensitive skin : the Sensitive Scale-10. Acta Derm Venereol 2014;94:635–639.