What is sensitive skin?

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What is sensitive skin?

Definition  |  Prevalence  |  Symptoms  |  Cause  |  Management

Dalibor Mijaljica profile image


Written by Dalibor Mijaljica BSC, PhD.

Updated on January 03, 2024
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Definition

What is sensitive skin?

A special interest group on sensitive skin in the International Forum for the Study of Itch (IFSI) has defined sensitive skin as follows1,2:

“A syndrome defined by the occurrence of unpleasant sensations (stinging, burning, pain, pruritus/itch and tingling) in response to stimuli that normally should not provoke such sensations. These unpleasant sensations cannot be explained by lesions attributable to any skin disease. The skin can appear normal or be accompanied by erythema/redness. Sensitive skin can affect all body locations, especially the face”. 

Simply put, ‘sensitive skin’ is when your skin reacts to something it normally should not. 

Prevalence

How prevalent is sensitive skin around the world?

It is very difficult to determine the prevalence of sensitive skin, since it varies in different geographies and cultures. Also, perceptions of sensitive skin at specific body sites are interpreted differently. It is generally agreed that sensitive skin affects a significant portion of the population2. Overall, approximately 60–70% of women and 50–60% of men report having some degree of sensitive skin2 and around 9% of people worldwide claim to have very sensitive skin, again, more frequently in women than men3. For example, in France, Italy, Portugal and Spain, the reported prevalence was approximately 80–90%, whereas in Belgium, Germany, Greece and Switzerland the reported prevalence was approximately 60–70%2. In China, 39.5% of the entire population (both genders) reported some degree of sensitive skin2. In a survey conducted in the UK, approximately 51% of women and 38% of men considered themselves to have sensitive skin4. There is limited data for Australia, but one study found 51% of Australian men had experienced sensitive skin of the face2.

Symptoms

What are the symptoms of sensitive skin?

Sensitive skin is characterised by subjective complaints of discomfort and a tingling sensation without visible signs of irritation and without an immune response. Although temporary dryness, redness, itching or tightness may accompany unpleasant sensations, and sensitive skin may be less hydrated or supple, people with sensitive skin often experience sensory effects only5. Sensitive skin displays a higher sensitivity than non-sensitive (normal) skin, allowing the skin to easily become irritated and allergic6,7.

Cause

What are the main causes of sensitive skin?

Even though sensitive skin is not exclusively caused by contact or reaction with any specific materials, the exact causes of sensitive skin are not well understood. Recent evidence suggests that exposure to environmental triggers including UV sun rays, harsh weather (heat, cold, wind) and pollution as well as lifestyle factors such as the use of cosmetics, diet and alcohol consumption, and physiological factors, such as stress, or hormonal changes may contribute to damage of the skin’s structure, function and nerve sensations, thus contributing to sensitive skin2,3,7. For example, fragrance is considered the most frequent cause of contact allergy due to cosmetics8. Around 32% of adults across Australia, UK, USA and Sweden report fragrance sensitivity, of which around 1 in 10 cases in Australia present as skin rashes9.

The skin acts as a protective barrier that effectively prevents the invasion of outside harmful factors and the loss of water and nutrients from the body. When compared to normal skin, sensitive skin shows a weaker protective function of the outermost layer of the skin, the stratum corneum7,10-12. This leads to increased penetration through the skin which in turn causes the skin to have higher reactivity and sensitivity, resulting in greater susceptibility to irritants and allergens compared to normal skin. As such, it is easy for sensitive skin to react to irritants or allergens that can further damage the skin’s barrier structure and nerve endings, resulting in a vicious cycle7.

Sensitive skin is characterised by subjective complaints of discomfort and a tingling sensation without visible signs of irritation and without an immune response.

Dr. Dalibor Mijaljica

Management

What are the ways to manage sensitive skin?

Since the causes of sensitive skin are complex, and may vary between individuals, there is no universal management or treatment program. However, there is a general consensus that the following tips can be helpful for most people to help minimise irritation and aggravation of existing skin sensitivity:

Avoidance of contributing triggers

including exposure to extreme temperatures, strong winds and direct sunlight3 as well as avoiding the use of skincare products that contain common sensitisers and irritants such as fragrance, harsh soap and alcohol12.

Regular use of moisturisers

It is important to use a combination of pH-balanced, mild cleansers and moisturisers to gently cleanse sensitive skin, leaving the skin hydrated and intact by replenishing its lipids (ceramides, cholesterol and free fatty acids), reducing its transepidermal water loss and keeping its pH at an appropriate level12. Therefore, the use of suitable skincare products and careful attention to daily skincare can play important roles in minimising the symptoms of dry and sensitive skin7,10,12.

Sun avoidance and sunprotection

Patients prone to sensitive skin should limit sun exposure by seeking shade when outside, wearing protective clothing, hats and eyewear, and using a daily moisturising sunscreen that has been formulated for sensitive skin13. Many skin-friendly broad-spectrum moisturising sunscreens can help to protect sensitive skin, especially exposed body parts, the face, lips and scalp from UV damage whilst also ensuring it is hydrated14,15.

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References

1. Misery L, Ständer S, Szepietowski JC, Reich A, Wallengren J, Evers AW, Takamori K, Brenaut E, Le Gall-Ianotto C, Fluhr J, Berardesca E, Weisshaar E. Definition of sensitive skin: an expert position paper from the special interest group on sensitive skin of the International Forum for the Study of Itch. Acta Derm Venereol. 2017; 97(1):4–6.

2. Farage MA. The prevalence of sensitive skin. Front Med (Lausanne). 2019; 6:98.

3. Misery L, Loser K, Ständer S. Sensitive skin. J Eur Acad Dermatol Venereol. 2016; 30:2–8.

4. Duarte I, Silveira JEPS, Hafner MFS, Toyota R, Pedroso DMM. Sensitive skin: review of an ascending concept. An Bras Dermatol. 2017; 92(4):521–525. 

5. Farage MA, Katsarou A, Maibach HI. Sensory, clinical and physiological factors in sensitive skin: a review. Contact Dermatitis. 2006; 55(1):1–14.

6. Misery L, Sibaud V, Merial-Kieny C, Taieb C. Sensitive skin in the Ameri¬can population: prevalence, clinical data, and role of the dermatologist. Int J Dermatol. 2011; 50(8):961967.

7. Fan L, He C, Jiang L, Bi Y, Dong Y, Jia Y. Brief analysis of causes of sensitive skin and advances in evaluation of anti-allergic activity of cosmetic products. Int J Cosmet Sci. 2016; 38(2):120–127.

8. Yazar K, Johnsson S, Lind M-L, Boman A, Lidén C. Preservatives and fragrances in selected consumer-available cosmetics and detergents. Contact Dermatitis. 2011; 64(5):265–272

9. Steinemann A. International prevalence of fragrance sensitivity. Air Qual Atmosphere Health 2019; 12(8):891–897.

10. Inamadar AC, Palit A. Sensitive skin: an overview. Indian J Dermatol Venereol Leprol. 2013; 79(1):9–16.

11. Berardesca E, Farage M, Maibach H. Sensitive skin: an overview. Int J Cosmet Sci. 2013; 35:2-8.

12. Guerra-Tapia A, Serra-Baldrich E, Prieto Cabezas L, González-Guerra E, López-Estebaranz JL. Diagnosis and treatment of sensitive skin syndrome: an algorithm for clinical practice. Actas Dermosifiliogr (Engl Ed). 2019; 110(10):800¬–808. 

13. Donglikar MM, Deore SL. Sunscreens: a review. Pharmacogn J. 2016; 8(3):171–179.

14. Sethi A, Kaur T, Malhotra SK, Gambhir ML. Moisturizers: the slippery road. Indian J Dermatol. 2016; 61(3):279¬–287.

15. Sander M, Sander M, Burbidge T, Beecker J. The efficacy and safety of sunscreen use for the prevention of skin cancer. CMAJ. 2020; 192(50):E1802–E1808.