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Sensitive Skin

Sensitive skin is a syndrome defined by cutaneous over-reactivity and low tolerance when in contact to various factors such as, poorly adapted cosmetics, soaps, detergents, chlorine water. Some environmental factors such as sunlight, pollution, heat, cold, or wind have also been reported to affect sensitive skin and worsen reactions. Emotional factors (stress), dry skin, and hormones (menstrual cycle, pregnancy, and menopause) can also play a role in susceptibility toward sensitive skin [1-3].

Sensitive skin is a very common syndrome and its prevalence has steadily been increasing over the last few years with climate change, rising pollution, and a growing number of complex cosmetics. Sensitive skin has been reported in approximately 68% of the population with no difference between women and men [3].

 

Skin Reactions

Subjects with sensitive skin commonly experience subjective reactions such as

  • stinging,

  • itching,

  • burning,

  • pain, and a

  • tightness sensation.

 

Occasionally, objective signs are also present such as skin redness, dryness, or a rash. Sensitive skin can affect any body part but is more common on the face [2-4].

Allergic Reaction vs. Sensitivity

A skin allergy results from contact with some allergen that triggers an immune reaction which is typically more pronounced than sensitivity. Skin allergic reactions can trigger a rash with redness, itching, burning sensation, and sometimes small bumps or blisters.

Identifying the allergy trigger is important and avoidance is key in managing the symptoms. Your physician can help differentiate an allergic skin reaction from other skin pathologies and prescribe proper treatment.

 

Pathophysiology

A review of the literature [1-3] shows that sensitive skin may be caused by different mechanisms such as impaired skin barrier, a strong response of the nerve system, or the cycle of inflammation. When the skin barrier (upper skin layer) is impaired or weakened (for example by environmental or chemical factor),  it becomes less effective at protecting against harmful external agents. A higher skin penetration of agents can lead to an increased reactivity and irritability.

Skin Care Routine

Sensitive skin benefits from a well-adapted and simple skin care routine.

 

Products should be fragrance free, non-irritant, and include a minimal number of carefully selected ingredients.  Formulations that include functional natural extracts [1] and antioxidants can help repair and maintain a healthy skin barrier while soothing irritation.

1. Cleanse

A mild hypoallergenic cleanser should be used twice a day to remove impurities, make-up, and pollution which cause damage and oxidative stress to the skin. Regular cleansing will also help remove the bacteria, dead skin cells, and excess sebum for a radiant skin complexion.

Targeted cleansers formulated with functional extracts, antioxidants, and hydrating ingredients will benefit sensitive skin by reducing irritation, strengthening the skin barrier, and alleviating the symptoms.

2. Moisturize

Moisturizing is essential for restoring the skin barrier functions. The moisturizer should ideally be applied while the skin it still damp to seal in hydration.

Very dry skin can also benefit from an emollient skin care oil infused with antioxidants and vitamins. The oil can be applied after showering and before applying a moisturizer to help locking in hydration and nourish the skin.

Careful attention to moisturizing will help relieve the symptoms of sensitive skin and improve the overall condition [1].

3. Protect

A sunscreen (ideally mineral) with an SPF of 30 to 50+ should also be applied daily to protect the skin from the harmful UV rays which can play a major role in skin irritation and premature skin aging.

If reactions are severe, it is recommended to consult your physician for stronger medication if necessary.

 

Fragrances and perfumes

Cosmetic products can contain from 10 to 300 fragrance compounds. Up to 14% of patients with eczema are allergic to cosmetic fragrances.

Studies have also shown that 16% of the general population is sensitive to fragrance products and 4% is allergic to at least one fragrance compound [5-7].

Preservatives

Some preservatives in cosmetics may trigger contact allergic reaction.  Preservatives such as merthiolate, thimerosal, vitaseptol, formaldehyde, and formaldehyde-releasing preservatives are frequent cause of allergy. To a lesser extent, widely used parabens can also produce allergic reactions [6].

 

Common Skin Allergens

Essential oils

Essential oils can produce contact skin allergy. Studies estimated that up to 2.7% of patients may experience allergic reaction to one or more essential oils [8}. 

Hair dyes

Many dyes (such as para-phenylenediamine (PPD), calcium salts of lithol red, toluidine red, and lead oxide) used in hair dyes, coloring shampoos, and color cosmetic products are potent skin allergens [6].

Rubber and some metals

Skin allergens also include latex, rubber, and metals such as nickel.

Elizabeth Hartinger, Ph.D., M.A.Sc., B.Eng.

REFERENCES:

[1] 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 Apr;38(2):120-7

[2] Inamadar AC, Palit A. Sensitive skin: an overview. Indian J Dermatol Venereol Leprol. 2013 Jan-Feb;79(1):9-16.

[3] Berardesca E, Farage M, Maibach H.Sensitive skin: an overview. Int J Cosmet Sci. 2013 Feb;35(1):2-8.

[4] 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 Jan 4;97(1):4-6.

[5] Basketter D, Safford B. Skin sensitization quantitative risk assessment: A review of underlying assumptions. Regul Toxicol Pharmacol. 2016 Feb;74:105-16.

[6] Lidén C, Yazar K, Johansen JD, Karlberg AT, Uter W, White IR. Comparative sensitizing potencies of fragrances, preservatives, and hair dyes. Contact Dermatitis. 2016 Nov;75(5):265-275.

[7] Zukiewicz-Sobczak WA, Adamczuk P, Wróblewska P, Zwoliński J, Chmielewska-Badora J, Krasowska E, Galińska EM, Cholewa G, Piątek J, Koźlik J. Allergy to selected cosmetic ingredients. Postepy Dermatol Alergol. 2013 Oct;30(5):307-10.

[8] Warshaw EM, Zug KA, Belsito DV, Fowler JF Jr, DeKoven JG, Sasseville D, Maibach HI, Mathias CGT, DeLeo VA, Taylor JS, Fransway AF, Marks JG Jr, Pratt MD, Zirwas MJ, Geier J, Uter W. Positive Patch-Test Reactions to Essential Oils in Consecutive Patients From North America and Central Europe. Dermatitis. 2017 Jul/Aug;28(4):246-252.

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