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 .
Subjects with sensitive skin commonly experience subjective reactions such as
pain, and a
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.
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  and antioxidants can help repair and maintain a healthy skin barrier while soothing irritation.
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].
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 .
Common Skin Allergens
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}.
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 .
Rubber and some metals
Skin allergens also include latex, rubber, and metals such as nickel.
Elizabeth Hartinger, Ph.D., M.A.Sc., B.Eng.
 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
 Berardesca E, Farage M, Maibach H.Sensitive skin: an overview. Int J Cosmet Sci. 2013 Feb;35(1):2-8.
 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.
 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.
 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.
 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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