Who can be concerned by a sensitive skin?

In people with sensitive skin, reported symptoms after exposure to certain products or environmental conditions can include objective visual effects such as:

• Redness
• Dryness
• Papules
• Subjective sensory effects such as burning, itching or stinging

Testing methods have been developed to evaluate the objective effects, including measurements of transepidermal water loss, hydration of the stratum corneum, redness, blood flow and surface pH.¹ However, the subjective effects are more difficult to quantify and have been less studied.²

Patients with sensitive skin rely on diagnostic skills and patience, as it is impossible to delineate responsible aetiological factors based on morphological characteristics and objective cutaneous signs.

Thus, sensitive skin varies not only in the signs and symptoms experienced, but also in the degree of sensitivity at different anatomical sites.

Furthermore, the features and complaints, which are very similar among these individuals, do not necessarily reflect the severity of the objective findings.

As a result, the management of such patients may pose a challenge for dermatologists.³

What is the prevalence of sensitive skin?

In a French epidemiological study, 61% of the women and 32% of the men stated that they had sensitive facial skin.³

In the most recent study published in 2009² with an epidemiological approach of sensitive skin, 68.4% of the total population claimed their skin to be sensitive in some degree:

• 77,3% reported sensitive skin on the face
• 60,7% reported sensitive skin on the body
• 56,2% reported sensitive skin in genital area

It has been shown that women report sensitive skin more than men.

Nevertheless, 40-70% of the population of women living in developed countries report that they have sensitive skin.³

The perception of sensitive skin overall and sensitive skin on the specific body sites of the face and body is independant from the gender but a significant relationship has been found between gender and sensitive skin in the genital area.

A significantly higher percentage of women perceived their genital skin as sensitive to some degree (58.1% for all women and 44.2% for all men).²

Among the determinants known to play a role in the expression of skin sensitivity, individual genetic predispositions and sex-related physiological characteristics may at least in part contribute to this difference.

In recent years, a variety of products have been marketed for sensitive skin for both men and women. It may be that such attention has made it more acceptable for men to claim their skin is sensitive.²

What about age and ethnic differences?

There is no clear trend with ageing and sensitive facial skin, nor with sensitive skin overall or sensitive body skin. The perception of sensitive skin in general and sensitive skin of the face and body are not dependent on age. However, for the genital area, older people are more likely to claim sensitivity.²

This finding is probably linked to age-related behavior and to a tendency to avoid environmental conditions and contact with certain substances whenever skin reactions have been previously experienced.

According to Guinot³, sensitive skin reactions are significantly less frequently reported among older individuals for both genders.

Moreover, significant decreases in the performance of sensory skin properties have been documented as a part of chronological ageing.⁶

What's to be done in practice currently?

Although initially believed to be an unusual reaction to common products, evidenced in only a small subset of consumers, epidemiological surveys surprisingly find a high prevalence of self-perceived sensitive skin across the industrialized world.

In addition, the reported prevalence of self-perceived skin sensitivity has increased steadily over time, particularly among men.

Most women in the United States, Europe and Japan believe that they have sensitive skin.

Approximately 70% of the population consider themselves to possess the characteristics of sensitive skin, and 50% of these patients with sensitive skin demonstrate these uncomfortable symptoms without accompanying visible signs of inflammation.⁷

Epidemiological studies have been carried out to assess whether there is a correlation with sex, age, skin type or race. Non-invasive evaluation of sensitive skin may successfully predict individual susceptibility to cosmetic-related adverse reaction.

It is believed that a biological plausibility for greater sensitivity exists, as thickness of the epidermis was observed to be greater in men than in women and hormonal differences which may produce inflammatory sensitivity in women have also been demonstrated.

Non-invasive evaluation of sensitive skin may successfully predict individual susceptibility to cosmetic-related adverse reaction.

All of the efforts in this direction appear undoubtedly important to improve tolerance to the majority of cosmetic products.⁷

Sensitive skin has historically been self-reported far more often in women than in men.³