Sensitive skin: myth or reality?
In Europe, the United States and Japan more than half the population reports suffering from sensitive skin. 1 ,2 ,6,9 That fact alone warrants a better understanding of this condition, how to diagnose it, evaluate it, and treat it. Alchimie Forever’s heritage makes this topic particularly near and dear to my heart, as our origin was in post-procedure skin care, meaning the treatment of sensitized skin.
Men or women?
We women are more sensitive than men overall, that is common knowledge… and as a result, we typically report sensitive skin more often than men do. While this was previously thought to be due to the fact that our epidermis is slightly thinner than that of men, and due to specific hormonal differences, recent objective testing has found that sensitive skin is just as prevalent for men as it is for women.
What is sensitive skin?
We can define sensitive skin as a hyper reactive response of the skin to an external source that results in inflammation. The source of irritation can be environmental conditions, cleaning products, personal care products, clothing, or anything that comes in contact with the skin. The symptoms concerned are often one or a combination of the following sensations: itching, burning, erythema (redness), tingling, flaking (scaling), tightness, and dryness.
Causes of Sensitive Skin
So why is sensitive skin… so sensitive? An exaggerated response to an external source may be caused by a compromise in the skin barrier’s protective function: specifically, a thinner stratum corneum and reduced corneocyte area.2 A thinner barrier makes it easier for water soluble chemicals to quickly traverse the stratum corneum and cause irritation, making the skin more sensitive than normal to environmental factors.
Neural transmission and structural changes to receptors in the epidermis can also contribute to sensitive skin. A study shows that all sensitive skin, when compared to non-sensitive skin, was found to have more nerve growth factors in the stratum corneum.2 This could explain hypersensitivity even when the skin’s barrier appears intact: sensory neurons are activated and we see an inflammatory response.
Evaluating Sensitive Skin
At times, sensitive skin symptoms are easily detectable, such as in the case of redness or scaling, but sometimes symptoms like burning, tingling and a sensation of tightness can be difficult to evaluate and quantify. Because of the presence of symptoms that are difficult to evaluate, sensitive skin is often a self-diagnosed condition, which does not make it any less serious (indeed, studies show that self-perceived symptoms of hyper-reactivity reliably precede the appearance of clinical signs3). Apart from self perception, clinical assessment of redness, dryness, coloration, transepidermal water loss (TEWL), and hydration, as well as engineering methods of Doppler flowmetry can be used to evaluate skin sensitivity. However, when there are no observable clinical signs, it can be a challenge to quantify and evaluate sensitive skin. This is one of the key reasons why this subject is not yet fully understood.
Sensitive Skin vs. Sensitized Skin
Many people who report having sensitive skin may in fact have sensitized skin. The difference is in genetics. People with sensitive skin have a genetically thinner or compromised stratum corneum barrier, which makes them more sensitive to factors that normal skin is protected from.
Sensitized skin is rather a result of external influences damaging the skin’s protective barrier, or of chronic exposure to damaging conditions wearing down the skin’s natural protection. A sensitized condition is a temporary state of sensitivity that can be reversed by ceasing exposure to the irritant and creating an ideal environment in terms of moisture and temperature so that the skin can restore its protective barrier.
A genetically sensitive condition is permanent and irreversible; exposure to provoking factors should be limited in order to avoid irritation. Extra steps should also be taken to protect sensitive skin.
Sensitive Skin vs. Irritated Skin
Sensitive skin is a condition, irritated skin is the result. Sensitive and sensitized skin can result in irritation. Irritated skin can be caused by any physical or chemical factor damaging the skin.
Sensitive Skin and Age
Children tend to have generally more sensitive skin than adults; their protective skin barrier is thinner and becomes thicker as they age. However, adults are chronically subject to conditions that can lead to sensitization with age.
Factors provoking irritation of Sensitive Skin
There are a variety of factors that have been found to provoke sensitive skin irritation. These factors affect people differently and irritation can result from a chronic or acute exposure.
- Household or Self Care Products or Treatments: alcohol, soaps, dyes, abrasive and harsh products, aggressive cosmetic treatments and more.
- Environmental: cold, heat, frequent and significant changes between temperatures, pollution, dryness in the air, indoor heating or air conditioning.
- Lifestyle: Emotions, stress.
Managing Sensitive Skin
There is no standard treatment for sensitive skin, it is a genetic condition and irritation is due to so many different factors. But there are some ways to protect and avoid irritation.
- Avoiding exposure to provoking factors.
- Using anti-irritant products that have a cooling, soothing, anti-inflammatory, or healing effect helps repair the skin barrier to its unique optimal state (my favorite is the Kantic+ intensely nourishing cream).
- Protecting your sensitive skin year-round with UVA and UVB sunscreen.
(Thank you to my fabulous Geneva intern Rachel for your help researching this blog post; references available upon request.)