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07/09/2023The term sensitive skin does not define a particular pathological state, but a personal condition. The term is used to describe skin that has reduced tolerance to the application of topical products, such as cosmetics or hygiene products. It is estimated that about half of women, and around four in ten men have sensitive skin.
Symptoms
Sensitive skin is characterized by:
- Subjective symptoms: itching, heat or burning, sensation of pins and needles, alteration of tactile perception
- Visible signs: redness, dryness, flaking, hives, folliculitis.
In most cases, sensitive skin is confined to the face, and often on or around the eyelids. The underarms, groin, and genital area are also common sites for sensitive skin to occur.

Causes
There is no one specific cause for sensitive skin, but there is a genetic predisposition to having the condition. Reduced skin tolerance can be traced back to an alteration of the epidermal barrier function, or more specifically, a change in the ceramides of the stratum corneum. On top of this, genetics, individual variations and other external causes can be added to the mix.
The main variables that are linked to individual behavior includes: stress, physical and psychological fatigue with consequent hormonal variation, dietary restrictions, habits in hygienic and cosmetic practices, work, and recreational activities.
External variables are usually linked to the quality of air, the seasons, travel or exposure to dry; humid; hot or cold weather.

Check-ups
There are no specific tests to test for sensitive skin, and in clinical practice, they are not requested. However, in controlled studies, the response to the stinging and sensitivity tests are evaluated. The stinging test is performed by passing a cotton ball soaked in 10% lactic acid in the fold between the nose and lip. Subjects who perceive sensations similar to needle pricks (stings) are defined as having sensitive skin. Tactile, painful, and thermal skin sensitivity tests can be used to recognize or rule out perceptual alterations such as hyperpathia, hyperalgesia, allodynia, but are more for research than practical purposes.
To establish if an individual is sensitive to a particular product, a tolerance test may be performed which involves applying the product with a cotton swab to the fold between the lower eyelid and cheek in the evening. The test is negative if no sensation or skin variation is perceived at the time of application and the following morning.

Confusion with atopic dermatitis
Individuals with atopic dermatitis are, by definition intolerant to cosmetic or topical hygiene products, and their intolerance is directly proportional to the severity of the dermatitis. However, atopic subjects without apparent dermatitis can be mistaken for those with sensitive skin. To avoid this confusion, some clinical concepts are reported in the table below.
TABLE I |
|
---|---|
ATOPIC SUBJECT | SENSITIVE SKIN SUBJECT |
Dry skin always present | Dry skin not necessarily always present |
Episode/s of allergic rhinoconjunctivitis | No episode(s) of allergic rhinoconjunctivitis |
Episode/s of bronchial asthma | No episode(s) of bronchial asthma |
Improvement in symptoms over summer months | Not necessarily any improvement over summer months |
Products for sensitive skin
As it stands, there are officially no products that can be defined as specific for sensitive skin. Despite this, a vast array of cosmetics or hygiene products now carry the phrase “for sensitive skin” for commercial purposes. When it comes to analyzing this term and the composition of the product, some useful information can be drawn for evaluation in relation to sensitive skin.
TABLE II |
|
---|---|
PRODUCT SUITABLE FOR SENSITIVE SKIN | PRODUCT NOT SUITABLE FOR SENSITIVE SKIN |
Composed of fewer than ten ingredients | Composed of more than ten ingredients |
Does not contain film-forming occlusive components (e.g. silicones) | Contains film-forming occlusive components (e.g. silicones) |
Low content of surfactants/emulsifiers | High content of surfactants/emulsifiers |
Fragrance free | Fragranced |
No preservatives | Contains preservatives |
Advice to improve skin tolerance
Some specific measures can improve skin tolerance regardless of genetic predisposition, individual or external causes. Table III discusses some of these steps.
Face
TABLE III |
|
---|---|
RECOMMENDED | NOT RECOMMENDED |
Applying mineral makeup | Applying cream makeup (foundation) |
Cleansing with non-foaming cleanser | Cleansing with milk cleanser, micellar water or wipes |
Using emollient / nourishing cream | Using moisturizing cream or tonic |
Applying mineral sun protection | Applying sun cream |
Body
TABLE IV |
|
---|---|
RECOMMENDED | NOT RECOMMENDED |
Using non-foaming cleanser | Using foaming cleanser |
Taking showers | Taking baths |
Using emollient / nourishing cream | Using body moisturizing cream |
Completely drying the body after showers, swimming etc. | Only partially drying the body after showers, swimming etc. |
Wearing natural fiber garments | Wearing synthetic garments |
Applying antiperspirants | Applying deodorants |