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Blog

Understanding Sensitive Skin: Exploring the Complexities and Challenges

February 24, 2024

Understanding Sensitive Skin: Exploring the Complexities and Challenges

Some people feel more discomfort than others after using everyday personal care products like lotions or shampoos. This is often referred to as "sensitive skin." It's a common issue, with many people reporting it in surveys.

The term "sensitive skin" is used when someone's skin reacts strongly to these products, causing discomfort. Surveys show that a lot of people say they have sensitive skin, regardless of their background.

Scientists have been studying this phenomenon, but it's challenging because the reactions are often hard to measure and not always visible. Even though these reactions might not show up physically, they're still important to understand because they affect people's choices when buying products.

Before releasing a new product, companies need to make sure it's safe for different types of skin. Understanding how people perceive sensitivity is crucial for both safety and commercial success.

Many consumers with sensitive skin avoid certain products because they cause discomfort, even if there's no obvious physical reaction.

The term "sensitive skin" is a bit tricky to pin down exactly. Generally, it refers to people experiencing discomfort without clear visible signs of irritation or any immune system response. They might feel things like itching, burning, or dryness without any obvious rash or redness.

Understanding sensitive skin is tough because it's often self-diagnosed and symptoms can vary widely. Some people might feel stinging or see redness, while others might not have any visible signs at all.

There are many factors that can contribute to sensitive skin, including age, genetics, hormones, and environmental factors. And testing for sensitive skin isn't straightforward either. Some people who say they have sensitive skin might not react to traditional tests, while others who don't think they have sensitive skin might react strongly.

Researchers think that sensitive skin might actually be made up of different groups with their own specific sensitivities. For example, some might have skin that's sensitive to lots of different things, while others might only react to certain products.

In studying sensitive skin, researchers have used various methods to understand how the skin reacts to different irritants. These methods can be grouped into three main categories: sensory reactivity tests, irritant reactivity tests, and dermal function tests.

  • Sensory Reactivity Tests: These tests focus on how the nervous system responds to irritants. One common test is the sting test, where substances like lactic acid are applied to the skin. Other substances like capsaicin or menthol have also been used. Sometimes, before applying these irritants, a procedure called tape stripping is done to remove the outer layer of skin. The irritant is usually applied to an area called the nasolabial fold, which is known to be sensitive due to its unique skin structure and nerve endings. Researchers measure the sensory response using a scale to quantify the sensation. While the sting test is popular for identifying potentially sensitive individuals, it doesn't always predict sensitivity to other irritants. However, it's simple, quick, and doesn't cause visible effects.
  • Irritant Reactivity Tests: These tests look at visible signs of irritation caused by irritants.
  • Dermal Function Tests: These tests measure structural and physiological changes in the skin due to irritants.

In addition to these tests, researchers have also looked at the nerve distribution in the skin to see if there are differences that could explain increased sensitivity. They do this by staining the skin to highlight specific parts of the nervous system.


Irritant reactivity tests aim to measure visible signs of skin irritation. One common method involves using Sodium Lauryl Sulfate (SLS), a chemical found in many cosmetics and personal care products. SLS can irritate the skin at certain concentrations by changing its surface tension, damaging the outer layer, and increasing blood flow and skin permeability. It directly harms the skin without needing prior sensitization.

Researchers use various techniques with SLS and other irritants, such as patch tests, repeat insult patch tests, open application tests, soak or wash tests, and plastic occlusion stress tests. These tests often involve exposing the skin to high concentrations of irritants to see how it reacts. Some newer methods add a frictional component to exaggerate the effects further.

Besides SLS, other irritants used in testing include dimethyl sulfoxide (DMSO), acids like benzoic acid and acetic acid, and substances that dilate blood vessels. Mechanical irritation tests have also been done using facial tissue and sanitary pad surfaces.

To assess skin reactions, researchers often visually score erythema (redness) and edema (swelling). They may also use techniques like measuring blood flow, plethysmography, and color reflectance. These methods provide objective assessments of skin changes, even if they're not visible to the naked eye. However, some techniques, like laser Doppler velocimetry (LDV) and color reflectance, might not be as sensitive in certain areas like the vulva.

Overall, these tests help researchers understand how different substances affect the skin and can guide the development of safer personal care products.


Structural sensitivity tests focus on detecting changes in the skin's structure or function that might be linked to its sensitivity. One common test is Transepidermal Water Loss (TEWL), which measures how much water evaporates from the skin's surface. TEWL indicates the integrity of the skin's protective barrier and can show if the skin is damaged. High TEWL levels are often considered a sign of sensitivity, and they've been found to increase with exposure to irritants like Sodium Lauryl Sulfate (SLS). TEWL measurements are more reliable indicators of sensitivity than visual assessments.

TEWL testing is often combined with tape stripping, a procedure that removes some of the outer skin layer. However, this method doesn't always accurately represent the effects on normal skin. TEWL measurements can also be influenced by factors like blood flow, time of day, and humidity.

Skin hydration is another aspect measured in structural sensitivity tests, usually using electrical capacitance. However, hydration levels can vary significantly between individuals and can be affected by factors like skin texture and hair density. Traditional classification of skin type is less reliable for assessing hydration.

Moving forward, there's a need for improved testing methods that can reliably distinguish between products for sensitive skin. These methods should be cost-effective, reproducible, and minimally invasive. Researchers are exploring enhancements to visual scoring using polarized light and assessing cytokine levels to detect subtle tissue damage.

In addition to TEWL and hydration, other structural measures like skin thickness and composition are also being studied using techniques like ultrasound and light microscopy. These methods help researchers understand how different products and irritants affect the skin at a deeper level.


Some people with sensitive skin, referred to as "stingers," tend to experience stronger sensations of stinging and burning when exposed to certain chemicals. Additionally, they might show higher levels of redness in response to irritants.

Early studies suggested that stingers might be more sensitive to general irritation, but later research didn't consistently support this idea. There's also a lack of correlation between strong sensory reactions and visible signs of irritation. However, some studies have found a link between sensory sensitivity and objective signs of irritation in subjects who specifically demonstrated sensory sensitivity.

For example, one study found that sensory effects were the most reliable measure of differences between products when evaluating sensitivity to facial tissue. Although individual sensitivity didn't reliably predict reactions to a range of irritants, statistical analysis showed a weak association between tests.

On the other hand, studies examining the relationship between skin barrier function and sensitivity have provided more conclusive results. High levels of Transepidermal Water Loss (TEWL), indicating compromised barrier function, have consistently been associated with increased susceptibility to various skin irritants across different assessment methods.


Various factors can influence how sensitive our skin is to different irritants. These factors include gender, ethnicity, age, anatomical site, culture, and environment. Here's a breakdown of some of these factors:

  • Gender: Generally, women tend to report sensitive skin more frequently than men. This might be due to hormonal differences and differences in skin thickness.
  • Ethnicity: Racial differences in skin sensitivity are a significant topic in dermatology. While some studies haven't found clear differences between races in reporting product sensitivity, others suggest that Asians may be more sensitive than Caucasians. However, results are conflicting, and further research is needed.
  • Skin Color: Fair-skinned individuals prone to sunburn might have higher sensory responses to certain irritants. Skin pigmentation seems to be inversely associated with susceptibility to irritation.
  • Structural Differences: There are structural differences in the skin among different racial groups, such as differences in epidermal thickness, distribution of sweat glands, and composition of ceramides. These differences can affect skin permeability and sensitivity.
  • Skin Hydration: Black, Asian, and Hispanic individuals tend to have higher skin hydration levels compared to Caucasians. This might affect how their skin responds to irritants.
  • Sweat Gland Activity: Sweat gland activity may vary among different racial groups, which could influence skin conductance and resistance.

Understanding how these factors interact and affect skin sensitivity is crucial for developing effective skincare products and treatments that cater to diverse populations. However, more research is needed to fully understand these relationships and their implications for skincare.


Age can also influence skin sensitivity. While studies on age-related differences in skin sensitivity are limited and not entirely conclusive, some trends have been observed:

  • Younger vs. Elderly Skin Sensitivity: Younger adults tend to have more sensitive skin compared to elderly individuals. Tactile sensitivity may decrease with age, but pain sensation remains preserved. Elderly individuals may show decreased sensory nerve function and skin innervation. Despite potentially lower reactivity to irritants, elderly skin may take longer to heal.
  • Barrier Function in the Elderly: Barrier function, as assessed by transepidermal water loss (TEWL), may not show as significant a difference between baseline and post-irritant exposure in the elderly compared to younger adults. While the thickness and layering of the stratum corneum remain relatively unchanged with age, the turnover time of the stratum corneum may increase in the elderly.
  • Other Age-Related Factors: Elderly individuals may exhibit decreased sweat function, inflammation and repair capability, skin hydration, and peripheral microcirculation.
  • Children: There is limited literature on skin sensitivity in children. Children may have a higher surface area to body mass ratio, leading to potentially higher systemic exposure from dermal use of products.

Anatomical Site: Skin sensitivity can also vary depending on the anatomical site. For example:

  • Exposed Skin: The nasolabial fold is often reported as the most sensitive region of the face, followed by other facial areas. Sensitivity may increase from the wrist to the cubital fossa area on the forearm.
  • Vulva: The vulva differs significantly from exposed skin in terms of structure and function. The outer mons pubis and labia majora are keratinized and stratified, while the inner labia minora and vestibule are thinner and less keratinized. The vulva's increased hydration, friction, and blood flow may make it more susceptible to irritation, although objective data on this are limited.

Cultural and Environmental Factors: Cultural and environmental factors can also influence skin sensitivity. For example:

  • Cultural Practices: Hygiene practices, such as the use of douches, perfumes, and contraceptives, can contribute to vulvar irritation. Additionally, cultural trends may influence perceptions of sensitive skin.
  • Environmental Factors: Factors such as temperature, humidity, sun exposure, pollution, and wind can affect skin sensitivity. For example, low temperatures and humidity in winter can lead to lower water content in the stratum corneum, potentially increasing susceptibility to irritants.

Other Host Factors: Various other factors, such as occupational exposures, use of personal care products, smoking habits, and underlying dermatological conditions like atopic dermatitis and rosacea, can influence skin sensitivity. Additionally, drug-induced sensitivity is possible, though less commonly reported.

Sensory differences may be related to skin innervation, but further research is needed in this area. Barrier function is critical in skin discomfort, with the lipid content of the stratum corneum being a more accurate predictor of skin permeability than thickness or cell number. Subclinical irritation may play a key role in understanding sensitive skin, as sensations are discerned before observable differences, and clinical signs occur only when the threshold level of irritation is exceeded.



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