Sensitive skin syndrome SSS is a common and challenging condition, yet little is known about its underlying pathophysiology. These complaints are out of proportion to the objective clinical findings. Defined as a self-diagnosed condition lacking any specific objective findings, SSS is by definition difficult to quantify and, therefore, the scientific community has yet to identify an acceptable objective screening test. In this overview we review recent epidemiological studies, present current thinking on the pathophysiology leading to SSS, discuss the challenges SSS presents, and recommend a commonsense approach to management. Sensitive skin syndrome is a common and challenging condition, yet little is known about its underlying pathophysiology.
Beauty August 27, By Immortal iron fist preview Jacoby. After a bad reaction, take several big steps back. Indicators that you may have a diagnosable skin issue include persistent symptoms—extreme redness and irritation, painful burning or stinging, itching, blistering, rashes, scaling, pus-laden bumps—that come out of the blue or stick around no matter which Dermatology and sensitive skin you use, according to Dr. In these cases, a 2-week trial of appropriate-strength corticosteroid may solve the mystery by pointing to an eczematous process in the case of symptoms resolution. You're welcome. If you often experience razor bumps, razor burns, or ingrown hairs, use a single- or double-blade razor instead and do not stretch your skin taut while shaving. Diane MadfesMD, dermatologist and clinical instructor at Mt. Then, as your tolerance grows over time, you can start to gradually increase the frequency and apply the product directly, before your moisturizer.
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Skin self-exams can help you find skin cancer early when it's highly treatable. The Best Skincare Products of Uncategorized read more. Plug this question into Google and you get over 70 million results skni all emphasize a resounding yes. For the best technique and results, dermatologists recommend these tips. This oil-free, lightweight lotion is a great daily moisturizer with SPF Spain, Mosby Elsevier: p. Having sensitive skin is no excuse to skip daily sunscreen. Dermatologist Joshua Zeichner, M. Additionally, TRPV1 sensiitive the release of neuropeptides 3846 in local neurogenic inflammation. Healthline and our partners may receive a portion of revenues if Latex yeso make a purchase using a link on this page. She skin-tested 58 subjects with history of strong positive SDS or lactic acid response. Thus the Dermatology and sensitive skin of a second problem such as an irritant or allergic contact dermatitis to a product being applied to the skin may be Dermatology and sensitive skin. Share via facebook dialog. It can be used by men and women in their 20s, 30s, 40s, 50s, 60s and beyond.
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Sensitive skin syndrome SSS is a common and challenging condition, yet little is known about its underlying pathophysiology. These complaints are out of proportion to the objective clinical findings. Defined as a self-diagnosed condition lacking any specific objective findings, SSS is by definition difficult to quantify and, therefore, the scientific community has yet to identify an acceptable objective screening test.
In this overview we review recent epidemiological studies, present current thinking on the pathophysiology leading to SSS, discuss the challenges SSS presents, and recommend a commonsense approach to management. Sensitive skin syndrome is a common and challenging condition, yet little is known about its underlying pathophysiology.
Sensitive skin is a common term used by patients and clinicians, as well as the cosmetic industry, and represents a complex clinical challenge faced by dermatologists and other skin care professionals. Patients with sensitive skin often present with subjective complaints that are out of proportion to the objective clinical findings. Defined as a self-diagnosed condition, SSS is by definition difficult to quantify.
Some of the contradictions between investigators could be explained by flawed methodologies since the scientific community has yet to identify an acceptable objective screening test for sensitive skin.
Robinson, by performing patch testing with sodium dodecyl sulfate SDS and looking for intra-individual response patterns, found that there is significant positive correlation between SDS and other irritants but noted overall low correlation coefficients.
He therefore deduced that it is inappropriate to define a subject's reaction to a chemical based on his or her response to another irritant. She skin-tested 58 subjects with history of strong positive SDS or lactic acid response. The subjects were tested with irritants and a sensory perception assessment was performed. Finally, Judge tested 22 nonatopic adults with varying doses of SDS and found marked inter-individual variation in the response threshold. Applied clinically, this complexityreinforces the need for a thorough diagnostic algorithm and, specifically, the need to test patients with multiple, repeated and complete i.
In order to formulate a systematic clinical approach, the medical and cosmetic communities have attempted to characterize the condition. Lacking an objective screening test, investigators resorted to epidemiological studies using patient surveys.
Interestingly, atopy did not appear to predict self-perceived sensitivity in the participating women. This finding validates the link between self-perception of sensitive skin and neurosensory discomfort.
This link has been validated in previous studies. In the US, the overall prevalence of sensitive skin was Females were significantly more concerned about sensitive skin than men; however, no age or ethnic differences were found.
In light of the increased incidence of self-reported hypersensitivity in females, Robinson's effort to objectively determine hyperreactivity draws interesting conclusions.
He compared the patch test responses of patients to SDS as the positive control and found increased reactivity in males compared to females.
Female self-perception of sensitivity is consistently increased compared to that of males, yet when put through objective reactivity testing the trend is unclear. This epidemiologic controversy also appears to pertain to ethnic tendencies towards hyperreactivity. Ethnic differences in skin reactivity have been explored through the years, leading to the clinical hypothesis that black skin is less reactive than Caucasian skin, which is in turn less reactive than Asian skin.
The investigators did, however, find minimally statistically significant ethnic differences in the self-reported triggers and symptoms of sensitivity: Afro-Americans reacted less to environmental and alcoholic triggers; Hispanics reacted less to alcohol; Asians reacted more to wind, spices, and alcohol; and Euro-American reacted more to wind.
In terms of symptomology, statistically significant increase in recurrent itching on the face was noted in the Asian population, and fewer Euro-American avoided certain cosmetics due to skin reactivity.
Recent data looking into age-related differences in hyperreactivity are showing more consistent results.
Whorl performed patch testing with 34 irritants on patients and found that young patients were more reactive than old patients. The mechanism leading to the SSS has been debated in the literature, but the leading hypothesis relates to increased stratum corneum permeability. As with many syndromes, the management scheme presented here emphasizes the diagnostic framework [ Table 1 ]. The clinical approach to the SSS demands a thorough process of eliminating obvious as well as more subtle diagnoses.
Once the diagnosis is made, deriving the appropriate treatment becomes a relatively simple task. Note that since much of the mechanisms of SSS are unknown, the clinician must be comfortable with a certain degree of ambiguity and uncertainty. Eczema, atopic dermatitis, and rosacea are likely the three most common causes of SSS related to barrier defect.
Careful history, including family history and occupational history, combined with a detailed physical exam will often reveal the diagnosis. In the history particular consideration should be given to culprits such as the masking effect of other topical agents applied by the patient. The physical exam should include scrutiny of the face and scalp for subtle signs of minor inflammation, which are often masked in SSS with underlying endogenous dermatoses.
Therefore, following specific treatment to halt the acute pathological process, preventing recurrence with a proper skin care regimen is indicated. In eczema and atopic dermatitis, the careful clinician may resort to short-term 2-week use of corticosteroids to stop the inflammatory process. Calcineurin inhibitors are alternatively indicated for delicate areas on the face. In rosacea, the mainstay of treatment is oral and topical antibiotics.
In seborrhoeic dermatitis, azoles are the mainstay of treatment and low potency corticosteroids and emollients can be added acutely to treat the inflammatory process.
Therefore, careful testing should be performed. CD and PCD can be visualized with skin patch and photopatch testing. Once the allergen has been identified, avoidance should lead to symptom resolution. Allergen-free products are now available and should be included as part of further skin care regimen in these patients.
Thus, after testing with small amounts of product on the skin, the patient should be carefully examined using minimal magnification: The lesions will be typically revealed within 20 minutes.
Common trigger agents are fragrances e. ICU can be demonstrated with open and occluded testing, followed by prick testing with appropriate positive and negative controls if no response is elicited.
However, there are cases in which no clinical clue is provided by the physical exam. In these cases, a 2-week trial of appropriate-strength corticosteroid may solve the mystery by pointing to an eczematous process in the case of symptoms resolution. Nonetheless, the careful clinician should consider avoiding prolonged use of topical corticosteroids since there is anecdotal clinical experience of topical corticosteroids inducing SSS[ 35 ] and, at least in the case of barrier dysfunction, earlier and complete steroid tachyphylaxis has been demonstrated.
The elusive category of invisible causes of SSS comprises subjective and objective irritation. In both of these cases defined by Maibach, no signs are present or can be elicited on the skin.
In objective irritation the cause is presumed subclinical inflammation due to occult dermatopathology. In subjective irritation the mechanism is unknown and this diagnosis likely bundles more than one pathological process in it.
Interestingly and clinically frustratingly , Maibach considers subjective irritation to be the most common cause of CIS. Finally, body dysmorphic disorder BDD should always be considered by the dermatologist when assessing skin complaints without objective findings. Referral to a mental health professional is indicated since these patients are at risk of suicidal behavior. Specific algorithms have been developed for the management of SSS but they are the result of accumulated clinical experience and lack experimental evidence to support their use.
Nonetheless, algorithmic thinking may aid in ensuring complete assessment. These algorithms include four basic steps: Discontinuation, assessment, testing, and slow re-introduction. The patient should then be assessed as described above for the occurrence of any visible dermatoses.
If no clear pathology has emerged, rigorous testing is the next step. Testing should include patch and photopatch testing of routine allergens as well as of all of the patient's skin care items. Specific testing for contact urticaria should be a part of the testing protocol. Finally, when all these tests are negative, evaluation of mental status is warranted.
For females, recommend adding low-allergenic- potential cosmetic products one at a time in the following order: Lipstick, face powder, and blush. This exhausting process is not only a rational solution from a clinical management standpoint but may also aid in diagnosing the specific culprit in cases of invisible SSS. Table 3 summarizes the general approach to managing SSS.
SSS is very common and poses a challenge to physicians and patients alike. We are still far from understanding the underlying mechanisms involved.
Therefore, more basic science research is warranted. Understanding the underlying mechanisms may lead to the development of a well-standardized screening test. This will allow clinical studies to rely on objective findings rather than self-reports and this, in turn, may result in more comprehensive and efficient management strategies. Fundamentally, SSS appears to be an orthergic phenomenon rather than an immunological response.
Source of Support: Nil. Conflict of Interest: Nil. National Center for Biotechnology Information , U. Journal List Indian J Dermatol v. Indian J Dermatol. Author information Article notes Copyright and License information Disclaimer. Address for correspondence: Dr. E-mail: ude. Received Aug; Accepted Mar. This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3. This article has been cited by other articles in PMC.
Abstract Sensitive skin syndrome SSS is a common and challenging condition, yet little is known about its underlying pathophysiology. Keywords: Cosmetic intolerance syndrome , sensitive skin syndrome , status cosmeticus. Introduction What was known? Epidemiological Data In order to formulate a systematic clinical approach, the medical and cosmetic communities have attempted to characterize the condition.
Current Thinking on Pathophysiology The mechanism leading to the SSS has been debated in the literature, but the leading hypothesis relates to increased stratum corneum permeability.
Clinical Approach As with many syndromes, the management scheme presented here emphasizes the diagnostic framework [ Table 1 ]. Table 1 Underlying mechanisms of sensitive skin syndrome.
Open in a separate window. Table 2 Systematic evaluation of sensitive skin syndrome.
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We use our own and third party cookies in order to improve our performance, and to obtain anonymous statistics about the use of the website. By continuing to browse, you authorize their use. In order to change the preferences and to obtain further information, please refer to our cookies policy. Sensitive skin with redness is skin that reacts excessively, reddening and perceiving unpleasant sensations tightness, burning, tingling, itching , in response to stimuli that usually do not provoke this reaction.
Repeated exposure to these triggers causes vasodilation of the facial skin capillaries. Initially, this redness blushing is transient; it can be defined as a hot sensation accompanied by visible reddening of the skin. Over time, redness or erythrosis becomes persistent, as the capillaries remain in a state of permanent vasodilation. Without adequate treatment, the condition can progress to more severe stages, such as rosacea subtype 1 erythematotelangiectatic or subtype 2 papulopustular.
The unpleasant burning or itching sensations on the face can have a great impact on the well-being of people with sensitive skin and facial redness. Redness also has a visible effect that, according to its degree, can affect the normal course of social or working life. Dermatology Who we are We take care of your skin Atopic skin What is atopic dermatitis or atopic eczema?
Animal health. Facial redness Sensitive skin with redness Skincare What is sensitive skin with facial redness? For red and sensitive skin, a specific solution.