Surveys have reported that almost 60% of people when asked if they had sensitive skin, said yes. So what does that really mean? Medically, it can be classified as “a syndrome with sensations of stinging, burning, pain, itching, and tingling sensations in response to stimuli that otherwise should not produce such sensations and they are not due to an existing skin disease.” It can affect all body areas and especially the face. It has been considered as a cosmetic problem and even psychosomatic but increasingly has been shown to be a condition with nerve and skin involvement.
The skin is usually normal and there may be varying degree of redness. Symptoms may appear spontaneously, but they are usually provoked by cosmetics, physical stimuli such as sunlight, temperature, or wind and stress or hormonal influences such as during menstruation. In most people the symptoms appear within 1 hour after exposure and persist from 5 minutes to hours. Diagnosis is usually on interviewing sufferers and there are tests such as stinging test but usually the diagnosis of sensitive skin is made from the questionnaires filled by patients.
The causation is poorly understood and until recently the theories have revolved around damaged or impaired barrier function of the skin. A role of the skin microbiome (micro organisms that are normally present on the skin) has been reported which is thought to lead to immune dysregulation and consequently impaired inflammatory response. The symptoms experienced by people who have sensitive skin can only be explained by a defect in the sensory perceptions in the skin. This could explain why rosacea sufferers complain of sensitive skin as the condition is known to be a combination of vascular and inflammatory factors in the facial skin. Stress is well known to aggravate symptoms of sensitive skin and is often reported as a triggering factor; however it is usually accompanied by other factors.
Combining all the known possible factors it makes sense to minimise the trigger factors to control the symptoms. So regularly moisturising the skin will help with impaired barrier function of the skin. The moisturiser is only acting as an artificial barrier which is helping to enhance the lacking natural barrier contributing to the syndrome of sensitive skin. Hence that is why most eczema sufferers usually have a sensitive skin because they genetically suffer from an impaired barrier function of the skin.
Balancing the need for skin cleansing and avoiding any further damage to the skin barrier is crucial in the care of sensitive skin. Using a gentle and emollient face wash and subsequent moisturisation will help to avoid problems with cleansing.
Low level light therapy has been shown to improve the symptoms noted with sensitive skin. It is possible that the light helps with immune dysregulation and reducing local inflammation thereby improving the neural sensory abnormalities producing the symptoms.
There is no clear solution to the problem with sensitive skin but for people who are most affected by this syndrome, following a routine of moisturising the skin and a soft cleansing routine and maybe use of equipment delivering low level light therapy may help to manage this skin condition.