INTRODUCTION
“Sensitive skin” is commonly reported by many patients and influences decision making in skincare routines. Skin sensitivity is generally accepted to be a reduced tolerance to cosmetics and other topical skin care products.1 Based on consumer surveys, it is estimated that 40% of the population believes that they have sensitive skin, and this number appears to be increasing in recent years.1,2 Typically lacking objective signs, skin sensitivity is usually a subjective finding by patients that is secondary to their own perceptions about their skin.3,4 The correlation between perceived sensitivity and objectively sensitive skin has not previously been evaluated. Furthermore, there is limited understanding of which skin types more commonly believe that they have sensitive skin.
The biological basis of skin sensitivity is thought to be the result of many factors. A thin stratum corneum, increased blood flow, and neuronal activation are thought to be major contributing factors.1,3,5 Studies looking at biophysical parameters of the skin reported trends towards increased transepidermal water loss and decreased capacitance in those with sensitive skin, indicating a possible barrier dysfunction.4,6 Fitzpatrick skin type has also been thought to be associated with subjective perceptions of skin sensitivity objective measures.7,8 One study assessing patients with skin responses to irritants found that 85% of affected patients were white.9 Another study found differing symptomatology of skin sensitivity between ethnic groups, showing that Caucasian patients were significantly more likely to report visual effects (eg, redness), whereas African American patients were more likely to report sensory effects (eg, stinging).1 However, other survey studies have shown similar rates of self-reported skin sensitivity across ethnic groups, and therefore the relationship between skin sensitivity and skin type remains unclear.10,11 There is data to suggest that there are biophysical differences in the skin among skin types, and the skin of African American individuals has a thicker stratum corneum and increased lipid content.11,12 Since there is limited research on the relationship between perceived skin sensitivity and skin type, it is unclear whether Fitzpatrick skin type truly plays a role in determining overall sensitivity.
A sting test using lactic acid solution (5% or 10%) is an effective way to create a non-damaging reaction on the face and is been widely accepted as a marker of skin sensitivity.4 Previous studies have shown significantly higher stinging scores in response to lactic acid in patients with sensitive skin, and that
The biological basis of skin sensitivity is thought to be the result of many factors. A thin stratum corneum, increased blood flow, and neuronal activation are thought to be major contributing factors.1,3,5 Studies looking at biophysical parameters of the skin reported trends towards increased transepidermal water loss and decreased capacitance in those with sensitive skin, indicating a possible barrier dysfunction.4,6 Fitzpatrick skin type has also been thought to be associated with subjective perceptions of skin sensitivity objective measures.7,8 One study assessing patients with skin responses to irritants found that 85% of affected patients were white.9 Another study found differing symptomatology of skin sensitivity between ethnic groups, showing that Caucasian patients were significantly more likely to report visual effects (eg, redness), whereas African American patients were more likely to report sensory effects (eg, stinging).1 However, other survey studies have shown similar rates of self-reported skin sensitivity across ethnic groups, and therefore the relationship between skin sensitivity and skin type remains unclear.10,11 There is data to suggest that there are biophysical differences in the skin among skin types, and the skin of African American individuals has a thicker stratum corneum and increased lipid content.11,12 Since there is limited research on the relationship between perceived skin sensitivity and skin type, it is unclear whether Fitzpatrick skin type truly plays a role in determining overall sensitivity.
A sting test using lactic acid solution (5% or 10%) is an effective way to create a non-damaging reaction on the face and is been widely accepted as a marker of skin sensitivity.4 Previous studies have shown significantly higher stinging scores in response to lactic acid in patients with sensitive skin, and that
