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Sensitive Skin—The Disconnect between Subjective and Medical Diagnosis: Towards Bridging...
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Sensitive Skin—The Disconnect between Subjective and Medical Diagnosis: Towards Bridging “Feelings” with “Seeing” It

A special issue of Cosmetics (ISSN 2079-9284).

Deadline for manuscript submissions: closed (28 February 2022) | Viewed by 41867

Special Issue Editors

Dr. Miranda A. Farage

E-Mail Website
Guest Editor
The Procter and Gamble Company, Mason, OH 45040, USA
Interests: skin health; sensitive skin; aging skin; biology; women’s health; neurobehavioral science; clinical toxicology; quality of life; driving holistic wellness benefits to consumers by linking science and perceptions
Prof. Dr. Laurent Misery

E-Mail Website
Co-Guest Editor
1. Department of Dermatology, University Hospital of Brest, 29200 Brest, France
2. Laboratory of Neurosciences, University of Western Brittany, 29238 Brest, France
Interests: itch; pain; neurodermatology; psychodermatology; autoimmune diseases
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Enzo Berardesca

E-Mail Website
Co-Guest Editor
Department of Dermatology and Cutaneous Surgery, University of Miami, Miami, FL 33136, USA
Interests: dermatology; skin care; contact dermatitis; cosmetic efficacy; cosmetic formulation; barrier function; skin irritation
Special Issues, Collections and Topics in MDPI journals
Dr. Howard I. Maibach

E-Mail Website
Co-Guest Editor
Department of Dermatology, University of California, San Francisco, CA 94117, USA
Interests: contact; occupational dermatitis; toxicology; neonatal skin; dose response of topical response; per-cutaeous penetration

Special Issue Information

Dear Colleagues,

Sensitive skin is a complex clinical phenomenon that is defined by the self-reported presence of different sensory perceptions, including tightness, stinging, burning, tingling, pain and pruritus. Sensitive skin syndrome has been reported on a global basis with approximately 40% of the population describing their skin as moderately or very sensitive. Due to the subjective nature of this clinical condition, the diagnosis is complex since there is often a disconnect between what subjects feel and what medical professionals can observe. The unpleasant sensations associated with sensitive skin cannot be seen, nor can they be explained solely by underlying skin disease. The mechanism is neither solely immunologic nor allergic per se. The authors explore the current understanding of the etiology of sensitive skin, along with the physiological characteristics associated with this condition. This Special Issue will review the latest factors that may contribute to sensitive skin including impaired epidermal barrier integrity, alterations in the skin microbiome, neurosensory hyperactivity, and vascular hyperreactivity. In addition, we will discuss other conditions and co-morbidities that are associated with sensitive skin, such as atopic dermatitis and pruritus. We will try to raise awareness to bridge the subjects’ perceptions and the physicians’ understanding of this real-life condition.

Dr. Miranda A. Farage
Guest Editor

Dr. Laurent Misery
Dr. Enzo Berardesca
Dr. Howard I. Maibach
Co-Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cosmetics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • sensitive skin
  • sensorial irritation
  • barrier dysfunction
  • neurosensory dysfunction
  • feeling it or seeing it for diagnosis

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Published Papers (6 papers)

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Research

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15 pages, 3667 KiB  
Article
Can Performance and Gentleness Be Reconciled? A Skin Care Approach for Sensitive Skin
by Cyril Messaraa, Justine Drevet, David Jameson, Gabriela Zuanazzi and Ileana De Ponti
Cosmetics 2022, 9(2), 34; https://doi.org/10.3390/cosmetics9020034 - 22 Mar 2022
Cited by 3 | Viewed by 6244
Abstract
People with self-reported sensitive skin may reluctantly use performing anti-ageing skin care products as it could elicit skin discomfort. We thus aimed to design and test an anti-ageing skin care routine that is suitable for people reporting sensitive skin. Key principles for developing [...] Read more.
People with self-reported sensitive skin may reluctantly use performing anti-ageing skin care products as it could elicit skin discomfort. We thus aimed to design and test an anti-ageing skin care routine that is suitable for people reporting sensitive skin. Key principles for developing products for sensitive skin were applied and formulas were screened for their mildness in vitro using the Reconstructed Human Epidermis ET50 method. Anti-ageing efficacy and mildness was evaluated during a clinical study in China, with 33 female volunteers aged 40–65 years, with sensitive skin. The anti-ageing benefits were measured using Primos 3D, the cutometer and clinical evaluation. Hallmarks for sensitive skin such as skin hydration, skin barrier, skin redness and response to lactic acid were also measured. The ET50 method yielded values suggesting moderate to mild expected irritancy effect in vivo for most of them, and non-irritating effect for the serum. During the clinical study, no physical or functional signs of discomfort were reported with twice-daily usage of the routine. Instrumental evaluation of Wrinkle depth, skin elasticity/firmness, skin hydration, skin barrier and skin redness revealed improvement at 4 and 8 weeks. Clinical evaluation evidenced skin smoothness, skin suppleness and radiance improvements. The skin was less reactive to lactic acid stimuli, while the sensitive skin burden was lowered according to the dermatological quality of life index. Lastly, a separate investigation suggested the potential relief aspect of such routines to alleviate discomforts from mask wearing. With the right formulation design, the benefits of layering products from a routine can be made accessible to people with sensitive skin while simultaneously alleviating the burden of sensitive skin. Full article
(This article belongs to the Special Issue Sensitive Skin—The Disconnect between Subjective and Medical Diagnosis: Towards Bridging “Feelings” with “Seeing” It)
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13 pages, 9920 KiB  
Article
Occurrence of Allergens in Cosmetics for Sensitive Skin
by Márcia S. Martins, Marta S. Ferreira, Isabel F. Almeida and Emília Sousa
Cosmetics 2022, 9(2), 32; https://doi.org/10.3390/cosmetics9020032 - 17 Mar 2022
Cited by 10 | Viewed by 11205
Abstract
Sensitive skin is characterized by symptoms such as stinging and tingling in response to stimuli that usually do not cause unpleasant sensations. Epidemiological studies show that individuals with sensitive skin are more prone to developing skin allergies, although the link between both conditions [...] Read more.
Sensitive skin is characterized by symptoms such as stinging and tingling in response to stimuli that usually do not cause unpleasant sensations. Epidemiological studies show that individuals with sensitive skin are more prone to developing skin allergies, although the link between both conditions is unknown. Aiming to evaluate the presence of allergens in facial-skin products for sensitive skin, a pool of 88 cosmetic products from international brands marketed in pharmacies and parapharmacies was analyzed. A list of allergens identified in product labels was compiled and grouped according to their function. Fragrances were the most common allergens, followed by skin-conditioning agents, surfactants, and preservatives. Fragrances presenting the highest use percentages were linalool, benzyl alcohol, geraniol, and citronellol. Overall, the majority of cosmetic formulations were absent of fragrance allergens, being present only in 7% of products. Other allergens were found in most products (95%). This finding should be interpreted with caution, since many of these compounds are rare sensitizers and studies demonstrating their risk for individuals with sensitive skin are lacking. With this study, useful information for health professionals is provided to support their advice and to help consumers choosing cosmetic products. Full article
(This article belongs to the Special Issue Sensitive Skin—The Disconnect between Subjective and Medical Diagnosis: Towards Bridging “Feelings” with “Seeing” It)
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12 pages, 10890 KiB  
Article
Clinical and Instrumental Exploration of Sensitive Skin in a Pediatric Population
by Gaëtan Boyer, Clarence De Belilovsky, Stéphanie Brédif, Caroline Baudouin, Laurent Misery and Gaëlle Bellemère
Cosmetics 2021, 8(2), 43; https://doi.org/10.3390/cosmetics8020043 - 30 May 2021
Cited by 3 | Viewed by 4583
Abstract
Studies on sensitive skin pathophysiology in infants are challenging because most assessment methods require self-reporting of signs. In this study, we aimed to identify and characterize sensitive skin in children for the first time. A newly developed parent-reported questionnaire was used to recruit [...] Read more.
Studies on sensitive skin pathophysiology in infants are challenging because most assessment methods require self-reporting of signs. In this study, we aimed to identify and characterize sensitive skin in children for the first time. A newly developed parent-reported questionnaire was used to recruit children with sensitive skin. This questionnaire was also tested on an adult group. Hydration, transepidermal water loss (TEWL), and inflammatory markers (cytokines, and polyunsaturated fatty acids (PUFAs)) were quantified. A total of 77 children and 20 adults (33 and 10 with sensitive skin, respectively) were recruited. The groups with sensitive skin had more clinical signs of skin dryness. Skin hydration was lower in children in the sensitive compared with the nonsensitive skin group. TEWL levels were similar between sensitive and nonsensitive subjects in both infant and adult groups. Sensitive skin exhibited higher levels of cytokines and proinflammatory PUFAs as well as lower levels of anti-inflammatory PUFAs. Sensitive skin syndrome was associated with normal skin barrier function but lower hydration in infants and children. The higher levels of proinflammatory markers suggest that sensitive skin is associated with low-level inflammation. It is hypothesized, for the first time, that PUFAs are involved in sensitive skin syndrome in infants. Full article
(This article belongs to the Special Issue Sensitive Skin—The Disconnect between Subjective and Medical Diagnosis: Towards Bridging “Feelings” with “Seeing” It)
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Review

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11 pages, 511 KiB  
Review
In Vitro Sensitive Skin Models: Review of the Standard Methods and Introduction to a New Disruptive Technology
by Alexandre Guichard, Noëlle Remoué and Thibault Honegger
Cosmetics 2022, 9(4), 67; https://doi.org/10.3390/cosmetics9040067 - 23 Jun 2022
Cited by 4 | Viewed by 5053
Abstract
The skin is a protective organ, able to decode a wide range of tactile, thermal, or noxious stimuli. Some of the sensors belonging to the transient receptor potential (TRP) family, for example, TRPV1, can elicit capsaicin-induced heat pain or histamine-induced itching sensations. The [...] Read more.
The skin is a protective organ, able to decode a wide range of tactile, thermal, or noxious stimuli. Some of the sensors belonging to the transient receptor potential (TRP) family, for example, TRPV1, can elicit capsaicin-induced heat pain or histamine-induced itching sensations. The sensory nerve fibers, whose soma is located in the trigeminal or the dorsal root ganglia, are able to carry signals from the skin’s sensory receptors toward the brain via the spinal cord. In some cases, in response to environmental factors, nerve endings might be hyper activated, leading to a sensitive skin syndrome (SSS). SSS affects about 50% of the population and is correlated with small-fiber neuropathies resulting in neuropathic pain. Thus, for cosmetical and pharmaceutical industries developing SSS treatments, the selection of relevant and predictive in vitro models is essential. In this article, we reviewed the different in vitro models developed for the assessment of skin and neuron interactions. In a second part, we presented the advantages of microfluidic devices and organ-on-chip models, with a focus on the first model we developed in this context. Full article
(This article belongs to the Special Issue Sensitive Skin—The Disconnect between Subjective and Medical Diagnosis: Towards Bridging “Feelings” with “Seeing” It)
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23 pages, 3723 KiB  
Review
Understanding the Sensitive Skin Subject to Achieve a More Holistic Diagnosis
by Miranda A. Farage
Cosmetics 2021, 8(3), 81; https://doi.org/10.3390/cosmetics8030081 - 2 Sep 2021
Cited by 5 | Viewed by 7875
Abstract
Sensitive skin Syndrome (SSS) is a complex global clinical phenomenon that is defined by the self-reported presence of different sensory perceptions, including tightness, stinging, burning, tingling, pain and pruritus and often without objective signs. Due to the subjective nature of this clinical condition, [...] Read more.
Sensitive skin Syndrome (SSS) is a complex global clinical phenomenon that is defined by the self-reported presence of different sensory perceptions, including tightness, stinging, burning, tingling, pain and pruritus and often without objective signs. Due to the subjective nature of this clinical condition, the diagnosis is complex and there is often a disconnect between what subjects feel and what medical professionals can observe. This chapter reviews the known underlying physiology, some of the triggering factors associated with SSS, co-morbidities as well as the psychological impact on individuals suffering from this condition. The goal is to bridge the gap between the physicians’ understanding and the subjects’ perceptions of this real-life condition that affects so many. Full article
(This article belongs to the Special Issue Sensitive Skin—The Disconnect between Subjective and Medical Diagnosis: Towards Bridging “Feelings” with “Seeing” It)
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8 pages, 272 KiB  
Review
Sensitive Skins May Be Neuropathic Disorders: Lessons from Studies on Skin and Other Organs
by Laurent Misery
Cosmetics 2021, 8(1), 14; https://doi.org/10.3390/cosmetics8010014 - 9 Feb 2021
Cited by 8 | Viewed by 4810
Abstract
Sensitive skin can be considered a neuropathic disorder. Sensory disorders and the decrease in intra-epidermal nerve ending density are strong arguments for small-fiber neuropathies. Sensitive skin is frequently associated with irritable bowel syndrome or sensitive eyes, which are also considered neuropathic disorders. Consequently, [...] Read more.
Sensitive skin can be considered a neuropathic disorder. Sensory disorders and the decrease in intra-epidermal nerve ending density are strong arguments for small-fiber neuropathies. Sensitive skin is frequently associated with irritable bowel syndrome or sensitive eyes, which are also considered neuropathic disorders. Consequently, in vitro co-cultures of skin and neurons are adequate models for sensitive skin. Full article
(This article belongs to the Special Issue Sensitive Skin—The Disconnect between Subjective and Medical Diagnosis: Towards Bridging “Feelings” with “Seeing” It)
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