Definition

Sensitive skin is characterised by inflammatory reactions such as redness and itching. Most people with sensitive skin experience itching, burning, and stinging. People with sensitive skin are more likely to react negatively to cosmetics and personal care items. For those with sensitive skin, using chemicals, colors, and scents in certain goods that come into close contact with the skin may induce local reactions. Individuals' triggers for inflammation in sensitive skin may differ. This issue is widespread, with up to 50% of women and 40% of men reporting having sensitive skin. Although uncommon, sensitive skin can occasionally be a symptom of a more serious medical issue, such as renal disease.

Sensitive skin can generally be divided into four types, namely:

• Naturally sensitive skin. This variant is typically hereditary and can be associated with inflammatory dermatological disorders such as eczema, rosacea, and psoriasis.
• Environmentally sensitive skin. As its name suggests, this type's sensitivity can vary depending on the environment. Exposure to sunlight, cigarette smoke, air pollution, or other substances that contact your skin might trigger a strong and uncomfortable reaction.
• Reactive skin. This skin type becomes red and inflamed from certain skincare products, causing very red, warm, and irritated skin. Furthermore, it is common for papules or pustules to develop at the site of skin irritation, typically with pus.
• Thin skin. As we age, our skin naturally becomes thinner as it becomes easier to be irritated.

Causes

The top layer of the skin's nerve endings becomes irritated, causing sensitive skin. When triggers weaken or break down the skin's natural barrier, nerve endings become irritated. Some triggers that can irritate sensitive skin include:

• Sun exposure
• Wind/weather
• Hot or cold weather
• Use of certain products applied directly on the skin, such as skin care products, soaps, detergents, dyes, and fragrances in topical products
• Hormonal disorders
• Lack of sleep
• Air pollution

Risk factor

Some  factors that may increase the risk of sensitive skin include:

• Certain skin disorders or allergic skin reactions. Sensitive skin may be a sign of another underlying skin disorder, such as:
  • Eczema/dermatitis
  • Rosacea is a skin disease that affects the face, with initial signs including skin that reddens more easily than others
  • Contact with certain substances that cause an allergic reaction on the skin results in allergic contact dermatitis
  • As a result of coming into contact with certain irritants that irritate the skin, people can develop irritant contact dermatitis
  • Urticaria, also known as hives, is a skin condition characterized by raised, itchy bumps resulting from an allergic reaction to certain substances.
  • Aquagenic pruritus is a rare condition that causes itchy skin when in contact with water.
  • Dry skin occurs when there is insufficient water and oil in the skin.
  • Photodermatosis is an abnormal skin reaction due to sun exposure
  • Cutaneous mastocytosis is a condition with too much accumulation of mast cells (cells that cause allergic reactions) in the skin.
• Excessive dryness or injury to the skin can cause reactions when nerve endings in the upper layers of the skin are no longer protected.
• Excessive exposure to skin-damaging environmental factors such as sun and wind or excessive heat or cold
• Genetic factors, age, gender, and race differences in skin sensitivity are less well-defined but still may play a role in causing skin reactions in sensitive skin.

Symptoms

Sensitive skin symptoms occur when your skin barrier breaks down due to various triggers, including environmental factors, dehydration, or underlying conditions. Sensitive skin can cause both objective signs and subjective symptoms. Objective signs are physical changes that a doctor can observe, such as:

• Rough, flaky patches
• Wrinkled, rough-textured
• Redness
• Swelling
• Open sores or yellow crust over the skin
• Peeling skin
• Dry skin
• Rashes or bumps on the skin

Meanwhile, subjective symptoms refer to the sensations that sensitive skin can cause, such as:

• Itching
• Burning sensation on the skin
• Pain
• Stinging sensation
• Skin discomfort

Symptoms of sensitive skin sometimes occur only on the face. The eyelids are also susceptible to the use of certain products. Due to thinner skin, the armpits, groin, and genitals may also be more sensitive than others.

Diagnosis

To diagnose sensitive skin, the doctor will conduct an interview. Some of the questions the doctor may ask are:

• Where on your body do you experience sensitive skin?
• Do any of your close relatives or family members have sensitive skin?
• How long have you been experiencing symptoms of sensitive skin?
• Is there anything that can reduce the symptoms or make them better?
• What makes symptoms worse?
• What cosmetic products and laundry detergents do you use at home?
• Are weather changes having an impact on your skin?

Additionally, the doctor will look for risk factors contributing to the onset of sensitive skin, such as other underlying skin diseases. Furthermore, the doctor will conduct a physical examination by looking directly at the condition of the affected quilt.

Management

Managing sensitive skin typically involves identifying and eliminating triggers while giving prescription drugs to relieve symptoms. Several options for treating your sensitive skin include:

Home remedies

There are several options for treating your sensitive skin at home. They include:

• Hypoallergenic moisturizers and lotions. If you have sensitive skin, you can use hypoallergenic moisturizers and lotions to reduce dryness without irritating the skin. The effectiveness of different ingredients may vary depending on the type of sensitivity you have. For instance, if you have dry skin, you may benefit from using ingredients like urea or lactic acid. On the other hand, simple oils such as shea butter or coconut oil may work better for others.
• Oatmeal baths or applying lotions containing oatmeal may be especially helpful for people with sensitive skin. Research shows that applying oatmeal can help with symptoms such as rashes, dry skin, and eczema. Oatmeal is effective because it can improve the skin barrier, not just treat symptoms.

Medical treatment

In severe cases, a person may need to see a dermatologist, an allergist, or a healthcare professional. 

They can prescribe ointments, creams, or prescription drugs.

• Steroid creams, both over-the-counter (OTC) and doctor-prescribed, like hydrocortisone, can help relieve inflammation and itching. However, these medications should not be used on the face.
• Analgesic creams can induce numbness and help reduce itching, making the person less likely to scratch or irritate the area.
• Antihistamines, such as diphenhydramine, can help relieve allergic reactions
• Sunscreen with a sun protection factor (SPF) of 30 or higher can help protect sensitive skin from ultraviolet (UV) rays.

Complications

Sensitive skin can be itchy, so patients tend to scratch it. Prolonged scratching can lead to skin infections. Long-term irritation and bleeding can also result from scratching irritated skin.

Prevention

Some steps that can be taken to prevent the onset of sensitive skin symptoms include:

• Taking shorter showers that last less than 10 minutes
• Avoid using very hot water for bathing and hand washing
• Avoiding products with strong fragrances, detergents, or other chemicals
• Using products, such as soaps, deodorants, and detergents, that are fragrance-free and hypoallergenic
• Avoiding harsh chemical cleansers
• Pat your body dry after showering instead of rubbing it. This helps to prevent skin irritation and damage.
• Test new products on a discreet area of skin at least one day before trying a full-application

When to see a doctor?

Sensitive skin is a recurring condition that may be caused by underlying skin disorders. It is advisable to consult a doctor to identify the cause and trigger of sensitive skin.

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