Sensitive skin: mechanisms and diagnosis

Sensitive skin is a condition of subjective cutaneous hyperreactivity to environmental factors. Subjects experiencing this condition report exaggerated reactions when their skin is in contact with cosmetics, soaps and sunscreens, and they often report worsening after exposure to dry and cold climate. Although no sign of irritation is commonly detected, itching, burning, stinging and a tight sensation are constantly present. Generally substances that are not commonly considered irritants are involved in this abnormal response. They include many ingredients of cosmetics such as: dimethyl sulfoxide, benzoyl peroxide preparations, salicylic acid, propylene glycol, amyldimethylaminobenzoic acid and 2-ethoxyethyl methoxycinnamate. Sensitive skin and subjective irritation are widespread but still far from being completely defined and understood. The aim of this paper is to summarize the relevant literature in order to elucidate the underlying mechanisms of sensitive skin and the best testing methodologies for investigation of sensitive skin.