[A history of sensitive skins]

Association between biophysical properties and anxiety in patients with sensitive skin

BACKGROUND

Sensitive skin (SS) is a syndrome in which neurosensory disorders accompany epidermal barrier dysfunction. However, it is not yet clear how high anxiety levels affect the biophysical parameters of the skin in patients with SS.

OBJECTIVES

We aimed to investigate the relationship between anxiety levels and facial neurosensitivity, the erythema index, sebum content, and sensitive skin scale scores in individuals with sensitive skin.

METHODS

The study was carried out on 35 individuals with SS and 40 without SS over three months. In the study, a questionnaire to detect the presence of sensitive skin, the sensitive skin scale for sensitive skin severity, the lactic acid sting test (LAST) to show facial neurosensitivity, a Mexameter for erythema index measurement, and a Sebumeter for sebum content measurement were used. In addition, the anxiety levels of the patient and control groups were measured using the hospital anxiety and depression scale (HADS).

RESULTS

While the HADS-Anxiety scores were found to be significantly higher in patients with sensitive skin, there was no significant difference in the HADS-Depression scores. Moreover, a strong positive correlation was found between the HADS-Anxiety scores and the erythema index in patients with sensitive skin.

CONCLUSIONS

Sensitive skin is a disorder that can sometimes occur without any dermatological examination findings. In particular, the sensations of the patients, along with their anxiety levels, are essential parameters that should be evaluated in the approach to patients with sensitive skin.

Sensitive Skins May Be Neuropathic Disorders: Lessons from Studies on Skin and Other Organs

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.

Efficacy and Tolerability of Phototherapy With Light-Emitting Diodes for Sensitive Skin: A Pilot Study

Sensitive skin (SS) syndrome is defined by the occurrence of unpleasant sensations in response to stimuli that should normally not induce such sensations. It affects ~50% of women and 40% of men and can impact the quality of life. There is no consensus on therapeutic management. Phototherapy by light-emitting diodes (LEDs) is increasingly being used in dermatology for various inflammatory skin disorders with significant reduction in SS-10 and good tolerability. A Korean study suggested its efficacy in alleviating SS symptoms associated with other facial diseases. Our objective is to obtain preliminary data on the efficacy of phototherapy with LEDs for alleviating SS symptoms and increasing tolerance in subjects with SS that is not associated with other facial skin disorders. This monocentric pilot study included 30 subjects with SS who had a Sensitive Scale-10 score ≥40. The treatment consisted of red LED light exposure twice a week until significant reduction in SS-10 with a maximal treatment length of 8 weeks. The primary outcome was defined by a 60% decrease in the SS-10 score compared to the baseline.

Results: Thirty subjects were included; 83% were women, and the mean age was 28.9 years. Two participants were considered lost to follow-up. The cheeks (90%) and the nose (70%) were the most frequently involved parts of the face. Cold, heat, temperature variation, water and sun were the most frequent triggering factors. Twenty-eight subjects (93.3%, 95% CI 77.9 to 99.2%) achieved the primary outcome. Significant reduction in SS-10 was achieved in 77% of subjects in six sessions or fewer. The mean (SD) SS-10 scores were 54.7 (12.1) at inclusion, 14.4 (6.0) at the last session and 13.9 (7.5) 2 months after the last session, suggesting that the benefits persist for a few weeks. Two side effects were reported: both were allergic reactions to the nickel contained in the protective goggles. This pilot study had a small sample size and no control group. LEDs were effective in treating SS in all 28 subjects who completed the study in accordance with the protocol, and the benefits persisted for 2 months after the last LED therapy session.