Are we reaching the limits or our ability to detect skin effects with our current testing and measuring methods for consumer products?

A Survey to Identify Determinants That Influence Self-Perceived Sensitive Skin in a British Population: Clues to Developing a Reliable Screening Tool for Sensitive Skin

Background

Skin sensitivity characteristics and triggers have been identified in populations in previous studies. However, few have compared these characteristics among self-reported sensitive skin.

Objective

The aim of the study was to evaluate and compare specific intrinsic and extrinsic triggers of skin sensitivity between individuals with self-reported sensitive skin and non-sensitive skin.

Methods

A systematic literature review was undertaken to identify intrinsic and extrinsic factors associated with sensitive skin. A 167-item survey was developed on the basis of the literature review. The survey was completed online by a sample of adult participants drawn from the general United Kingdom population. Participants also completed sociodemographic and self-reported health questions.

Results

A total of 3050 surveys were completed: 1526 participants with self-reported skin sensitivity and 1524 participants not reporting skin sensitivity. There was a decrease in self-reported skin sensitivity with increasing age (p<0.05), and proportionally more women reported sensitive skin. Smoking also led to a higher frequency of sensitive skin. All signs and symptoms of sensitive skin, such as itch, dryness/flakiness, roughness and flushing/blushing were more commonly reported by those with self-reported sensitive skin. These were frequently reported in association with external factors (cold/windy weather, clothes and fabrics), as well as internal factors such as pre-existing skin conditions and atopy.

Conclusion

The study evaluated self-reported sensitive skin against a non-sensitive skin in order to identify common inherent and external triggers to distinguish between these groups in a large general population study in the United Kingdom. The key symptoms and signs of this syndrome identified in the literature were confirmed to be reported significantly more when compared with those without sensitive skin. However, no correlation or pattern of symptomology could be identified, reinforcing the complexity of this condition. Given the strong differentiation from the non-sensitive group, the results of this research could be utilised for the development of a clinically meaningful screening tool.

The Prevalence of Sensitive Skin

Sensitive skin has been described as unpleasant sensory responses to stimuli that should not provoke such sensations. Objectively measurable signs of irritation are not always present in individuals with sensitive skin, however, subjective sensory effects such as, itching, burning, stinging, tightness, and dryness, are consistently present. Given the subjective nature of the phenomenon known as sensitive skin, surveys have been a popular approach to evaluating the prevalence of this condition among the general population, and a number of them have been conducted worldwide. Overall, ~60–70% of women and 50–60% of men report having some degree of sensitive skin. However, there are differences between populations in various geographies, and perceptions of sensitive skin at specific anatomic sites. This article is a review of survey data on the prevalence of self-declared sensitive skin in various geographies, among different gender and age groups, and at various anatomic sites. In addition, we review the factors that may contribute to sensitive skin, and the physiological characteristics associated with this condition, including impaired barrier function and heightened neural reactions.

Dermatological testing of an improved apertured film surface for feminine hygiene pads

CONTEXT

Apertured polyethylene films (AF) have been used as a surface for sanitary pads for decades because they are compatible with the skin and keep the pad surface drier. A modified film (AF-plus) with improved fluid handling and a smoother, suppler texture has been developed. We hypothesized that these changes would improve both performance and skin compatibility. However, distinguishing the skin effects of materials that are inherently mild is a challenge.

OBJECTIVES

(i) To compare the skin irritation potential of pads with AF-plus modified film relative to the standard AF film and (ii) to assess the potential for the AF-plus film to induce delayed contact hypersensitivity.

MATERIALS AND METHODS

Pads bearing the AF-plus film were compared to pads with the standard AF film in a behind-the-knee (BTK) test, which assesses the combination of chemical irritation and frictional effects of materials applied to the popliteal fossa under a semi-occlusive bandage. Erythema on the skin surface was scored with the naked eye and subsurface tissue erythema was visualized and scored using cross-polarized illumination. Skin dryness was scored with the naked eye only. One-sided statistical evaluations were performed to test the hypothesis of AF-plus film superiority. The potential of the AF-plus film to induce delayed contact hypersensitivity was assessed by a human repeat insult patch test (HRIPT).

RESULTS

Pads with the AF-plus surface were significantly milder to skin in the BTK test, producing lower levels of both surface and subsurface tissue erythema. Moreover, subjects with preexisting erythema on the skin surface at study start developed comparatively less erythema over the course of the study overall with the AF-plus pad compared to the AF pad. No significant difference in skin dryness was observed between product groups. The AF-plus pad showed no evidence of inducing delayed contact hypersensitivity.

CONCLUSIONS

The AF-plus pad was superior to the AF pad in terms of skin mildness as discerned by objectively scored surface and subsurface tissue erythema. In subjects with preexisting erythema, the AF-plus pad appeared to contribute less to the further development of inflammation under the test conditions. Given the compositional similarities in the two films, the results could point to more limited contribution of the AF-plus film to skin friction, one of the factors simulated by the BTK test protocol.

Sensory, clinical and physiological factors in sensitive skin: a review

Certain individuals experience more intense and frequent adverse sensory effects than the normal population after topical use of personal care products, a phenomenon known in popular usage as sensitive skin. Consumer reports of sensitive skin are self-diagnosed and often not verifiable by objective signs of physical irritation. Companies who manufacture cosmetic and personal care products are challenged to provide safe products to an audience with tremendous differences in skin type, culture and habits. This review examines the still incomplete understanding of this phenomenon with respect to aetiology, diagnosis, appropriate testing methods, possible contributing host factors such as, sex, ethnicity, age, anatomical site, cultural and environmental factors, and the future directions needed for research.