Skin sensitivity and intolerance in Shanghai: cumulative influence of different meteorological parameters

The Challenges in Investigating the Pathogenesis of Sensitive Skin by Noninvasive Measurements: A Systematic Review

Sensitive skin (SS) is a common cutaneous condition that seriously affects people's quality of life, but studies of sensitive skin pathogenesis are unclear, the exploration are ongoing, and the biophysical properties of sensitive skin disagree with the study results. In this paper, we summarize the noninvasive biophysical and imaging instrumental methods used for sensitive skin and provide support for the classification of sensitive skin subtypes to prescribe precise treatment. PubMed and Web of Science databases were searched according to PRISMA guidelines for articles from January 1971 to May 2022 that used noninvasive biophysical or imaging methods to monitor adult subjects with sensitive skin. The quality of the included articles was determined based on 22 items of the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) statement. A total of 55 studies were included, representing 8 biophysical and 5 imaging methods and their applications in treatment efficacy evaluation studies. The biophysical parameter and cutaneous morphological property changes in sensitive skin subjects were observed. The quality of the studies was relatively low, and there was high variability in results between studies. Several parameters have shown tremendous potential in exploring the pathogenesis with different sensitive skin subtypes: type I may be detected with higher transepidermal water loss and lower stratum corneum hydration values, as well as with thinner epidermis with a shallower and more irregular honeycomb structure; Type II and III are more prone to higher blood flow, lower current perception threshold than normal skin. This systematic review identifies key reasons for the lack of uniform trends in noninvasive measurements and recommends the use of effective selection instruments or relevant parameters to explore the pathogenesis of sensitive skin, and to differentiate the subtypes of sensitive skin for achieving the precise treatment.

Association between lactic acid sting test scores, self-assessed sensitive skin scores and biophysical properties in Chinese females

Background

Lactic acid sting test (LAST) is a classical method to identify sensitive skin. However, some subjects with self‐perceived sensitive skin are negative for LAST.

Objective

To determine whether LAST scores are associated with specific phenotype of sensitive skin.

Methods

A total of 292 subjects with self‐perceived sensitive skin were enrolled in this study. The Sensitive Scale was used to evaluate the severity of burning, stinging, itching, tautness, erythema and scaling based on 0–10 scale scores. In addition to the assessment of LAST scores, epidermal biophysical properties were measured using an MPA system.

Results

The Sensitive Scale scores of stinging, itching, tautness and scaling were significantly different between the LAST‐positive and ‐negative groups. However, burning and erythema scores did not differ between the LAST‐positive and ‐negative groups. LAST scores were positively correlated with the Sensitive Scale scores for stinging, itching, tautness and scaling, but not for burning and erythema scores. Moreover, LAST scores negatively correlated with stratum corneum hydration, but positively with transepidermal water loss (TEWL) rates.

Conclusions

Lactic acid sting test scores positively correlated with TEWL rates. LAST scores could be used to identify subjects with sensitive skin characterized mainly by stinging and itching, but not those mainly by burning and erythema.

Reflectance confocal microscopy for the evaluation of sensitive skin

BACKGROUND

Nowadays, the diagnosis for sensitive skin relies on subjective assessment or on the combination of subjective and objective evaluation. No quantitative evaluation is available. It could be expected that confocal microscopy imaging could be of interest to better define the condition.

METHODS

Total 166 healthy female subjects were recruited in this study. Firstly, all subjects completed the sensitive questionnaire. Then, the cutaneous structures were measured by the reflectance confocal microscopy (RCM) on the face and fossa cubitalia. The lactic acid sting test was conducted finally. According to the results of self-perception sensitive skin questionnaire and lactic acid stinging test to evaluate facial skin sensitivity the both positive subjects were regarded as sensitive skin group and both negative group as healthy control group.

RESULT

The results of RCM indicating that the proportion of 'disarranged honeycomb pattern' and 'spongiform edema' in the sensitive group and healthy control group were statistically different (P < 0.05), respectively; The following report 'damaged dermal papilla rings' was not a distinctive pattern, with no significant statistical difference (P > 0.05). The epidermal thickness was 38.88 ± 6.81 μm, healthy control group was 40.31 ± 9.37 μm in, respectively, sensitive skin group and healthy control group, there was no significant statistical difference between the two groups (P > 0.05). The honeycomb structure depth of sensitive group was 20.57 ± 4.86 μm. It was for 23.27 ± 6.38 μm, healthy control group the difference being statistically different between the two groups (P < 0.05).

CONCLUSION

Based on the RCM results, 'epidermal honeycomb structure' and 'spongiform edema' may be used as new skin signs of RCM evaluation of sensitive skin effectively. Indeed, sensitive skin honeycomb structure depth was thinner compared with healthy control group. Such a specific pattern has good clinical and monitoring value for the further exploration. RCM could provide new data and patterns for the evaluation of sensitive skin.

Evaluation of the severity and triggering factors of sensitive scalp in Chinese females

BACKGROUND

Sensitive scalp which has been recently proposed and assessed by several questionnaires is one of the most cosmetic concerns in sensitive skin syndrome by consumers.

OBJECTIVE

This study is to investigate the prevalence and factors related to the scalp sensitivity in China.

METHODS

Two well-known questionnaires including four-grade self-assessment and 3S, and a new questionnaire we proposed (10Q), were used to evaluate the severity and symptoms of sensitive scalp.

RESULTS

The proportions of sensitive scalp according to self-assessment and 3S were 35.77% and 57.45%, respectively. Distributions of severity and tendency of proportion along ages were significantly different between the two methods. The 10Q questionnaire which we designed could discriminate different grade of severity of sensitive scalp with superior reliability. Moreover, triggering factors which have significant impacts on the symptoms of sensitive scalp were elucidated by logistic regression analysis, including air dryness, exercises, humidity, heat, and sun.

CONCLUSION

Questionnaires with more dimensions and details such as 10Q and 3S should be used for the diagnosis, prognosis, and treatment monitoring on sensitive scalp in Chinese female.