According to the survey, people with sensitive skin account for 30% to 40% of the total population, and this group is also the focus of our cosmetic dermatologists’ attention.
Strictly speaking, sensitive skin is not a disease, but a subhealthy state of the skin. When subjected to external stimuli, this skin is prone to erythema, papules, especially capillary dilation and other objective symptoms, while the patient feels a tingling sensation, burning sensation, and is intolerant to ordinary cosmetics, a condition we call sensitive skin.
From a medical point of view, there are two main types of sensitive skin: primary and secondary. Primary, for example, genetic factors, especially women with thin skin epidermis, are easily sensitive; at the same time, there are many dermatological conditions that can complicate sensitivity, such as inflammatory skin diseases (acne, solar dermatitis), drugs (hormones, retinoids, salicylic acid), inappropriate skin care and whitening of spots (peeling syndrome), minimally invasive and invasive skin treatments (post-laser surgery), etc., when dermatologists should be concerned.
The main triggers and potential groups of primary sensitive skin
Due to genetic factors, some people have a thin epidermis, and because there are no blood vessels in the epidermis, the dermal blood vessels are exposed. Under external stimulation such as heat, sunlight exposure, air pollution, etc., capillary dilation is severe, and together with indiscriminate use of cosmetics will induce sensitive skin. In addition to those affected by genetic factors, people who do not pay attention to sun protection, excessive exposure to sunlight, indiscriminate use of cosmetics, and those who do not take reasonable care of themselves after cosmetic treatments are all potentially susceptible to sensitive skin.
Clinical Diagnostic Criteria for Sensitive Skin
Diagnosis is made from the patient’s subjective and objective symptoms. Patients with sensitive skin often subjectively feel redness and burning sensation on their skin, and are unable to tolerate ordinary skin care products. Objectively, I use the lactic acid test for judgment. A 5% lactic acid solution is applied to both sides of the nasolabial folds at the time points of 2 minutes and 30 seconds and 5 minutes, respectively, to see if there is an erythematous reaction, followed by the use of a four-point scale (0, 1, 2, 3). After the 2 minutes and 30 seconds and 5 minutes scores are added together, a score greater than 3 is diagnosed as sensitive skin, and its severity is also assessed.
In addition, with some equipment, such as under VISIA, it is possible to see how the redness of the skin capillaries changes, and the erythema as well as the capillary dilation is more pronounced in patients with sensitive skin than in normal people.
Pathogenesis of sensitive skin
There are many problems in the treatment of sensitive skin. When patients come to the clinic, our doctors usually use tacrolimus, glycopyrrolate, etc. However, often many doctors do not have a definite plan for treatment and are not mentally sure. For their part, patients believe that they do not need to see a doctor and go directly to life beauty. Others will fear extreme treatment and resist skin care products or overly fetishize skin care products.
According to the survey, the sensitive skin population accounts for 30% to 40% of the total population, and this group is also the focus of our cosmetic dermatologists.
Strictly speaking, sensitive skin is not a disease, but a subhealthy state of the skin. When subjected to external stimuli, this skin is prone to erythema, papules, especially capillary dilation and other objective symptoms, while the patient feels a tingling sensation, burning sensation, and is intolerant to ordinary cosmetics, a condition we call sensitive skin.
From a medical point of view, there are two main types of sensitive skin: primary and secondary. Primary, for example, genetic factors, especially women with thin skin epidermis, are easily sensitive; at the same time, there are many dermatological conditions that can complicate sensitivity, such as inflammatory skin diseases (acne, solar dermatitis), drugs (hormones, retinoids, salicylic acid), inappropriate skin care and whitening of spots (peeling syndrome), minimally invasive and invasive skin treatments (post-laser surgery), etc., when dermatologists should be concerned.
The main triggers and potential groups of primary sensitive skin
Due to genetic factors, some people have a thin epidermis, and because there are no blood vessels in the epidermis, the dermal blood vessels are exposed. Under external stimulation such as heat, sunlight exposure, air pollution, etc., capillary dilation is severe, and together with indiscriminate use of cosmetics will induce sensitive skin. In addition to those affected by genetic factors, people who do not pay attention to sun protection, excessive exposure to sunlight, indiscriminate use of cosmetics, and those who do not take reasonable care of themselves after cosmetic treatments are all potentially susceptible to sensitive skin.
Clinical Diagnostic Criteria for Sensitive Skin
Diagnosis is made from the patient’s subjective and objective symptoms. Patients with sensitive skin often subjectively feel redness and burning sensation on their skin, and are unable to tolerate ordinary skin care products. Objectively, I use the lactic acid test for judgment. A 5% lactic acid solution is applied to both sides of the nasolabial folds at the time points of 2 minutes and 30 seconds and 5 minutes, respectively, to see if there is an erythematous reaction, followed by the use of a four-point scale (0, 1, 2, 3). After the 2 minutes and 30 seconds and 5 minutes scores are added together, a score greater than 3 is diagnosed as sensitive skin, and its severity is also assessed.
In addition, with some equipment, such as under VISIA, it is possible to see how the redness of the skin capillaries changes, and the erythema as well as the capillary dilation is more pronounced in patients with sensitive skin than in normal people.
Pathogenesis of sensitive skin
There are many problems in the treatment of sensitive skin. When patients come to the clinic, our doctors usually use tacrolimus, glycopyrrolate, etc. However, often many doctors do not have a definite plan for treatment and are not mentally sure. For their part, patients believe that they do not need to see a doctor and can go directly to life beauty, while others will fear extreme treatment and resist skin care products or overly fetishize them.
Returning to the pathogenesis of sensitive skin, under the influence of various causes, whether they are pharmaceutical, laser, or even genetic, the first and foremost is the impaired skin barrier function. The meaning of the barrier: external resistance to external sunlight microbial anti-inflammatory substances, internal locking moisture, so that the skin is not easy to dry. After the barrier is damaged, the external stimulus will easily lead to redness of the skin, while the loss of the ability to retain water will lead to dryness and flaking, the blood vessels in the superficial dermis will expand, and the vascular nerves will be highly reactive. When these people are nervous, the blood vessels will expand and subsequently erythema papulosum will appear, and together with the nerve signal transmission, some inflammatory reactions will be formed.