Sensitive skin: a complex and multifactorial syndrome

Many people complain of discomfort after application of commonly used skin care products, particularly to the face. This hyperreactivity of the skin is a non-immunologically mediated skin inflammation. It seems to be the result of an intolerance of the skin to various stimuli that are normally well tolerated. It is difficult to assess the prevalence of ‘sensitive skin’ and sensitive skin-related cosmetic intolerance because of the many possible exogenous and endogenous factors that trigger or aggravate this multifactorial syndrome. A thorough history is essential. Sometimes patch testing is needed both to standard allergens and also to all the patients’ cosmetics and skin care products. All cosmetics should be stopped and then reintroduced one by one, at intervals of one to two weeks. The number, type and frequency of the application of skin care products used in the final programme should remain limited. Some patients benefit from psychological or even psychiatric help. Management is usually difficult and all therapeutic measures should be undertaken with patience and tenacity.