Clinical and Instrumental Exploration of Sensitive Skin in a Pediatric Population

Abstract

Studies on sensitive skin pathophysiology in infants are challenging because most assessment methods require self-reporting of signs. In this study, we aimed to identify and characterize sensitive skin in children for the first time. A newly developed parent-reported questionnaire was used to recruit children with sensitive skin. This questionnaire was also tested on an adult group. Hydration, transepidermal water loss (TEWL), and inflammatory markers (cytokines, and polyunsaturated fatty acids (PUFAs)) were quantified. A total of 77 children and 20 adults (33 and 10 with sensitive skin, respectively) were recruited. The groups with sensitive skin had more clinical signs of skin dryness. Skin hydration was lower in children in the sensitive compared with the nonsensitive skin group. TEWL levels were similar between sensitive and nonsensitive subjects in both infant and adult groups. Sensitive skin exhibited higher levels of cytokines and proinflammatory PUFAs as well as lower levels of anti-inflammatory PUFAs. Sensitive skin syndrome was associated with normal skin barrier function but lower hydration in infants and children. The higher levels of proinflammatory markers suggest that sensitive skin is associated with low-level inflammation. It is hypothesized, for the first time, that PUFAs are involved in sensitive skin syndrome in infants.

Can Performance and Gentleness Be Reconciled? A Skin Care Approach for Sensitive Skin

“…Assessing the rebalancing effect of skincare routines is worth considering, bearing in mind the overlap of several preservative systems within a routine. More recently, cytokines and polyunsaturated fatty acid (PUFA) sampled in vivo, have been shown to be relevant inflammatory markers of sensitive skin in a paediatric cohort [4]. The lactic acid test used in this study remains a relevant trigger, as seen with its larger effect upon brain activity for people with sensitive skin [31], and provides evidence of a stronger resilience of the skin towards chemical stimuli.…”

“…Skin barrier defect is a frequently cited attribute of sensitive skin [3], notably as a more permeable skin would be more prone to react to external stimuli. Levels of inflammatory biomarkers such as cytokines, proinflammatory PUFAs and prostaglandin E2 are hallmarks of sensitive skin [4,5]. There is nowadays a greater emphasis on the skin's nociception capabilities, or transduction of noxious stimuli to nerve fibre free endings located in the epidermis, to explain the pathophysiology of sensitive skin.…”

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

“… 17 , 22–30 Among them, it was found that Chinese females subjected to semisubjective tests (LAST/CAT) showed higher TEWL values on the cheek. Additionally, ten studies showed no difference in the values on the cheek, 33 , 35 face, 27 , 28 , 37 , 38 , 40 forearm, 34 , 36 , 37 body 34 , 35 or hand. 39 …”

“… 22 , 23 , 25–33 , 36 , 38–43 , 45 In cross-sectional and cohort studies, a wide range of skin capacitance values was reported (16.7–80.3 AU). 23 , 25 , 26 , 28 , 29 , 32 , 33 , 36 , 40–43 Among the case–control studies, four articles clearly reported lower SCH values in subjects with SS or stingers at different facial sites (forehead, cheek, nasolabial fold, and chin). 22 , 27 , 30 , 45 Of these, two studies used questionnaires, 22 , 30 one used LAST, 45 and one used both questionnaires and LAST.…”