DOI: https://dx.doi.org/10.18203/issn.2455-4529.IntJResDermatol20214924
Published: 2021-12-24

Expert consensus statement on diagnosis and management of sensitive skin in current clinical practice

Hema Pant, Nina Madnani, Sachin Dhawan, Anchala Parthasaradhi, M. K. Shetty, Maya Vedamurthy

Abstract


Sensitive skin is a very commonly seen entity in current dermatological practice that has a significant impact on quality of life. The pathophysiology, classification, diagnosis, and treatment of sensitive skin have evolved over the years, with new studies trying to bring about new robust evidence about the same. The current consensus aims at providing a comprehensive overview on evidence and experience-based approaches for sensitive skin. A total of 35 experts in the field of clinical dermatology participated in expert group meetings organized via teleconference webinar. Current evidence elaborating various aspects like classification, diagnosis, and management of sensitive skin along with clinical experience of experts were discussed in detail. The prerequisites for selecting suitable products, importance of cosmeceuticals as adjunctive therapy and the need for avoiding triggering factors in individuals with sensitive skin as well as associated dermatological disorders were also described. In addition to medical history, physical examination and routine investigations, a draft checklist and its clinical relevance in accurately diagnosing sensitive skin were emphasized upon by the experts. The overall management encompasses avoidance of individual trigger factors, thorough topical therapy using mild, non-irritating ingredients along with adjunctive therapies like moisturizers, sunscreens, and cleansers. The “two-week” strategy was described to be a useful approach for treating sensitive skin. This review article provides a consensus clinical viewpoint of expert dermatologists for effective evaluation, differential diagnosis and appropriate pharmacological as well as non-pharmacological management of sensitive skin in Indian subjects.


Keywords


Sensitive skin, Cleanser, Moisturizer, Sunscreen

Full Text:

PDF

References


Farage MA. The prevalence of sensitive skin. Front Med (Lausanne). 2019;6:98.

Inamadar AC, Palit A. Sensitive skin: An overview. Indian J Dermatol Venereol Leprol. 2013;79:9-16.

Duarte IAG, Silveira JEPS, Hafner MFS, Toyota R, Pedroso DMM. Sensitive skin: review of an ascending concept. An Bras Dermatol. 2017;92:521-5.

Lev-Tov H, Maibach HI. The sensitive skin syndrome. Indian J Dermatol. 2012;57:419-23.

Brenaut E, Misery L, Taieb C. Sensitive skin in the Indian population: An epidemiological approach. Front Med (Lausanne). 2019;6:29.

Farage MA. Sensitive skin in the genital area. Front Med (Lausanne). 2019;6:96.

Misery L, Ständer S, Szepietowski JC, Reich A, Wallengren J, Evers AW, et al. Definition of sensitive skin: An expert position paper from the special interest group on sensitive skin of the International Forum for the Study of Itch. Acta Derm Venereol. 2017;97:4-6.

Misery L, Weisshaar E, Brenaut E, Evers AWM, Huet F, Ständer S, et al. Pathophysiology and management of sensitive skin: position paper from the special interest group on sensitive skin of the International Forum for the Study of Itch (IFSI). J Eur Acad Dermatol Venereol. 2020;34:222-9.

Huet F, Misery L. Sensitive skin is a neuropathic disorder. Exp Dermatol. 2019;28:1470-3.

Pons-Guiraud A. Sensitive skin: a complex and multifactorial syndrome. J Cosmet Dermatol. 2004;3:145-8.

Muizzuddin N, Marenus KD, Maes DH. Factors defining sensitive skin and its treatment. Am J Contact Dermat. 1998;9:170-5.

Kligman AM, Sadiq I, Zhen Y, Crosby M. Experimental studies on the nature of sensitive skin. Skin Res Technol. 2006;12:217-22.

Yokota T, Matsumoto M, Sakamaki T, Hikima R, Hayashi S, Yanagisawa M, et al. Classification of sensitive skin and development of a treatment system appropriate for each group. IFSCC Mag. 2003;6:303-7.

Guerra-Tapia A, Serra-Baldrich E, Prieto Cabezas L, González-Guerra E, López-Estebaranz JL. Diagnosis and treatment of sensitive skin syndrome: An algorithm for clinical practice. Actas Dermosifiliogr. 2019;110:800-8.

Lazzarini R, Duarte I, Ferreira AL. Patch tests. An Bras Dermatol. 2013;88:879-88.

Shin WU, Baek YS, Kim TJ, Oh CH, Kim J. Laboratory tests and compliance of dermatologic outpatients. F1000Res. 2013;2:206.

Do LHD, Azizi N, Maibach H. Sensitive skin syndrome: An update. Am J Clin Dermatol. 2020;21:401-9.

Akinboro AO, Adelufosi AO, Onayemi O, Asaolu SO. Body dysmorphic disorder in patients attending a dermatology clinic in Nigeria: sociodemographic and clinical correlates. An Bras Dermatol. 2019;94:422-8.

Berardesca E, Farage M, Maibach H. Sensitive skin: an overview. Int J Cosmet Sci. 2013;35:2-8.

Sethi A, Kaur T, Malhotra SK, Gambhir ML. Moisturizers: The slippery road. Indian J Dermatol. 2016;61:279-87.

Mukhopadhyay P. Cleansers and their role in various dermatological disorders. Indian J Dermatol. 2011;56:2-6.

Latha MS, Martis J, Shobha V, Sham Shinde R, Bangera S, Krishnankutty B, et al. Sunscreening agents: a review. J Clin Aesthet Dermatol. 2013;6:16-26.

Sunscreens and Photoprotection. Available at: https://www.ncbi.nlm.nih.gov/books/NBK537164/. Accessed on 21 August 2020.

Draelos ZD. Sensitive skin: perceptions, evaluation, and treatment. Am J Contact Dermat. 1997;8:67-78.

Papier A, Strowd LC. Atopic dermatitis: a review of topical nonsteroid therapy. Drugs Context. 2018;7:212521.

Bowes L. Using cosmeceutical ingredients and combination regimens for sensitive skin. J Aesth Nurs. 2017;6:522-9.

Martin KI, Glaser DA. Cosmeceuticals: the new medicine of beauty. Mo Med. 2011;108:60-3.

Zaenglein AL, Pathy AL, Schlosser BJ, Alikhan A, Baldwin HE, Berson DS, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2016;74:945-73.

Fox L, Csongradi C, Aucamp M, du Plessis J, Gerber M. Treatment modalities for acne. Molecules. 2016;21:1063.

Rathi SK. Acne vulgaris treatment: the current scenario. Indian J Dermatol. 2011;56:7-13.

Goh CL, Noppakun N, Micali G, Azizan NZ, Boonchai W, Chan Y, et al. Meeting the challenges of acne treatment in Asian patients: A review of the role of dermocosmetics as adjunctive therapy. J Cutan Aesthet Surg. 2016;9:85-92.

Levin J, Miller R. A Guide to the ingredients and potential benefits of over-the-counter cleansers and moisturizers for rosacea patients. J Clin Aesthet Dermatol. 2011;4:31-49.

Rivero AL, Whitfeld M. An update on the treatment of rosacea. Aust Prescr. 2018;41:20-4.

Desai SR. Hyperpigmentation therapy: a review. J Clin Aesthet Dermatol. 2014;7:13-7.

Sarkar R, Arora P, Garg KV. Cosmeceuticals for hyperpigmentation: What is available? J Cutan Aesthet Surg. 2013;6:4-11.

Gary G. Optimizing treatment approaches in seborrheic dermatitis. J Clin Aesthet Dermatol. 2013;6:44-9.

Purnamawati S, Indrastuti N, Danarti R, Saefudin T. The role of moisturizers in addressing various kinds of dermatitis: A review. Clin Med Res. 2017;15:75-87.

Baysal V, Yildirim M, Ozcanli C, Ceyhan AM. Itraconazole in the treatment of seborrheic dermatitis: a new treatment modality. Int J Dermatol. 2004;43:63-6.

Piquero-Casals J, Hexsel D, Mir-Bonafé JF, Rozas-Muñoz E. Topical non-pharmacological treatment for facial seborrheic dermatitis. Dermatol Ther (Heidelb). 2019;9:469-77.

Lee JH, Son SW, Cho SH. A comprehensive review of the treatment of atopic eczema. Allergy Asthma Immunol Res. 2016;8:181-90.

Cheong WK. Gentle cleansing and moisturizing for patients with atopic dermatitis and sensitive skin. Am J Clin Dermatol. 2009;10(1):13-7.

Hon KL, Kung JSC, Ng WGG, Leung TF. Emollient treatment of atopic dermatitis: latest evidence and clinical considerations. Drugs Context. 2018;7:212530.

Godse K, Zawar V. Sensitive scalp. Int J Trichology. 2012;4:102-4.

Lahiri K, Coondoo A. Topical steroid damaged/dependent face (TSDF): An entity of cutaneous pharmacodependence. Indian J Dermatol. 2016;61:265-72.

Kakkar S, Sharma PK. Topical steroid-dependent face: Response to xylometazoline topical. Indian J Drugs Dermatol. 2017;3:87-9.

Seite S. Thermal waters as cosmeceuticals: La Roche-Posay thermal spring water example. Clin Cosmet Investig Dermatol. 2013;6:23-8.

Kerscher M, Buntrock H. Treatments for sensitive skin. In: Honari G, Andersen R, Maibach HL, eds. Sensitive skin syndrome. CRC Press. 2017.

Castillo DE, Keri JE. Chemical peels in the treatment of acne: patient selection and perspectives. Clin Cosmet Investig Dermatol. 2018;11:365-72.

Loesch MM, Somani AK, Kingsley MM, Travers JB, Spandau DF. Skin resurfacing procedures: new and emerging options. Clin Cosmet Investig Dermatol. 2014;7:231-41.

Anitha B. Prevention of complications in chemical peeling. J Cutan Aesthet Surg. 2010;3:186-8.