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.
Highlights
Sensitive skin is a syndrome defined by “the occurrence of unpleasant sensations in response to stimuli that normally should not provoke such sensations” [1]
As questionnaires developed in adults [6,7] are not transposable to infants, we developed a new questionnaire, which was designed for the identification of sensitive skin in infants according to the parent description of skin reactions to multiple triggers grouped into three main categories
We show that sensitive skin presents greater levels of scaling and roughness than nonsensitive skin, in line with our hypothesis that sensitive skin may stem from altered stratum corneum and corneocyte cohesion, which leads to a subtle imbalance in the regulation of water homeostasis in sensitive skin
Summary
Sensitive skin is a syndrome defined by “the occurrence of unpleasant sensations in response to stimuli that normally should not provoke such sensations” [1]. Sensitive skin syndrome is mostly characterized by objective skin signs, such as skin redness, as well as by a number of perceived and subjective sensations, such as stinging, burning, pain, pruritus, and tingling sensations [1]. While the physiology of sensitive skin in adults remains unclear, this syndrome has been associated with impaired skin barrier function [8,9] in a number of studies, while this association was not identified in others [10,11]. A recent study performed using confocal Raman spectroscopy did not discover any alterations in the skin barrier of sensitive skin in terms of stratum thickness, water, natural moisturizing factors (NMFs), or ceramide/fatty-acid content [14]
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