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Sensitive Skin vs Rosacea

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An article published in the Chinese Medical Journal states that Sensitive Skin (SS) should be a differential diagnosis from Rosacea, concluding, “The pathogenesis, medication, and prognosis of rosacea and SS are quite different, so it is necessary to find reliable non-invasive method to differentiate between the two conditions.” [1]

"Sensitive skin is a skin condition in which skin is prone to itching and irritation experienced as a subjective sensation when using cosmetics and toiletries. When questioned, over 50% of women in the UK and US, and 38% of men, report that they have sensitive skin." [2]

"Using the Delphi method, sensitive skin was defined as 'A syndrome defined by the occurrence of unpleasant sensations (stinging, burning, pain, pruritus, and tingling sensations) in response to stimuli that normally should not provoke such sensations. These unpleasant sensations cannot be explained by lesions attributable to any skin disease. The skin can appear normal or be accompanied by erythema. Sensitive skin can affect all body locations, especially the face'." [3]. 

Some authorities propose listing SS as a syndrome, stating, "Moreover, the presence of erythema in patients with sensitive skin does not imply that the erythema is due to sensitive skin, as sensitive skin is sometimes associated with skin diseases, particularly atopic dermatitis (AD). AD is not the only dermatosis that can be associated with sensitive skin; in fact, some authors propose to define a subcategory of sensitive skin associated with dermatological diseases (for example: AD, rosacea, psoriasis, seborrhoeic dermatitis, acne, etc.)." [3]

"SS is defined as a syndrome defined by the appearance of unpleasant sensations (stinging, burning, pain, pruritus, and tingling sensations) in response to stimuli that would not normally cause such sensations..." [4]

"Sensitive skin syndrome (SSS) is a common and challenging condition, yet little is known about its underlying pathophysiology. Patients with SSS often present with subjective complaints of severe facial irritation, burning, and/or stinging after application of cosmetic products. These complaints are out of proportion to the objective clinical findings. Defined as a self-diagnosed condition lacking any specific objective findings, SSS is by definition difficult to quantify and, therefore, the scientific community has yet to identify an acceptable objective screening test...Defined as a self-diagnosed condition, SSS is by definition difficult to quantify. Some of the contradictions between investigators could be explained by flawed methodologies since the scientific community has yet to identify an acceptable objective screening test for sensitive skin...SSS is very common and poses a challenge to physicians and patients alike. We are still far from understanding the underlying mechanisms involved. Therefore, more basic science research is warranted. " [5]

It is common for rosaceans to complain of sensitive skin and the line between sensitive skin and rosacea is very thin. Do you want the RRDi to sponsor some investigative clinical research into sensitive skin and rosacea? Could 10K members of the RRDi each donate one dollar to sponsor such research?  

End Notes

[1] Chin Med J (Engl). 2020 Aug 5.  doi: 10.1097/CM9.0000000000001001. 
A predictive model for differential diagnosis between rosacea and sensitive skin: a cross-sectional study
Xiao-Yan Wang, Yun-Yi Liu, Yi-Xuan Liu, Wei-Wei Ma, Jia-Wen Zhang, Zi-Jing Liu, Juan Liu, Bing-Rong Zhou, Yang Xu


[2] Sensitive Skin, Wikipedia

Allergic Dermatitis Image Courtesy of Wikimedia Commons

[3] ActaDV
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 Laurent Misery, Sonja Ständer, Jacek C. Szepietowski, Adam Reich, Joanna Wallengren, Andrea W. M. Evers, Kenji Takamori, Emilie Brenaut, Christelle Le Gal-Ianotto, Joachim Fluhr, Enzo Berardesca, Elke Weisshaar

[4] Sensitive Skin and Rosacea

[5] Indian J Dermatol. 2012 Nov-Dec; 57(6): 419–423.doi: 10.4103/0019-5154.103059
The Sensitive Skin Syndrome
Hadar Lev-Tov and Howard I Maibach

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