Sensitive Skin Unit

Sensitive skin is characterised by a persistent sensation of itching, tightness, burning, stinging and even pain in response to stimuli that do not cause abnormal reactions in healthy skin. These sensations may vary in intensity and may be accompanied by erythema (redness), telangiectasia or couperosis (small superficial red blood vessels). However, visible signs are not always present, which is why sensitive skin can be particularly difficult to diagnose.

Symptoms most commonly appear on facial skin, especially in the nasolabial fold—the area extending from the sides of the nose to the corners of the mouth. However, sensitive skin frequently affects other areas, including the hands, scalp, feet, neck, décolletage, back and genital region.

The face is particularly vulnerable because it is exposed to a higher number of potentially irritating cosmetic products, is more affected by environmental factors, and has a thinner stratum corneum (the outermost layer of the epidermis), making it more delicate.

Sensitive skin is believed to result from hypersensitivity of the skin’s nerve endings, which transmit pain signals in response to stimuli that are normally harmless. Sensitive or intolerant skin appears to secrete excessive cytokines via certain neurotransmitters located in superficial nerve endings, promoting the inflammatory response characteristic of this condition.

In addition, some research indicates that sensitive skin is associated with increased levels of free radicals—by-products of cellular metabolism linked to oxidative stress and skin ageing.

Ultimately, the underlying cause of sensitive skin symptoms is disruption of the skin barrier—the lipid-and-water structure that covers the skin and acts as a protective shield against dehydration and external irritants. When this barrier is compromised, the stratum corneum becomes more permeable and therefore more susceptible to substances that would not normally cause irritation.

This type of barrier dysfunction is similar to that observed in other dermatological conditions, such as atopic dermatitis and seborrhoeic dermatitis. Some studies also suggest that sensitive skin may have an underlying immunological and inflammatory component related to other dermatological diseases, increasing skin reactivity and favouring the development of sensitivity. The skin conditions most frequently associated with sensitive skin include acne, contact dermatitis, psoriasis, vitiligo, atopic dermatitis and seborrhoeic dermatitis.

Although not all mechanisms are fully understood, sensitive skin symptoms may be triggered by a wide range of internal and external factors. The most relevant include:

Inappropriate hygiene and cosmetic products

The use of cosmetic or hygiene products not formulated for sensitive skin—or the simultaneous use of multiple potentially irritating ingredients—is the most common trigger, particularly among women. Ingredients with a higher irritant potential include propylene glycol, trichloroacetic acid, alpha-hydroxy acids (AHAs), retinol and alcohol, among others.

Aggressive hygiene routines

While cosmetics are the most common trigger in women, facial shaving is a frequent trigger in men. Prolonged hot showers, excessive use of soap or cleansing products, overuse of exfoliants, rough sponges or exfoliating gloves also increase the risk of symptoms in sensitive skin.

Chemical exposure

Occupations involving prolonged exposure to chemicals or detergents may trigger sensitive skin symptoms.

Environmental factors

Cold, wind, extreme heat, sun exposure, pollution and any climatic factor that promotes transepidermal water loss can trigger symptoms. Heating systems, air conditioning and climate control systems are also common aggravating factors.

Diet

Alcohol, spices, hot or spicy foods may exacerbate symptoms in individuals with sensitive or reactive skin, particularly on the face and neck.

Very dry skin

Individuals with extremely dry skin and low lipid content are more prone to skin barrier disruption and, consequently, to sensitive skin symptoms.

Dermocosmetic procedures

Certain facial rejuvenation treatments that accelerate skin renewal by removing superficial layers may disrupt the skin barrier and trigger sensitivity. These include chemical peels, dermabrasion and laser resurfacing.

Other factors

Certain topical medications, textiles, medical dressings, frequent contact with powdered detergents or household cleaning products, anxiety and stress may also act as triggers.

The content of this page has been prepared by the Communication Department and the Medical Team of Grupo Pedro Jaén, in line with our editorial commitment to ensuring the accuracy and up-to-date nature of the information provided.

References on sensitive skin:

1. Berardesca E, Farage M, Maibach H. Sensitive skin: an overview. Int J Cosmet Sci. 2013 Feb;35(1):2-8. doi: 10.1111/j.1468-2494.2012.00754.x. Epub 2012 Sep 21. PMID: 22928591.

2. Farage MA, Maibach HI. Sensitive skin: closing in on a physiological cause. Contact Dermatitis. 2010 Mar;62(3):137-49. doi: 10.1111/j.1600-0536.2009.01697.x. PMID: 20565500.

3. Inamadar AC, Palit A. Sensitive skin: an overview. Indian J Dermatol Venereol Leprol. 2013 Jan-Feb;79(1):9-16. doi: 10.4103/0378-6323.104664. PMID: 23254724.

4. 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 (Engl Ed). 2019 Dec;110(10):800-808. English, Spanish. doi: 10.1016/j.ad.2018.10.021. Epub 2019 May 27. PMID: 31146882.

5. Escalas-Taberner J, González-Guerra E, Guerra-Tapia A. La piel sensible: un síndrome complejo [Sensitive skin: a complex syndrome]. Actas Dermosifiliogr. 2011 Oct;102(8):563-71. Spanish. doi: 10.1016/j.ad.2011.04.011. Epub 2011 Jul 14. PMID: 21757181.