Development and validation of a prospective questionnaire for assessing oily sensitive skin

BACKGROUND

Skin type has a strong influence on how sensitive skin develops, with oily skin accounting for a larger proportion of sensitive skin. However, there has not been a scientifically sound questionnaire for determining oily sensitive (OS)-type skin in prior studies.

OBJECTIVES

In order to identify OS-type skin in the general population, we therefore intend to create an OS-type skin evaluation questionnaire, develop various thresholds through data analysis and classify skin based on two dimensions of sensitivity and oiliness.

METHODS

A questionnaire with questions regarding subjects' basic information, skin oiliness and skin sensitivity was given to each individual who participated in the study (n = 1297). To define the thresholds for OS-type skin, receiver-operating characteristic (ROC) curves were generated. The results of the lactic acid stinging test (LAST) and noninvasive instrument information obtained were compared with the thresholds mentioned above to verify the effectiveness of this tool.

RESULTS

According to the ROC curves, questionnaire cut-off values of 11.5, 20.5 and 29.5 can be used to detect mildly, moderately and severely sensitive skin, respectively. In addition, the questionnaire cut-off values of 22.5 and 31.5 can be used to detect moderately and severely oily skin, respectively. According to our study, the four sensitive-skin groups' LAST scores differed significantly from one another, while the skin sebum levels differed significantly between the three oily groups. Additionally, the EI and LAST scores were significantly correlated with skin sensitivity levels, whereas sebum, moisture and EI were positively correlated with skin oiliness levels.

CONCLUSIONS

We developed an OS-type skin evaluation questionnaire that has been tested and shown scientifically to be a promising method for evaluating OS-type skin and to completely examine the traits of sensitive and oily skin.

A review of factors influencing sensitive skin: an emphasis on built environment characteristics

Background

Sensitive skin (SS) is a condition characterized by hyperreactivity. Impacting around 37 percent of the worldwide population and exerting an influence on the quality of life for affected individuals. Its prevalence rate has increased due to factors such as elevating stress levels and deteriorating environmental conditions. The exposome factors influencing SS have extended from demographic, biological attributes, and lifestyle to external environments. Built environments (BEs) have demonstrated as root drivers for changes in behaviors and environmental exposure which have the potential to trigger SS, but the review of the associations between BEs and SS is currently lacking.

Objective

This review aims to achieve two primary objectives: (1) Examine exposome factors that exert influence on SS at the individual and environmental levels. (2) Develop a theoretical framework that establishes a connection between BEs and SS, thereby offering valuable insights into the impact of the built environment on this condition.

Methods

An extensive literature search was carried out across multiple fields, including sociology, epidemiology, basic medicine, clinical medicine, and environmental research, with a focus on SS. To identify pertinent references, renowned databases such as PubMed, Web of Science, and CNKI were utilized.

Results

SS is the outcome of interactions between individual attributes and environmental factors. These influencing factors can be categorized into five distinct classes: (1) demographic and socioeconomic characteristics including age, gender, and race; (2) physiological and biological attributes such as emotional changes, skin types, sleep disorders, and menstrual cycles in women; (3) behavioral factors, such as spicy diet, cosmetic use, alcohol consumption, and physical exercise; (4) natural environmental features, including climate conditions and air pollution; (5) built environmental features such as population density, green space availability, road network density, and access to public transportation, also have the potential to affect the condition.

Conclusion

The importance of interdisciplinary integration lies in its ability to ascertain whether and how BEs are impacting SS. By elucidating the role of BEs in conjunction with other factors in the onset of SS, we can provide guidance for future research endeavors and the formulation of interventions aimed at mitigating the prevalence of SS.

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

Sensitive skin (SS) is a common cutaneous condition that seriously affects people's quality of life, but studies of sensitive skin pathogenesis are unclear, the exploration are ongoing, and the biophysical properties of sensitive skin disagree with the study results. In this paper, we summarize the noninvasive biophysical and imaging instrumental methods used for sensitive skin and provide support for the classification of sensitive skin subtypes to prescribe precise treatment. PubMed and Web of Science databases were searched according to PRISMA guidelines for articles from January 1971 to May 2022 that used noninvasive biophysical or imaging methods to monitor adult subjects with sensitive skin. The quality of the included articles was determined based on 22 items of the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) statement. A total of 55 studies were included, representing 8 biophysical and 5 imaging methods and their applications in treatment efficacy evaluation studies. The biophysical parameter and cutaneous morphological property changes in sensitive skin subjects were observed. The quality of the studies was relatively low, and there was high variability in results between studies. Several parameters have shown tremendous potential in exploring the pathogenesis with different sensitive skin subtypes: type I may be detected with higher transepidermal water loss and lower stratum corneum hydration values, as well as with thinner epidermis with a shallower and more irregular honeycomb structure; Type II and III are more prone to higher blood flow, lower current perception threshold than normal skin. This systematic review identifies key reasons for the lack of uniform trends in noninvasive measurements and recommends the use of effective selection instruments or relevant parameters to explore the pathogenesis of sensitive skin, and to differentiate the subtypes of sensitive skin for achieving the precise treatment.

Burden of Sensitive Skin (BoSS) Questionnaire and Current Perception Threshold: Use as Diagnostic Tools for Sensitive Skin Syndrome

The assessment of sensitive skin syndrome, characterized by subjective unpleasant sensations, remains a challenge, since there is no international consensus on the best diagnostic tools. This study evaluated the combination of the Burden of Sensitive Skin (BoSS) questionnaire and the current perception threshold as diagnostic tools for sensitive skin syndrome, and the relationship between BoSS and the subjects’ smoking status, phototype and skin type. A total of 100 women completed the BoSS questionnaire, and current perception threshold was measured on the face. The BoSS score was significantly higher in the self-reported sensitive skin group compared with the non-sensitive skin group (25.61 vs 14.05; p < 0.001), and in non-smokers vs smokers (23.00 vs 18.37; p < 0.05). In addition, the current perception threshold values were similar between the sensitive and non-sensitive groups. These results suggest that BoSS is a better diagnostic tool for sensitive skin syndrome than the current perception threshold, and that smokers less frequently have sensitive skin than do non-smokers.

Demodex infestation as a cause of sensitive skin in a dermatology outpatient clinic

BACKGROUND

Sensitive skin is subjective cutaneous hyperreactivity to environmental factors. Demodicosis is a skin disorder caused by Demodex mites. There may be a link between demodicosis and sensitive skin.

AIM

This study aimed to examine facial Demodex mites density and other factors associated with sensitive skin in patients.

METHODS AND METHODS

A total of 349 randomly selected patients presented to the dermatology department. The research data were collected using a questionnaire form that included the participants' sociodemographic and lifestyle characteristics, a sensitive skin questionnaire, the Dermatology Life Quality Index (DLQI), and European Health Interview Survey (EHIS). Patients underwent standardized superficial skin surface biopsy of 4 areas of the face. D. folliculorum count greater than 5 mites/cm² was considered positive.

RESULTS

In relation to Demodex, there was an increase in skin sensitivity with higher Demodex density (p = 0.04). There was a statistically significant, weak positive correlation between skin sensitivity and DLQI score (r = 0.33, p = 0.00), and there was also a significant but very weak negative correlation between skin sensitivity and EUROHIS (r = -0.164, p = 0.002). Skin sensitivity was more common in patients with a concomitant dermatological disease (p = 0.01) and increased with more frequent cosmetic use (p = 0.00).

CONCLUSION

Alongside other risk factors, for the patients presenting with complaints of sensitive skin, investigating Demodex population density may help alleviate sensitive skin symptoms with appropriate therapies and preventive measures.

Relationship between sensitive skin and sleep disorders, fatigue, dust, sweating, food, tobacco consumption or female hormonal changes: Results from a worldwide survey of 10 743 individuals

BACKGROUND

Sensitive skin is related to environmental factors.

OBJECTIVES

We aimed to investigate the roles of poorly known associated and triggering factors on sensitive skin in a large global population.

METHODS

A survey was administrated to a representative sample of the adult population aged 18-75 years in five different countries (Brazil, China, France Russia, and the United States). All participants answered a web-based questionnaire on sociodemographic characteristics, sensitive skin and environmental factors.

RESULTS

Among the 10 743 included individuals (5285 men and 5458 women), 48.2% declared that they had sensitive skin. The group with sensitive skin reported significant increases in fatigue, dust or sweating and to a lesser extent food or tobacco consumption. The members of this group also declared that they experienced more sleep disorders than individuals without sensitive skin. Sensitive skin was very frequent in pregnant women, women with painful menstruations or women using contraceptive pills.

CONCLUSIONS

This large cohort study identified new factors, including female hormonal status, fatigue, sleep disorders and food, associated with sensitive skin. These associations suggest that sensitive skin is not restricted to an epidermal disorder but may be included in a larger context. The identified factors are potential upstream drivers of neurogenic inflammation in sensitive skin.

Influence of family history, body mass index, selected dietary factors, personal habits, and menstrual history on oily skin in young women

BACKGROUND

Sebum secretion is affected by many internal and external factors.

OBJECTIVE

To identify risk factors in terms of family history, body mass index, selected dietary factors, personal habits, and menstrual history that may be associated with oily skin in young women.

PARTICIPANTS AND METHODS

We conducted a case-control study of young women aged 18-35 who came to Beijing Tongren Hospital for attending a health checkup. Cases were subjects with subjective skin type as oily skin. Control subjects were people with normal or dry skin. A standardized questionnaire on subjective skin type, family history of oily skin in first-degree relatives, menstrual history, personal habits, and selected dietary factors was administered to 540 subjects. Univariate and multivariate logistic regression analyses were performed for risk factors associated with oily skin.

RESULTS

A family history in first-degree relatives and a body mass index of more than 24 kg/m² were risk factors that increases likelihood of oily skin in young women (odds ratio 3.281, 95% confidence interval 2.204-4.882; odds ratio 1.677, 95% confidence interval 1.081-2.600, respectively). For those who consumed more than three servings of milk or sweets per week, the risk increased with the diet (odds ratio 1.634, 95% confidence interval 1.126-2.370; odds ratio 1.970, 95% confidence interval 1.034-3.754, respectively). There was no correlation between smoking, drinking alcohol, or menstrual variables and the risk of oily skin.

CONCLUSIONS

Family history, overweight and obesity, and a diet rich in milk or sweets are risk factors that increase likelihood of oily skin in young women. These findings may provide an opportunity to better guide skin care for patients.

Sensitive Skin in the Genital Area

When evaluating sensitive skin, it is common to focus on the face. However, it is becoming increasingly clear that individuals can have different perceptions about the degree of skin sensitivity at distinct anatomic sites. Structural variations in the skin of different body sites can contribute to differences in barrier function, which may contribute to differences in skin sensitivity. Potential triggering factors for skin sensitivity would be expected to vary by body site. For example, the face is exposed to all ambient environmental conditions in the course of daily life, and to several products (e.g., cosmetics for women) and practices (e.g., shaving for men) that may lead to adverse sensations associated with sensitive skin. In contrast, the skin of the genital area is protected from ambient environmental conditions. However, the genital area can be exposed to conditions of higher temperature, different habits and practices and moisture due to the semi-occlusive environment. For some individuals, additional challenges such as incontinence can provide triggering factors for skin sensitivity that effect only the genital area. This article reviews data on the perception of sensitive skin of the genital area, differences based on gender, age, racial differences, and the effects of incontinence on skin sensitivity. The effects of menopause are also considered with regards to sensitive skin perceptions and to emerging differences in biomolecular and physical measures of the urogenital skin.

The Prevalence of Sensitive Skin

Sensitive skin has been described as unpleasant sensory responses to stimuli that should not provoke such sensations. Objectively measurable signs of irritation are not always present in individuals with sensitive skin, however, subjective sensory effects such as, itching, burning, stinging, tightness, and dryness, are consistently present. Given the subjective nature of the phenomenon known as sensitive skin, surveys have been a popular approach to evaluating the prevalence of this condition among the general population, and a number of them have been conducted worldwide. Overall, ~60–70% of women and 50–60% of men report having some degree of sensitive skin. However, there are differences between populations in various geographies, and perceptions of sensitive skin at specific anatomic sites. This article is a review of survey data on the prevalence of self-declared sensitive skin in various geographies, among different gender and age groups, and at various anatomic sites. In addition, we review the factors that may contribute to sensitive skin, and the physiological characteristics associated with this condition, including impaired barrier function and heightened neural reactions.

Sensitive skin in France: a study on prevalence, relationship with age and skin type and impact on quality of life

BACKGROUND

Many epidemiological studies have been performed, but a potential increase in the prevalence of sensitive skin, its relationship with age and skin type and the impact of sensitive skin on quality of life are still debated.

OBJECTIVE

To answer these unresolved questions.

METHODS

An opinion poll was conducted on a representative French 5000 person sample.

RESULTS

Fifty-nine per cent of the people declared very sensitive or fairly sensitive skin (together: sensitive skin), and women (66%) declared sensitive skin more frequently than men (51.9%). The results also showed that sensitive skin is more common (more than 60%) in younger people (<35 years old), and there was a decrease in the following age groups. The univariate analysis demonstrated that sensitive skin was more likely to be reported by people with fair skin (OR = 1.83) and by people with an atopic predisposition (OR = 2.51). The risk of sensitive skin is higher for people with dry skin (OR = 6.18 compared with normal skin), but sensitive skin can occur in other skin types (OR = 2.45 for mixed skin and OR = 2.16 for greasy skin). Quality of life was clearly altered in patients with sensitive skin, as assessed by SF-12 and DLQI.

CONCLUSION

This large study demonstrates that sensitive skin can alter quality of life and is more common in young people and in women as well as patients with dry skin or fair skin or an atopic predisposition. It also suggests that there is an increase in the prevalence of sensitive skin.