Sensitive Skin in the Genital Area

Scratching the Surface: A Comprehensive Guide to Understanding and Managing Vulvovaginal Itching

Vulvovaginal itching is a common yet often under-recognized condition affecting women across all age groups. Despite its prevalence, many dermatologists receive minimal training in vulvar diseases, leading to delayed diagnoses and prolonged discomfort for patients. This review explores the broad spectrum of causes, including infections, inflammatory conditions, neuropathic disorders, and systemic illnesses. The complexity of vulvovaginal pruritus often requires a multidisciplinary approach to accurately diagnose and treat. Contributing factors such as hormonal changes, personal hygiene practices, and environmental exposures must also be considered. Treatment strategies typically begin with lifestyle modifications and topical therapies, such as corticosteroids and antifungals, but can extend to systemic medications and biologics for resistant cases. Additionally, nonpharmaceutical options such as sitz baths and psychological interventions can be crucial for managing chronic symptoms. However, there remains a significant gap in research, particularly regarding the characterization of female-specific pruritus and its long-term impact on quality of life. Despite some advances, the available studies largely focus on isolated causes rather than the holistic nature of the condition. Further research is urgently needed to develop comprehensive, evidence-based guidelines for diagnosing and treating vulvovaginal itching, a condition that has a profound effect on both physical and emotional well-being.

Probiotic knowledge of adults with cystic fibrosis is limited but is associated with probiotic use: A cross-sectional survey study

Background: Probiotics are used by people with cystic fibrosis (CF) and other chronic diseases to manage gastrointestinal symptoms. Aim: To describe probiotic knowledge; its relationship with probiotic use, probiotic information sources and factors influencing choice in adults with CF and a general population control group. Methods: A cross-sectional questionnaire study was conducted in adults with CF (n = 205) and Controls (n = 158). Probiotic knowledge was compared between CF and Controls using a knowledge score (maximum 5) based on predefined criteria: (1a) bacteria/microorganism; (1b) live; (2a) administered; (2b) adequate dose and (3) health benefit, using independent samples t-test. Two-way analysis of variance explored knowledge scores between CF and Control and between Ever User and Never User groups. Chi-square and Fisher's exact tests compared knowledge criterion, probiotic sources and influences on probiotic choice between groups. Thematic analysis of open-text responses explored probiotic-related knowledge and influences on probiotic decision making. Results: Knowledge scores (mean ± SD) did not differ between CF (1.70 ± 1.12) and Controls (1.89 ± 0.99), p = 0.13. Probiotic use was associated with knowledge score (p < 0.001). More CF Ever Users than Never Users correctly identified criteria 1a (65% vs. 38%), 1b (16% vs. 0%), 2a (45% vs. 22%) and 3 (73% vs. 42%) (all p < 0.005). CF participants considered 'dairy yoghurt' (69%), 'live cultures' (64%) and 'fermented foods' (37%) as 'all/mostly' probiotic sources. The internet was the commonest source of probiotic-related information. Conclusion: Probiotic knowledge and use were associated in adults with CF. Understanding of probiotic characteristics and sources were limited. Education is needed to help guide patient probiotic decision making.

Safety assessment of female sexual hygiene product containing cannabidiol in new zealand white rabbit and clinical trial

Cannabis is an herb known for its significant pharmacological effects. This study evaluated the safety of a female sexual hygiene product containing cannabidiol on the skin of experimental animals and humans. Irritation symptoms were tested using three female New Zealand white rabbits. In human trials, irritation and sensitivity symptoms were assessed in 30 healthy female volunteers. The results from the animal study indicated that body weight and clinical symptoms remained normal, with only slight irritation noted in the primary irritation index of the skin (PII = 0.6). In human trials, transepidermal water loss was observed during the induction phase but decreased over time. No abnormalities were found during the induction phase; however, irritation occurred during the challenge phase, which resolved after 8 h. It was concluded that the rinse-off product caused slight irritation when applied for more than 4 h in animals and 24 h in humans, which differs from its intended use of immediate rinse-off, where no irritation was observed.

Psychological Aspects of Sensitive Skin: A Vicious Cycle

Sensitive Skin Syndrome (SSS) has been the subject of intense research in the past several years. Recent reviews confirm that about 40% of the population report moderate or very sensitive skin, and an additional 30% report slightly sensitive skin. Although certain phenotypes are more susceptible, anyone can suffer from SSS and this condition can manifest in all anatomic sites. A wide variety of environmental and lifestyle factors can trigger SSS symptoms of itching, stinging, burning, pain, and tingling. In order to avoid such triggers, the SSS individuals often alter their behaviors and habits such as restricting their daily activities, and modifying the use of everyday products that non-sensitive individuals take for granted. In addition, there is an association between SSS and some common psychological problems. Sensitive skin symptoms such as itching, stinging, burning and pain can result in sleep disorders, fatigue, stress and anxiety. Conversely, lack of sleep and stress from external sources can make the SSS sufferer more prone to the symptoms. This becomes a vicious cycle that impacts consumers’ quality of life and well-being. We are beginning to understand the importance of the underlying causes that can impact skin conditions. However, in order to better understand the SSS individual, we need to also be aware of the psychological factors that can trigger and/or worsen this skin condition, as well as the psychological stresses the condition places on the individual.

Sensitive Skin Syndrome: A Low-Noise Small-Fiber Neuropathy Related to Environmental Factors?

Background and Objectives

Patients frequently complain of mild, transient, unpleasant skin sensations that cannot be diagnosed as common neuropathies. Dermatologists have termed these symptoms “sensitive skin syndrome.” This narrative review was performed for a better knowledge by other specialists.

Databases and Data Treatment

Publications on pain in sensitive skin syndrome were obtained from PubMed.

Results

There is a growing body of data supporting the concept that sensitive skin is a type of small-fiber neuropathy. The arguments are based on clinical data, a decrease in intra-epidermal nerve fiber density, quantitative sensory testing abnormalities and an association with irritable bowel syndrome and sensitive eyes. Sensitive skin is triggered by environmental factors. Sensitive skin is a frequent condition, with a lifetime prevalence of ~50% according to self-reports.

Conclusions

Mild levels of skin pain or itch are frequently experienced by patients, who rarely report them. There is a need for a better knowledge of sensitive skin because it can be the first level of small-fiber neuropathies.

Menstrual Products as a Source of Environmental Chemical Exposure: A Review from the Epidemiologic Perspective

PURPOSE OF REVIEW

Menstrual bleeding is a regular, common occurrence in a substantial portion of the population. Menstruators may use more than 10,000 menstrual products over the lifetime. Given the potential for environmental chemicals in menstrual products to be absorbed by the vulvar and vaginal epithelium into systemic circulation, we reviewed the available data on menstrual products as a source of environmental chemical exposure.

RECENT FINDINGS

Nearly two dozen studies have been conducted measuring environmental contaminants in menstrual products; all have detected environmental chemicals but had discrepant conclusions on exposure risks. Only three human studies have investigated menstrual product use and environmental chemical concentrations and all observed associations. Detection of environmental chemicals in menstrual products, in combination with challenges of exposure assessment, scarcity of human studies, and the exceedingly common occurrence of menstrual bleeding, motivates the need for further research. We provide recommendations to move this field forward.

Understanding the Sensitive Skin Subject to Achieve a More Holistic Diagnosis

Sensitive skin Syndrome (SSS) is a complex global clinical phenomenon that is defined by the self-reported presence of different sensory perceptions, including tightness, stinging, burning, tingling, pain and pruritus and often without objective signs. Due to the subjective nature of this clinical condition, the diagnosis is complex and there is often a disconnect between what subjects feel and what medical professionals can observe. This chapter reviews the known underlying physiology, some of the triggering factors associated with SSS, co-morbidities as well as the psychological impact on individuals suffering from this condition. The goal is to bridge the gap between the physicians’ understanding and the subjects’ perceptions of this real-life condition that affects so many.

The protective role of SOD1 overexpression in central mediation of bradycardia following chronic intermittent hypoxia in mice

Obstructive sleep apnea (OSA) is a highly prevalent sleep disorder that is associated with many cardiovascular complications. Similar to OSA, chronic intermittent hypoxia (CIH) (a model for OSA) leads to oxidative stress and impairs baroreflex control of the heart rate (HR) in rodents. The baroreflex arc includes the aortic depressor nerve (ADN), vagal efferent, and central neurons. In this study, we used mice as a model to examine the effects of CIH on baroreflex sensitivity, aortic baroreceptor afferents, and central and vagal efferent components of the baroreflex circuitry. Furthermore, we tested whether human Cu/Zn Superoxide Dismutase (SOD1) overexpression in transgenic mice offers protection against CIH-induced deficit of the baroreflex arc. Wild-type C57BL/6J and SOD1 mice were exposed to room air (RA) or CIH and were then anesthetized, ventilated, and catheterized for measurement of mean arterial pressure (MAP) and HR. Compared with wild-type RA control, CIH impaired baroreflex sensitivity but increased maximum baroreceptor gain and bradycardic response to vagal efferent stimulation. Additionally, CIH reduced the bradycardic response to ADN stimulation, indicating a diminished central regulation of bradycardia. Interestingly, SOD1 overexpression prevented CIH-induced attenuation of HR responses to ADN stimulation and preserved HR responses to vagal efferent stimulation in transgenic mice. We suggest that CIH decreased central mediation of the baroreflex and SOD1 overexpression may prevent the CIH-induced central deficit.