The Skin Irritations of Corrosive and Non-corrosive Irritants in Patients with Sensitive Skin / 대한피부과학회지

ABSTRACT

BACKGROUND: Sensitive skin is largely agreed to be a lay term used by individuals who have reduced tolerance to frequent or prolonged use of cosmetics and toiletries, with symptoms ranging from subjective neurosensory forms of discomfort such as stinging, burning, itching, tightness and smarting sensations to visible signs of irritation such as erythema and scaling. Although the concept of sensitive skin is intriguing to many dermatologists, the diagnosis is dependant on self-perceived symptoms. Models to define sensitive skin are not standardized, and the term sensitive skin can be misleading. OBJECTIVE: The purpose of this study was to evaluate difference of influence to skin barrier function between corrosive and non-corrosive agents in sensitive skin. METHODS: 0.1%, 0.25%, 0.5%, 2% solution of sodium lauryl sulfate (SLS) and 1%, 2.5%, 5%, 20% solution of nonanoic acid (NAA) were applied on volar forearm skin for 24 hours in healthy controls and self-perceived sensitive skin subjects without underlying problems. Clinical score, transepidermal water loss (TEWL), and erythema-index (E-index) were compared between healthy controls and the sensitive skin group. RESULTS: Clinical scores, TEWL values and E-indices showed a rising curve concentration for each irritant in a similar pattern. There were no significant differences in clinical score and TEWL value between non-sensitive and sensitive skin. In contrast, E-indices evaluated from sensitive skin subjects were much higher than those in a healthy controls. CONCLUSION: An elevated TEWL value indicates barrier impairment. An increase in the erythema parameter shows that cutaneous vascular reactions have an unspecifically exaggerated reaction to various irritants and this induces multifarious inflammatory reactions and vasodilation. Therefore, the results of this study suggest that sensitive skin without underlying disease is derived from cutaneous vascular hyperreactivity and various inflammatory reactions, rather than barrier impairment.