Sensitive Skin Part 1: What We Know About Sensitive Skin Today

The ESK blog

Sensitive Skin Part 1: What We Know About Sensitive Skin Today

29 September 2021

What is sensitive skin?

There is a lack of clear consensus regarding the definition and diagnosis of sensitive skin.  Sensitive skin (or reactive skin) may be defined as a syndrome involving the onset of unpleasant sensations (stinging sensation, burning sensation, pain, itch, tingling) that wouldn’t affect non sensitive skin. These symptoms can’t be attributable to any skin disease. The skin either looks normal or a bit red. And while it can affect any part of the body, it is most common on the face.

The nasolabial fold (the line from the nostrils to the outer corner of the mouth) is the most sensitive part of the face, followed by the malar eminence (skin over the cheek bones), the chin, the forehead and the upper lip.

How common is it?

Around 60–70% of women and 50–60% of men report having sensitive skin.

Several international studies have shown an increase in self-reported sensitive skin over the last 5 years, especially in men

What are the symptoms?

  •   Itch
  •   dryness/flakiness
  •   roughness
  •   flushing/ blushing/ redness

What causes it?

We still don’t know for sure.

Changes in the skin

Some people with sensitive skin seem to have a thinner stratum corneum (outermost skin layer) and less actual skin cells in this layer. The result?  The skin is penetrated more easily by certain water-soluble chemicals. And we see an increase in Trans epidermal Water Loss or TEWL. Some studies have also suggested that fewer ceramides in the stratum corneum plays a role.

A second group of people with sensitive skin have a normal skin barrier function but inflammation in the skin.

And a third group have normal skin barrier and no inflammation at all. So what is going on there?

Nerve changes in the skin

In all sensitive skin, studies have revealed a high content of “nerve growth factor” in the stratum corneum, compared to non-sensitive skin. The result? Some studies suggest a high concentration of sensory nerves in sensitive skin.

There is also some evidence that the nerves themselves might be hypersensitive so you feel itchier and more discomfort than less sensitive skin. We know people with sensitive skin are more likely to experience nerve pain, and that in a study on 5000 volunteers, very sensitive skin was twice as common in people with irritable bowel syndrome. Both of these conditions are thought to be partly due to hypersensitivity of nerves as well.

Stress and skin sensitivity

There is a link, we’re just not sure what it is or how it happens. But it is worth talking about the Nocebo effect, which is the opposite to a placebo effect (where you experience an improvement even though you have had no real intervention. The nocebo effect on the other hand is where you experience negative symptoms possibly due to negative expectations but nothing physical. In sensitive skin, there is relatively consistent evidence from studies that 27% of people get nocebo effects from various triggers. My mum feels itchy whenever she smells a seafood dish at a restaurant because she once had a major allergic reaction to iodine in a medical procedure. There’s no link between eating seafood and iodine allergies. But smelling seafood makes her start scratching!


There are some fairly common triggers and factors with sensitive skin including:

Typical triggers;

  1. Environmental (UV, heat, cold, low humidity and wind)
  2. Mechanical factors (friction, pressure and occlusion)
  3. Chemical (cosmetics (THE BIGGEST TRIGGER), soaps, water, irritating body fluids such as sweat, urine and faeces and pollutants). Special shout out here to hair dyes especially those containing ammonia which is a universal irritant.
  4. Psychological (stress) or hormonal (menstrual cycle)

On a background of

  1. genetic susceptibility including a family history of eczema
  2. gender (women are more prone to sensitive skin than men)
  3. smoking (smokers get more skin sensitivity than non smokers)

What works to fix it?

Sensitive skin is such a vague term it has been under-researched. Much of the research has focused on dryness or trans epidermal water loss or inflammation. At this stage the data we have from good studies are simply insufficient for doctors to have reached a consensus on sensitive skin management.

Avoid your triggers.

Try to keep a diary to help you identify what sets your skin off and keep well away from those triggers.

Look for skincare ingredients that can help...But that's the topic of another blog. Stay tuned!

In light of this research, we created the Repair + jam packed with powerful, yet well tolerated and safe ingredients to specifically target dry and sensitive skin. 

Repair +

Repair +

Stay hydrated all day with this deeply nourishing cream to repair irritable, dry and moody skin to restore it to its natural radiance.

  • Hydrate dry and sensitive skin.
  • Improve acne, rosacea, psoriasis and eczema symptoms. 
  • Repair skin's barrier function