Exploring environmental triggers for sensitive skin

Novel environmental triggers for sensitive skin, including sleep disorders, tobacco use, and hormone levels, were identified in results of a study published in the Journal of the European Academy of Dermatology and Venereology.

Investigators conducted an online survey of adults living in Brazil, China, France, Russia, and the United States. Participants were recruited using a stratified sampling method to ensure that the samples were representative of the general population.

The 25-question survey captured socio-demographic characteristics and data on the presence of sensitive skin. Respondents were asked to rate their skin sensitivity on a 10-point scale. Tobacco exposure, sleep disorders, diet, and hormone levels were also assessed. Logistic regression models were used to identify sensitive skin correlates.

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A total of 10,743 participants took part in the survey, of whom 5285 (49.2%) were men. The distribution of respondents by country was as follows: 1912 (17.8%) from Brazil; 2942 (27.4%) from China; 1999 (18.6%) from France; 1955 (18.2%) from Russia; and 1935 (18.0%) from the United States. A total of 5176 (48.2%) participants were classified as sensitive skin.

More subjects with sensitive skin were women (55.1% versus 46.9%) and had a younger mean age (39.35 versus 42.15 years) compared to subjects without sensitive skin (both P <0.001). Compared to the insensitive skin group, people with sensitive skin reported more frequently dermatological reactions to known environmental triggers such as air pollution, dust, cosmetics, sweating, certain foods and tobacco smoke (all P <0.001).

In univariate analyzes, current smoking was associated with a higher probability of declaring sensitive skin (odds ratio) [OR]1.16; 95% CI, 1.04-1.29; P <0.001). Women using hormonal contraception were also at an increased risk of having sensitive skin (OR, 1.79; 95% CI, 1.48-2.17; P <0.001) compared to women not using contraception. In addition, pregnant women were more likely to report sensitive skin than non-pregnant women (64.5% versus 51.9%; P <0.001).

Of 8296 people who said they had trouble sleeping, 51.8% had sensitive skin. Multivariate analyzes showed no differences in skin sensitivity according to the severity of the sleep disorders. However, patients with sensitive skin had higher scores for the severity of the sleep disorder compared to patients without sensitive skin (P <0.001).

According to the researchers, the results of this international survey underscore the role of the environment in skin sensitivity. In addition to confirming the effects of known triggers, survey responses also showed that tobacco use, hormone levels, and sleep disorders can all affect skin sensitivity.

One of the limitations of the study is the use of self-reported survey responses instead of data from medical records, which can lead to bias. These results are also not transferable to adult population groups in countries without a sample.

“These associations suggest that sensitive skin is not limited to an epidermal disorder but can be put into a larger context,” the researchers wrote. “The factors identified are potential upstream drivers of neurogenic inflammation in sensitive skin.”

Disclosure: Several authors of the study have stated that they are part of the pharmaceutical industry. For a full list of the authors’ information, see the original reference.


Misery L., Morisset S., Séité S. et al. Relationship between sensitive skin and sleep disorders, fatigue, dust, sweating, food, tobacco consumption or hormonal changes in women: results of a global survey of 10,743 people. J Eur Acad Dermacol Venereol. Published online February 9, 2021. doi: 10.1111 / jdv.17162

This article originally appeared on Dermatology Advisor

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