Pathophysiology Of Sensitive Skin

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Managing sensitivity
Sensitive skin is a self-diagnosed condition. It is estimated that 50% of women and 40% of men view themselves as having sensitive skin to some degree (34, 35). They describe their skin as highly reactive, itchy, uncomfortable, red, and dry, and exacerbated by the environment (UV radiation, temperature, and wind), topical medicinal and cosmetic products, pollution, stress, and hormones (36).

Although the exact pathophysiology of sensitive skin is not fully understood, there is evidence that three broad areas may be involved: barrier function, inflammation, and sensory nerve abnormalities. The barrier function is compromised in sensitive skin compared to normal skin (37), allowing allergens and irritants into the skin
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For both teens and adults, acne is stigmatizing. Acne sufferers are often viewed as unhealthy, unattractive, unclean, and unlovable. The spectrum of breakouts ranges from blackheads and an occasional pimple to chronic, widespread nodulo-cystic lesions, with scarring potential. The darker one’s skin type, the more likely one is to experience post-inflammatory hyperpigmentation. These dark marks often last from months to years, frequently causing as much psychological distress as the inflammatory lesion that preceded it.

The role of OTC products in managing mild to moderate breakouts is significant and continues to evolve. OTC medications include salicylic acid (0.5–5%), benzoyl peroxide (2.5–10%), and sulfur (3-10%). The keratolytic activity of salicylic acid helps to unclog pores and exfoliate the stratum corneum. Benzoyl peroxide provides broad-spectrum antimicrobial action against P. acnes without risk of resistance, and sulfur has a mild inhibitory action on bacteria as well as modest anti-inflammatory
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Formulations should be esthetically pleasing, without a medicinal odor, and ideally contain anti-aging ingredients. Sulfur is difficult to tolerate in a leave-on product due to its offensive smell. Therefore, sulfur masks left on the skin for 10-15 minutes before washing off are a recommended alternative to a leave-on product. Exfoliating cleansers with small grains that mechanically slough off dead cells and unclog pores, or those with salicylic acid, are worthwhile choices. Benzoyl peroxide at a low strength (2.5%) is generally effective for long-term treatment and prevention of breakouts. Retinoids, either prescription or OTC, offer benefits for acne as well as aging. Because many acne treatment actives, including retinoids and benzoyl peroxide, are slightly sun sensitizing, daily sunscreen must be used in conjunction with these ingredients and is especially critical to address concerns about skin aging. In acne-prone skin, non-comedogenic, oil-free products with either zinc oxide or avobenzone as an active ingredient are recommended. Topical anti-oxidants, including resveratrol, quercetin, and cinnamic acid, provide potential benefit for both the inflammatory component of acne and photodamage (45, 46). Finding the “best” medicated acne skincare products for an individual depends on their underlying skin type