January 29, 2025

by Sarah Villafranco, MD

sensitive skin is a term that many people are familiar with, yet it is important to understand that it is not classified as an official medical diagnosis. Instead, it encompasses various conditions that can lead to discomfort and irritation. Medical terminology associated with sensitive skin includes Sensitive Skin Syndrome, Cosmetic Intolerance Syndrome, and the somewhat humorous “status cosmeticus.” (Imagine a frantic medical resident exclaiming, “Someone remove this woman’s toxic mascara immediately!”) Sensitive skin can manifest in two ways: subjectively sensitive skin, where individuals report sensations such as burning, tingling, or discomfort without any visible changes, or objectively sensitive skin, which can exhibit signs like dryness, redness, dermatitis, or acne. Although an official diagnosis doesn’t exist, surveys indicate that up to 50% of women and 30% of men perceive their skin as sensitive. This is a significant issue that affects many individuals, including myself.

Sensitive skin refers to a condition where the skin reacts more intensely to environmental factors. This heightened sensitivity can present itself through sensations like burning or itching, or visible symptoms such as redness or rashes. Even though sensitive skin is not classified as a medical diagnosis, individuals often recognize its presence by the discomfort or unsightly appearance it causes. Let’s explore the deeper implications of what it truly means to have sensitive skin.

Identifying the Various Causes of Sensitive Skin

Due to the broad and somewhat ambiguous nature of sensitive skin, it is challenging to compile an exhaustive list of its potential causes. However, research indicates that women are more likely to experience sensitive skin compared to men, mainly because their skin is generally thinner. Additionally, underlying medical conditions that contribute to heightened inflammation can trigger sensitive skin. Ongoing treatments, such as certain medications or radiation therapy, may also lead to increased skin sensitivity. Environmental factors, including extreme temperatures and humidity fluctuations, can exacerbate this condition. However, in my educated opinion, the leading culprit behind sensitive skin is sodium lauryl sulfate (SLS), along with its ethoxylated relative, sodium laureth sulfate (SLES).

Interestingly, SLS was originally formulated as an engine degreaser during World War II and has since infiltrated nearly every household product, from dish soaps to shampoos to laundry detergents. Most people unknowingly use SLS daily, even if they switch to purportedly cleaner brands. While it can be biodegradable and derived from plants, it remains a known skin irritant. In fact, SLS is the primary irritant used in medical tests designed to produce skin irritation, allowing companies to evaluate the efficacy of their soothing products. Although the concentrations used in these studies are much higher, chronic, low-level exposure can lead to persistent irritation—which is often termed sensitive skin—by damaging the skin’s barrier function over time. To mitigate this, I highly recommend following my guide on eliminating SLS from your life, especially if you struggle with sensitive skin.

Recognizing Common Symptoms of Sensitive Skin

There are various symptoms associated with skin sensitivity, which can be categorized into two groups: subjective symptoms, which are personal experiences, and objective signs, which can be observed by others. The most common subjective symptoms include:

• itching
• burning
• tightness
• stinging

On the other hand, the most frequent objective signs of sensitive skin that others can see include:

• redness
• rashes
• flaking
• dryness
• breakouts

Assessing Whether You Have Sensitive Skin

If you find yourself hesitant to try new products due to previous adverse reactions, it is quite likely that you have sensitive skin. Experiencing regular sensations of itching, tightness, burning, or stinging when using certain products is a strong indicator of skin sensitivity. Furthermore, if you have any form of dermatitis or eczema, it is highly probable that you also have sensitive skin, as these conditions are associated with compromised skin barrier function. In essence, if you suspect that you have sensitive skin, you likely do. However, remember that it is not classified as a formal diagnosis, which is beneficial. Instead, consider it an opportunity to educate yourself about your skin and learn effective management strategies.

Effective Strategies for Managing Sensitive Skin

Initially, I observe that many individuals become overly fixated on the question: “Why is my skin so sensitive?” While it is undoubtedly a frustrating condition that can feel unjust, particularly when it arises unexpectedly, I recommend shifting your focus away from seeking an answer to that question and instead asking what proactive measures you can take to support your sensitive skin.