Probably the biggest formulation challenge for the cosmetic chemist and the biggest treatment challenge for the dermatologist is sensitive skin. Sensitive skin can present with visible outward changes, easily recognized by the dermatologist, or invisible signs with marked symptoms presenting a treatment challenge.
Visible sensitive skin is the easiest condition to diagnose, since the outward manifestations of erythema, desquamation, lichenification, and inflammation identify the presence of a severe barrier defect. Any patient with a barrier defect will possess the signs and symptoms of sensitive skin until complete healing occurs. The three most common causes of barrier defect induced facial sensitive skin are eczema, atopic dermatitis, and rosacea. These three diseases nicely illustrate the three components of sensitive skin, which include barrier disruption, immune hyper-reactivity, and heightened neurosensory response.