Exploring Environmental Triggers for Sensitive Skin

Woman itching arm.
Woman itching arm.
The roles of poorly known associated and triggering factors for sensitive skin in a large international population were investigated.

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

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

The 25-question survey captured sociodemographic 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 disturbances, diet, and hormone levels were also assessed. Logistic regression models were used to identify correlates of sensitive skin.

A total of 10,743 participants completed 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 having sensitive skin.

More individuals with sensitive skin were women (55.1% vs 46.9%) and had a younger mean age (39.35 vs 42.15 years) compared with individuals without sensitive skin (both P <.001). Compared with the nonsensitive skin group, those with sensitive skin more often reported dermatologic reactions to known environmental triggers, including air pollution, dust, cosmetics, sweating, certain foods, and tobacco smoke (all P <.001).

In univariate analyses, current smoking was associated with greater odds of declaring sensitive skin (odds ratio [OR], 1.16; 95% CI, 1.04-1.29; P <.001). Women using hormonal contraception also had increased risk for sensitive skin (OR, 1.79; 95% CI, 1.48-2.17; P <.001) compared with women not using contraceptives. In addition, pregnant women more often reported sensitive skin than nonpregnant women (64.5% vs 51.9%; P <.001).

Among 8296 individuals who reported having sleep disruptions, 51.8% presented with sensitive skin. Multivariate analyses did not reveal differences in skin sensitivity by severity of sleep disruptions. However, patients with sensitive skin had higher scores for sleep disorder severity compared with patients without sensitive skin (P <.001).

Results from this international survey emphasize the role of the environment in skin sensitivity, the researchers believe. In addition to confirming the effects of known triggers, survey responses also indicated that tobacco use, hormone levels, and sleep disruptions may influence skin sensitivity.

Study limitations include the use of self-reported survey responses rather than medical records data, which may introduce bias. Also, these results are not generalizable to adult populations in unsampled countries.

“These associations suggest that sensitive skin is not restricted to an epidermal disorder but may be included in a larger context,” investigators wrote. “The identified factors are potential upstream drivers of neurogenic inflammation in sensitive skin.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


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