ABSTRACT
For many patients, sensitive skin stands in general for allergic reactions to common contact allergens, for example, nickel.1,2 Their main problems are eczematous skin reactions by contact (e.g., in costume jewelry), or by ingestion in food, followed by hematogenic eczema.3,4
Other patients who are particularly affected by the problem of sensitive skin are atopic individuals or patients with a disrupted epidermal barrier function.5-9 These individuals develop dermatitis caused by numerous triggers. Exogenous triggers (e.g., chemical or mechanical irritation, allergens, climatic conditions, wrong skin care, nutrition) are for these patients as relevant as endogenous ones (e.g., psychological stress, endogenous eruption, predisposition to dry, xerotic skin).9-11 The atopic individual describes his skin in the symptom free intervals as a sensitive skin, which can be transformed by a combination of the mentioned triggers to a clinical visible atopic eczema. Indeed, many patients with acute eczematous problems complain about sensitive skin. This is so far understandable, since all kind of eczema are frequently accompanied by a skin barrier disruption leading to the so-called sensitive skin, since due to this barrier disruption even slight irritations (handwashing) may lead to a clinical visible skin reaction (e.g., worsening of the underlying dermatitis).12 Such a skin reaction may concern individuals with rosacea, irritant dermatitis, nummular eczema, and exsiccation eczema as well.13
