357 Sensitive skin panels
QUESTIONNAIRES
It is obviously not possible to objectively determine the presence or absence of sensitive
skin,33 as sensitive skin is primarily a sensory disorder. However, the concept of diagnosing
sensitive skin through questionnaires emerged long after the development of reactivity
tests. While many scales have been proposed, they are often limited to use by a single
company, author, or even a single study.
Some scales have gained broader use because they were developed, validated, and translated
into multiple languages using the recommended methodologies. Examples include the
Sensitive Scalp Severity34 questionnaire for assessing sensitive scalp, and the Sensitive Scale
(SS) for evaluating sensitive skin in general.35More recently, the Burden of Sensitive Skin
(BoSS) scale was introduced to measure the impact of sensitive skin.36
SENSITIVE SCALE
The Sensitive Scale (SS-10) is a 10-item scale (Figure 1) that was initially validated across 11
countries and translated into multiple languages, involving a total of 2,966 participants..35
The internal consistency was high. Correlations with the dry skin type, higher age, female
gender, fair phototypes, and the Dermatology Quality of Life Index (DLQI) were found.
DLQI is a tool to evaluate the quality of life in patients with skin disorders.37 The 10-item
version is preferred over the 14-item version as it is quicker and easier to complete while
maintaining the same level of internal consistency. Additionally, the four excluded items
were found to be rarely relevant to patients. The mean initial score was around 37/100 (and
44/140 in the initial 14-item version). More recently, a SS-10 cut-off value of 12.7 to detect
sensitive skin was identified (with a sensitivity of 72.4% and specificity of 90.3%).38 For
practical reasons, we propose that a score greater than 13 on the SS-10 can be used as the
cut-off to diagnose sensitive skin, and a score greater than 5 can be used as the cut-off to
diagnose slightly sensitive skin.
3S QUESTIONNAIRE
The 3S questionnaire was created to assess sensitive scalp (Figure 2).34 The total score is
obtained by multiplying score severity of abnormal sensations by the number of these
sensations. The 3S questionnaire allowed discrimination between subjects with slightly
sensitive, sensitive, and very sensitive scalps. Itching and prickling were the most frequent
symptoms. The 3S questionnaire is a convenient and effective tool for investigating the
severity and symptomatology of the sensitive scalp.
BoSS QUESTIONNAIRE
The burden of a disease encompasses its physical, psychological, social, and economic
consequences. The BoSS questionnaire was specifically designed to evaluate all these
aspects in individuals with sensitive skin.36 Its development followed standardized
methodologies for creating and validating quality-of-life questionnaires, consisting of
three phases: design, development, and validation. The BoSS questionnaire demonstrated
strong psychometric properties, including excellent internal consistency and robust

358 JOURNAL OF COSMETIC SCIENCE
item-scale, convergent, and construct validity. It was also significantly correlated with
both components of the SF-12 and the DLQI, confirming its concurrent validity, with a
stronger correlation observed with the DLQI. Additionally, it showed high internal and
external validity and clear reliability in relation to the severity of sensitive skin and other
associated factors.
The BoSS questionnaire could be also used as a diagnostic tool for sensitive skin. A positive
and statistically significant correlation was observed between the SS-10 score and the BoSS
Figure 1. Sensitive scale.
Figure 2. The 3S Questionnaire.