368 JOURNAL OF COSMETIC SCIENCE
Lifestyle and personal habits can also trigger symptoms, such as wearing rough fabrics,
the use of cosmetics, and exposure to tobacco smoke. A wide array of triggering conditions
must be avoided in order to circumvent the onset of SSS symptoms.
Such avoidance may lead to a restriction of outdoor or indoor activities important for social
interactions, leisure, recreation, and fitness. Thus, it may impact overall QoL.35
Factors that contribute to the symptoms of SSS may differ depending on age group. Among
those who claimed to have sensitive skin, hot weather and rough fabrics were the factors
most strongly associated with skin sensitivity among the oldest adults (aged 50 and older)
and were specifically associated with genital skin sensitivity in this group (Table IV).1 Cold
weather was most strongly associated with skin sensitivity in midlife (40–49 age group),
and stress was the most important factor cited by younger adults (i.e., individuals younger
than 40).1 The menstrual cycle was perceived to contribute to skin sensitivity by women of
all age groups except those aged ≥50.
Many everyday products were identified by individuals with SSS as potential triggers to
SSS symptoms. These included facial products and cosmetics, personal care products, and
common household products (Figure 3). A Cincinnati study reported by Farage with 1,039
individuals reported that 68.4% of the study population claimed their skin was sensitive to
some degree (very, moderately, or slightly).49 SSS seems to also influence shopping behavior
and practices. Subjects claiming SSS were 5 times more likely to look for skin-related
claims on products (such as “safe for sensitive skin” and “hypoallergenic”) compared with
subjects who had nonsensitive skin (OR =5.3) (Figure 4A). Meanwhile, they were 5 times
more likely to avoid specific ingredients, because the individual perceived they caused skin
irritation (OR =5.2) (Figure 4B).
Consumer product manufacturers are now fully aware of the need to develop products
specifically for individuals with SSS. The authors’ laboratory developed and validated a self-
administered scientific tool, Farage QoL (FQoL™, P&G), to assess the potential impact of
a variety of consumer products on health-related QoL.50,51 The tool consists of 27 general
items scored on a Likert scale and covering overall QoL (1 item), Well-Being (12 items),
and Energy and Vitality (14 items). The Well-Being domain has 3 subdomains: Emotion,
Self-Image, and Self-Competence the Energy and Vitality domain also has 3 subdomains:
Personal Pleasure, Physical State, and Routine Activity. The resulting FQoL™ instrument
has been used several times to evaluate the impact of various consumer products on the
consumers’ QoL.52
FATIGUE AND SLEEP DISORDERS
Fatigue has a high prevalence among patients with skin diseases.53 In a study conducted
in France by Misery and colleagues among 2,502 individuals, these authors found the
risk of fatigue was over four times greater for individuals with skin diseases compared
to those with no skin diseases.54 Sleep disorders and fatigue are common in patients with
inflammatory skin disorders, such as psoriasis and chronic eczema,55 and they have been
reported as upstream drivers of other sensory disorders.48
Itching and pain are major symptoms of sensitive skin and can contribute to sleep disorders.11
In a 2019 publication, Schmelz reported that individuals classified as having sensitive skin
experienced itching and pain sensations upon weak external stimuli that were not typically
painful or itchy in individuals without sensitive skin.56 Halioua and colleagues found that
subjects suffering from cutaneous disorders had a significantly higher severity of sleep

Table
IV
Perceptions
About
Irritation
Due
to
Environmental
Factors
for
Those
Claiming
Genital
Skin
Sensitivity
Sensitive
skin
in
the
genital
area
Hot
weather
Cold
weather
Rough
fabric
Dry
weather
Stress
Humid
weather
Menstrual
cycle a
≥50 Total
sensitive responders
59
59
64
60
62
60
23
Factor
causes irritation
(%)
88%
b
86%
86%
c
72%
58%
47%
30%
d
40–49 Total
sensitive responders
68
70
70
67
68
66
42
Factor
causes irritation
(%)
57%
79%
71%
73%
44%
e
39%
52%
31–39 Total
sensitive responders
256
261
255
257
256
245
229
Factor
causes irritation
(%)
64%
86%
71%
79%
62%
44%
62%
≤30 Total
sensitive responders
151
151
150
152
150
147
137
Factor
causes irritation
(%)
59%
82%
75%
76%
65%
45%
65%
A
total
of
1,039
individuals
participated
in
the
study
on
self-reported
sensitive
skin.47Total
sensitive
responders
refer
to
the
number
of
subjects
with
skin
sensitivity
of
the
genital
area
who
responded
to
this
question.
The
percentage
of
these
responders
who
claimed
the
environmental
factor
caused
some
degree
of
skin
irritation
(i.e.,
“sometimes,”
“frequently,”
or
“always”)
is
given
in
the
following
line.
Paired
comparisons
of
age
groups
were
done
using
the
MH
chi-square
test.
Adapted
with
permission
from
references
1
and
29.
Copyright
2021
and
2017
MDPI
and
Springer.
a
Women
only.
b
≥50
age
group
significantly
higher
than
40–49,
31–39,
and
≤30
age
groups
(≤0.001).
c
≥50
age
group
significantly
higher
than
40–49,
31–39,
and
≤30
age
groups
(≤0.03).
d
≥50
age
group
significantly
lower
than
31–39
and
≤30
age
groups
(
0.02).
e
40-49
age
group
significantly
lower
than
31–39
and
≤30
age
groups
(
0.02).
369 Sensitive Skin Syndrome