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Distinguishing Sensitive Skin Syndrome from Rosacea at the Biological Level: Study

Pilot study findings suggest that the inflammatory pathways central to rosacea may not drive sensitive skin syndrome.

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By: Christine Esposito

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Image: Shutterstock.com/iso100production

Research from a pilot study at George Washington University (GW) School of Medicine and Health Sciences offers evidence that sensitive skin syndrome is biologically distinct from rosacea. This, say the scientists involved, may help clarify the debate in dermatology and could help to develop treatment approaches.

Published in the Journal of the American Academy of Dermatology, the pilot study examined whether hallmark drivers of rosacea, including Demodex mite overgrowth and heightened innate immune activity, also contribute to sensitive skin syndrome. GWU researchers found they do not.

Sensitive skin syndrome (SSS) affects millions of people and is characterized by symptoms such as burning, stinging, itching, tingling, tightness, pain, and redness triggered by environmental, chemical, hormonal, or psychological factors. Because these symptoms overlap with rosacea, the two conditions are often confused clinically.

The findings further support GW ongoing work that sensitive skin syndrome is a unique skin condition, not simply a milder form of rosacea, a condition well known for imparting skin sensitivity, noted Adam Friedman, professor and chair of dermatology at GW and senior author of the study.

“This distinction matters because it can help clinicians avoid treatments that may not benefit sensitive skin patients and instead focus on over the counter and prescription therapies better aligned with the biology of the condition,” he added.

The study included 30 women between the ages of 30 and 50, half with sensitive skin syndrome and half with non-sensitive skin. Researchers used advanced skin imaging to assess the presence of Demodex folliculorum mites and analyzed skin protein samples to measure levels of antimicrobial peptides linked to inflammation.

According to GW, key findings included:

  • Demodex mites were present at the same rate in both sensitive skin and non-sensitive skin participants.
  • Two antimicrobial peptides commonly elevated in rosacea — cathelicidin and dermcidin — were significantly reduced in participants with sensitive skin syndrome.
  • The findings suggest that the inflammatory pathways central to rosacea may not drive sensitive skin syndrome.

“These results help provide biologic evidence that sensitive skin syndrome has its own unique mechanisms,” noted Nikita Menta, first author of the study and GW SMHS/Galderma Sensitive Skin Research Fellow. “Understanding those differences is important for developing more precise diagnostic and treatment strategies.”

Galderma created the fellowship in connection the formation of its global sensitive skincare faculty in 2022, as reported by Happi.

What’s Next?

The authors note that additional research with larger patient populations is needed, but say the findings represent an important step toward defining sensitive skin syndrome as a standalone dermatologic condition, according to GW.

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