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Abstract
Findings obtained on objective assessments to evaluate sensitive skin do not correlate well with the symptomatology. We utilized reflectance confocal microscopy (RCM) to compare transepidermal application of zinc in sensitive and non-sensitive skin. Thirty-six subjects participated in this study. They were divided into groups based on lactic acid sting test (LAST):‘stinger’ and ‘non-stinger’; transepidermal water loss (TEWL) measurements; and sensitivity self-assessments: ‘sensitive’ and ‘non-sensitive’. RCM images were taken to visualize transepidermal application of topically-applied zinc. The intensity of zinc reflectance at different depths was measured by ImageJ software. Based on LAST scores, the ‘stinger’ group showed significantly higher reflectance of zinc at 8 µm (stratum corneum) [face (P < 0.001), forearm (P = 0.004)], and at 80–104 µm (dermo-epidermal junction layer) on the face. High-TEWL group showed increased zinc reflectance at 8–24 µm (tight junction layer, P < 0.001). There were no significant differences amongst subjects self-reporting ‘sensitive’ and ‘non-sensitive’ skin. RCM demonstrates that in sensitive skin, there is deeper and higher reflectance of zinc at multiple depths. Structural differences are also visualized. We suggest that RCM is a useful tool for evaluating skin barrier integrity.
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1 Kyung Hee University, Department of Medicine, Graduate School, Seoul, South Korea (GRID:grid.289247.2) (ISNI:0000 0001 2171 7818); Kyung Hee University Medical Center, Department of Dermatology, Seoul, South Korea (GRID:grid.411231.4) (ISNI:0000 0001 0357 1464)
2 Kyung Hee University Medical Center, Department of Dermatology, Seoul, South Korea (GRID:grid.411231.4) (ISNI:0000 0001 0357 1464)
3 DERMAPRO Ltd, Dermapro Skin Research Center, Seoul, South Korea (GRID:grid.411231.4)
4 Chungnam National University, Department of Dermatology, School of Medicine, Daejeon, South Korea (GRID:grid.254230.2) (ISNI:0000 0001 0722 6377); Rutgers Robert Wood Johnson Medical School, Department of Dermatology, Somerset, USA (GRID:grid.430387.b) (ISNI:0000 0004 1936 8796)
5 Rutgers Robert Wood Johnson Medical School, Department of Dermatology, Somerset, USA (GRID:grid.430387.b) (ISNI:0000 0004 1936 8796)
6 Rutgers Robert Wood Johnson Medical School, Department of Dermatology, Somerset, USA (GRID:grid.430387.b) (ISNI:0000 0004 1936 8796); Department of Dermatology, Weill Cornell Medical Center, New York, USA (GRID:grid.413734.6) (ISNI:0000 0000 8499 1112)
7 Kyung Hee University, Department of Medicine, Graduate School, Seoul, South Korea (GRID:grid.289247.2) (ISNI:0000 0001 2171 7818); Kyung Hee University Medical Center, Department of Dermatology, Seoul, South Korea (GRID:grid.411231.4) (ISNI:0000 0001 0357 1464); Kyung Hee University, Department of Dermatology, College of Medicine, Seoul, South Korea (GRID:grid.289247.2) (ISNI:0000 0001 2171 7818)