Reduced AMP Expression Seen in Sensitive Skin Syndrome: Pilot Study

Key Takeaways

• Sensitive skin syndrome (SSS) showed reduced antimicrobial peptide expression compared with non-sensitive skin controls, according to results from a new pilot study.
• No difference in Demodex folliculorum prevalence was observed between SSS and non-sensitive skin groups.
• Findings suggest distinct pathophysiologic mechanisms between SSS and rosacea, particularly regarding innate immune activity.

A pilot study published in the Journal of the American Academy of Dermatology evaluated whether key pathophysiologic features of rosacea—Demodex colonization and antimicrobial peptide (AMP) dysregulation—are also present in sensitive skin syndrome (SSS).

Investigators enrolled 30 female participants, including 15 with SSS and 15 with non-sensitive skin (NSS), classified using the SensiScale-10 tool. The then used reflectance confocal microscopy to assess Demodex folliculorum presence, while liquid chromatography–mass spectrometry quantified protein expression from cheek swabs.

Demodex was identified in 20% of participants in both groups, with no significant difference (P = 0.674). AMP analysis showed, by contrast, reduced expression of cathelicidin (protein abundance ratio 0.661; P < 0.05) and dermcidin (0.471; P < 0.05) in SSS compared with NSS. The authors noted that over-the-counter skincare use was not controlled, representing a study limitation. The small sample size and restricted demographic may also limit generalizability.

“These findings further support our 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” said Adam Friedman, MD, professor and chair of dermatology at GW and senior author of the study, in a press release. “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.”