Sensitive scalp (SSc) is considered a sensitive skin on the scalp, with its particularities. Although it is not rare in the dermatological practice and the term is commonly present in personal care products, this entity is poorly investigated in the medical literature. The etiopathogenesis is still uncertain, and the sensitivity may be associated with hair loss. Clinical manifestations are subjective symptoms of pruritus, burning, pain, pricking, and/or trichodynia, often with scalp erythema. SSc can be triggered by several factors (endogenous or exogenous). The diagnosis is guided by the anamnesis, and there are still no specific trichoscopic features. Trigeminal trophic syndrome and postherpetic neuralgia are the main differential diagnosis to be considered. We organized the therapeutical approach in three steps: scalp care, topical and systemic treatment.

UNASSIGNED: Sensitive scalp is one of the most frequent complaints related to sensitive skin syndrome, characterized by unpleasant sensory reactions in the absence of visible signs of inflammation. In this study, the effects of topical application of postbiotic Himalaya-derived Saccharomyces and Lactobacillus ferment complex (SLFC) on the bacterial and fungal scalp microbiome at the taxonomic level and alleviation of sensitive skin syndrome were investigated.
UNASSIGNED: Firstly, healthy female participants (aged 30-45) were classified into a healthy scalp group and a sensitive scalp group based on the questionnaire. Thereafter, topical application of SLFC on sensitive scalp as well as scalp microbiome was evaluated, with the difference in the distribution of microbial taxa between healthy and sensitive scalp communities was assessed using 16S rRNA and ITS1 sequencing analysis. In addition, the effect of SLFC on scalp microbiome at the species level for Cutibacterium acnes, Staphylococcus epidermidis, and Malassezia restricta was evaluated by the qPCR assessment.
UNASSIGNED: After treatment with SLFC for 28 days, the abundance of Staphylococcus, Lawsonella, and Fusarium in the sensitive scalp group was highly significantly increased (p < 0.001), while the abundance of Cutibacterium and Malassezia was highly significantly decreased (p < 0.001). Furthermore, the self-assessment questionnaire indicated a syndrome alleviation effect of 100% after 28 days with a twice-daily application of the SLFC.
UNASSIGNED: The obtained results would help to better understand the microbial community of the sensitive scalp and provide useful information on utilization of SLFC for maintaining a healthy scalp and modulating the scalp microbiome.

Sensitive scalp is a common condition defined by the presence of erythema and/or subjective symptoms as pain, pricking, burning, pruritus of the scalp elicited by triggering factors. Trichodynia is a term that describes a sensation of pain or burning of the scalp and was assumed to be part of sensitive scalp. Main goal of the study was to establish the prevalence of sensitive scalp in patients with trichological disorders. We conducted a retrospective observational study recorded: age, sex, trichological disorder (telogen effluvium, androgenetic alopecia, alopecia areata, scarring alopecia, trichotillomania) and scalp symptoms (pruritus, pain, burning and itching sensation). We studied 317 patients. 102 patients (32%) complained of sensitive scalp. Telogen effluvium patients had a significantly higher prevalence of sensitive scalp (p <0.001), pain (p= 0.028), burning sensation (p=0.018), pruritus (p=0.016) and trichodynia (p<0.001) than other patients with alopecias. Likewise, AA patients had a statistically significant higher prevalence of pruritus (p=0.0256) and trichodynia (p=0.0223) than other alopecias patients. Sensitive scalp is a frequent symptom reported by patients with hair loss. Telogen effluvium and alopecia areata seem to be most associated to sensitive scalp.

A sensitive scalp is defined by the occurrence of unpleasant sensations (tingling, burning, pain, pruritus) triggered by stimuli that should not cause such sensations. Environmental factors, particularly cosmetics, can be triggering factors. The aims of this study were to assess hair cosmetic product consumption in subjects with sensitive scalp and to perform a clinical evaluation of sensitive scalp. After a dermatological examination, women between the ages of 18 and 65 years with or without a sensitive scalp completed different questionnaires. Their use of hair cosmetics (frequency, amount per application) was recorded. A total of 160 women with a mean age of 41 years were included. Twenty-seven subjects presented with seborrheic dermatitis or psoriasis, so only 133 were included in the analysis. Five percent of the subjects declared they had a very sensitive scalp, 25% had a sensitive scalp, 38% had a slightly sensitive scalp, and 32% had a scalp that was not sensitive. The mean sensitive scalp score (3S) score was 3.7 ± 1.6 in the very sensitive scalp group, 3.6 ± 2.1 in the sensitive group, 1.2 ± 1.2 in the slightly sensitive group and 0.1 ± 0.4 in the non-sensitive group. Two groups were analyzed: the 56 subjects with a sensitive scalp (3S ≥ 2 score) and the 56 subjects with a null 3S score. In the sensitive scalp group, 89% suffered from itch, and 45% suffered from tingling. No parameter (hormonal status, smoking, age, phototype, BMI) was associated with the 3S score. No differences in the exposure to shampoos and masks between the two groups were noted. The exposure to hair conditioners was significantly higher in the sensitive scalp group than in the group without sensitive scalp. Itch is the main symptom of a sensitive scalp. The frequency of a sensitive scalp was lower than that previously described when the subjects with scalp dermatosis were excluded. The amount of hair conditioners used was significantly higher in subjects with sensitive scalp than in those without sensitive scalp, suggesting a possible link.

BACKGROUND: The scalp care market is growing rapidly and research into the factors associated with sensitive scalp is performed in many countries. However, to the best of our knowledge, no previous study has examined the factors triggering sensitive scalp in Korean women. Thus, the aim of our study was to establish objective standards for sensitive scalp, investigate factors that trigger this condition, and determine the ratio of sensitive scalp in Korean women.
METHODS: A total of 125 Korean adult women participated in the study. The participants answered the questionnaire, had their scalp temperature measured, and the sensitive scalp condition was evaluated and analyzed.
RESULTS: Compared to the non-sensitive scalp (NS) group, the sensitive scalp (SS) group had a significantly higher average temperature and increased heat sensation, dandruff, erythema in the scalp, past history of atopy, history of hair loss, medical history of scalp disease, concern for scalp care, and interest in mild products and frequency of use. The majority of participants in the SS group had a dry scalp, and itching was common.
CONCLUSIONS: This study may help us to understand the characteristics of the sensitive scalp in Korean females and determine factors associated with triggering a sensitive scalp.

BACKGROUND: Sensitive scalp, one of the most frequent complaints among sensitive skin syndrome, has been described as abnormal and unpleasant sensory reactions of the scalp to environmental stimulus. However, the symptoms are usually objective and hard to diagnose.
OBJECTIVE: This study aimed to reveal the biophysical properties and etiology of sensitive scalp.
METHODS: Sixty-two healthy female subjects were enrolled and divided into nonsensitive scalp (NS) and sensitive scalp (SS) groups according to questionnaires. Noninvasive instruments were used to measure biophysical properties. Ultra-performance liquid chromatography-tandem mass spectrometry and gas chromatography mass spectrometry were introduced to quantify skin lipids profiles, and 16S rRNA sequencing was used to detect the composition of bacteria.
RESULTS: Sensitive scalp showed elevated pH level, more irritated skin, and more fluorescence of porphyrins. Increased sebum production was found in SS group at occiput, among which free fatty acids, cholesteryl ester, and squalene were significantly in higher amount compared with NS. SS also had significantly higher percentage of Propionibacterium, and lower bacterial diversity.
CONCLUSIONS: Taken together, sensitive scalp showed disrupted barrier function, abnormal sebum amount and composition, as well as perturbed microbiome, which might be the direct cause. Products targeting these features could be helpful for the treatment of sensitive scalp.

BACKGROUND: A sensitive scalp is a frequent problem in daily clinical practice and often represents a major challenge for dermatologists.
OBJECTIVE: The objective was to evaluate the efficacy of a Northamerican Virginian Witch Hazel (Hamamelis virginiana)-based shampoo and tonic (Erol(®) Energy) for treatment of the sensitive scalp.
METHODS: Retrospective observational study of male and female patients given Erol(®) Energy products in the period between August 2010 and December 2013 at the Center for Dermatology and Hair Diseases Professor Trüeb to treat irritable scalp conditions or as concomitant treatment to minoxidil therapy for androgenetic alocepia.
RESULTS: Shampoo was applied successfully in 1,373 patients (1,233 women and 140 men). Patients reported improvement of subjective manifestations of irritation and rated tolerance of both products as good to excellent. During this period, 369 (26.9%) have received Erol(®) shampoo more than once.
CONCLUSIONS: The choice of appropriate hair-care products represents an important aspect in the management of the sensitive scalp and related conditions. With the Erol(®) Energy hair-care products, the advantages of H. virginiana are available for successful treatment of the scalp, especially in the context of problems associated with red scalp, scalp burn-out, and the use of topical minoxidil for androgenetic alopecia.