Sensitive Skin: A Survey of Dermatology Resident Physicians’ Perspectives and Educational Exposures

February 2024 | Volume 23 | Issue 2 | 85 | Copyright © February 2024


Published online January 30, 2024

Erika T. McCormick BSc, Adam Friedman MD FAAD

George Washington University Medical Faculty Associates, Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC 

Abstract
Sensitive skin (SS) is a common patient complaint presenting to the dermatology office, but there exists a lack of consensus on defining criteria and evidence-based management approaches. Furthermore, incorporation of SS training into the dermatology residency curriculum is unknown, and therefore the authors herein sought to determine dermatology resident physicians' exposure to education about SS, perspectives on SS, and management approaches. Ninety-nine percent of residents believe that SS should be included in some capacity in their dermatology residency training. However, less than half of responding residents received education specifically about SS during their training and less than one-fourth of residents reported feeling very knowledgeable about SS diagnosis, clinical evaluation, or management. Residents who had received specific education about SS were significantly more likely to self-describe as "very knowledgeable" about all queried topics. Residents reported challenges with all aspects of SS patient care, and cited heterogenous approaches to SS patients. These data highlight a gap in residency education, as indicated by limited consensus over diagnostic and management approaches to SS.

J Drugs Dermatol. 2024;23(2):85-89.   doi:10.36849/JDD.7830

INTRODUCTION

Sensitive skin (SS) is a subjective syndrome of cutaneous hyperreactivity, characterized by symptoms of redness, itching, burning, tightness, or stinging in response to innocuous stimuli.1,2 SS is common, with an estimated global prevalence between 40% and 70%.3 Currently, there is an incomplete understanding of SS pathophysiology and a lack of consensus on diagnostic and management approaches. Nevertheless, dermatologists must be knowledgeable about SS; an estimated 60% to 80% of individuals with SS and without primary skin disease have seen a dermatologist in the past.4,5 Further, given the frequency with which SS patients seek dermatologic care, diagnosis, and management of SS based on the current and available evidence on SS should be an expected competency achieved during residency training. To date, there have been no studies assessing the inclusion of SS in dermatology residency curricula. We sought to assess dermatology resident physicians' educational exposure to SS and to gauge residents' perspectives and management approaches to SS.

MATERIALS AND METHODS

A 26-question survey was developed by the authors and approved by the George Washington University Institutional Review Board (#NCR224549). Survey questions were uploaded to SurveyMonkey, a cloud-based survey tool, and the survey link was e-mailed to dermatology resident physicians registered to the Orlando Dermatology, Aesthetic, and Surgical Conference (ODAC) e-mail list. Participation in the survey was optional, and no personally identifiable information was collected. The response rate was 28%. Survey responses were compiled for analysis. Statistical testing was performed with GraphPad Prism software, using Fisher's exact tests (significance=P<0.05).

RESULTS

Demographics 
There were 214 survey respondents -- demographic information is included in Table 1. Residents at all levels of training were represented, and residency program locations varied among all regions of the United States. 

Exposure to Sensitive Skin Education
Ninety-nine percent of dermatology residents agreed that it is very (65%) or somewhat (34%) important for SS to be included in their dermatology residency training. Additionally, 84% of residents reported having personal experience with patients presenting with a chief complaint of SS during their residency training. However, only 48% of residents reported receiving specific education about SS, with 51% having received non-specific education about SS in the context of other skin diseases and 1% received no education. 
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