When you look closer at individuals who have sensitive skin, there are three clear categorie :18One would be an individual who has eczema-atopic eczema, atopic dermatitis with dryness of the skin poor barrier function gives them a sensitivity to various products. The other would be individuals with rosacea may also have a barrier function problem in the epidermis. Their skin is labile-their blood vessels open and close easily so it appears that they are particularly sensitive to fragrances and harsh cleansers. The other group would be called cosmetic intolerance syndrome and that's less well understood and there may be some neuro-sensitive mechanisms that explain why they can't tolerate most of the cosmetics that we recommend. and perhaps there's another group that have different mechanisms for their sensitivity. I don't think that we can brush the thing aside just because we don't have a definition for it. We have to accept and we have to modify our recommendations in the light of what our patients tell us.