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Male skin: an increasingly sensitive subject A review of male sensitive skin and the role of the Gillette® Sensitive Skin product range in its management Executive Summary Sensitive skin is a very real problem for the majority of the population and has a measurable impact on quality of life. Although the precise pathophysiology remains undefined, recent advances in the assessment of sub-clinical symptomatology have revealed a potential relationship between structural changes in the stratum corneum and the structure and function of the epidermal nerve supply. These changes suggest a link between sensitive skin and the increased passage of potential irritants through the stratum corneum. While traditionally viewed as a female problem, it has recently become apparent that the rates of occurrence of self-assessed sensitive skin in men are rapidly approaching those in women. Gillette® has prepared this white paper to provide healthcare professionals with the latest information on the impact of shaving on sensitive facial skin, including suggested product regimens. Three bodies of new research explore this topic offering healthcare professionals not only dermatologist’s opinions and clinical research, but also information directly from men themselves regarding their increased perception of sensitive skin. This is especially important as these men are turning to the dermatologist community for guidance to address this matter. A recent global study by Gillette® found that two-thirds of men believed themselves to have sensitive facial skin – with nearly half of men reporting that the problem had become worse over the last five years – and that for more than half of men with sensitive skin, shaving is a significant issue. The results of two recent studies by Gillette® into the experience of dermatologists reflected those of the male public. The great majority of dermatologists surveyed reported that they have seen an increase in male sensitive skin, caused in part by an increased acceptance in society of the issue. Nearly six in ten men actively seek out shave and skin care products designed for sensitive skin, and more than 90 percent of dermatologists agree that a man’s choice of shaving products matters. The range of sensitive skin-specific shaving products developed by Gillette® is based on decades of research and deep understanding of the specific needs of men and their skin. This range includes both pre- and post-shave skincare products uniquely designed to minimise skin irritation, maximise skin moisturization and reduce cutting forces for lower drag and pull. When combined with Gillette’s ProGlide™ range of razors – offering Gillette’s thinnest, finest blades which have been proven to be well tolerated on sensitive skin – these products together offer a shaving solution that dermatologists can be comfortable recommending to men with sensitive skin. 1 Male skin: an increasingly sensitive subjecT Introduction Sensitive skin can be a sensitive subject. For a long time it was thought to be a primarily female condition, and the lack of objective symptoms or compelling pathophysiology have contributed to questions over whether it was a genuine dermatological condition. Lately, research has shown that the majority of the population self-assess as having sensitive skin, with reported rates in men increasingly catching up with those in women. Although a definitive pathophysiological explanation for sensitive skin remains to be verified, the use of increasingly sophisticated testing technologies has clearly demonstrated the presence of sub-clinical markers for sensitive skin and confirmed sensitive skin as a condition worthy of treatment. In many cases, men with sensitive skin on the face and/or neck face a daily challenge in managing their need or desire to remain clean-shaven with the discomfort that can be caused by shaving. These men are increasingly turning to the dermatology community for guidance on the correct shaving regimen, so this white paper sets out to give a background to the latest understanding of the causes and epidemiology of sensitive skin. It then goes on to discuss the consensus view on optimal management, before outlining the advances made by Gillette® in the development of a portfolio of products that harness this understanding to offer men with sensitive skin suitable shaving solutions. 2 What is sensitive skin? Sensitive skin is in many ways a challenge for the dermatology community, presenting as a subjective hyper-reactivity to ‘normal’ stimuli, with few objective measures usually available to allow for accurate diagnosis and treatment. Sensitive skin appears to present in most areas of the body, however it is most commonly found on the facial skin, particularly around the nasolabial fold, cheeks, chin, forehead and upper lip. Currently, diagnosis is dependent on self-reported symptoms of tightness, itching, burning or stinging, becoming particularly noticeable on exposure of affected skin to irritants (frequently soaps, cosmetics and sunscreens are cited as triggers). Symptoms are often reported to worsen in relation to stress, excessively dry and excessively cold or warm conditions. While some objective signs of irritation may be present (erythema, dryness, rash), these are not common. The lack of objective signs has led to some debate in the past around the existence of sensitive skin as a discrete condition; however this has diminished as a clearer functional definition has appeared. Facial sensitive skin is a particular problem for many people as it impacts upon their ability to maintain their appearance in the way they would wish, with many women choosing to forego cosmetics or a skincare regime and many men finding it difficult to maintain their preferred skincare and shaving schedule as a result of the discomfort associated with prolonged irritation of sensitive areas. Perhaps as a result of the daily discomfort experienced, there is also evidence that sensitive skin is linked to reduced psychological quality of life (Misery 2007), with a direct relationship between increased symptom severity and reduced quality of life. Conditions such as Pseudofolliculitis barbae, atopic dermatitis and other dermatological conditions with a distinct pathology are outside the scope of this paper. This discussion concerns subjectively self-assessed sensitive skin in the general shaving population without a medical diagnosis or objective clinical etiology. 3 Male skin: an increasingly sensitive subjecT What makes skin sensitive? While its pathophysiology is still not fully understood, it appears that sensitive skin is distinct from a allergic or immune disorder (Misery 2007) and that a number of factors may be involved in its occurrence. One of the main contributory factors appears to be an alteration in the stratum corneum. People with sensitive skin have been shown to have a thinner stratum corneum with reduced corneocyte area (Berardesca 1991) along with an imbalance in the intercellular lipids of the stratum corneum (Ohta 2000). Together, these findings suggest a stratum corneum that is more susceptible to loss of water and penetration of chemical irritants. Indeed, when compared with a non-sensitive population, sensitive skin is drier, less flexible, more erythematous and more teleangiectatic (Seidenari 1998). Another factor believed to play a role in sensitive skin is altered nerve function (Berardesca 2012, Misery 2007, Misery 2002). While the stratum corneum itself is not innervated, elevated levels of nerve growth factor and other neurotransmitters have been found in the stratum corneum of sensitive skin (Misery 2007, Misery 2002). The presence of these substances may be related to a ‘priming’ of the nerves of the epidermis that leads to increased sensitivity and/or neurogenic inflammation. On a molecular level, the activity of transient receptor potential (TRP) channel family members such as TRPV1 (TRP vanilloid subfamily, member 1) is also being researched with regard to their association with sensitive skin (Kueper 2010). Interestingly, animal models have suggested a possible link between stress and skin sensitivity. Stress has been shown to lead to the release of substance P from unmyelinated nerve fibres (similar to those found in the epidermis) in animals, ultimately leading to mast cell degranulation and histamine release (Kumagai 2011). Studies in sensitive skin sufferers have demonstrated high densities of mast cells and increased size of microvasculature, perhaps reflecting the existence of a similar mechanism in human subjects (Berardesca 2012, Quaresooz 2009). 4 How common is sensitive skin? Sensitive skin has traditionally been considered a predominantly female concern, particularly given the theoretical relationship between skin thickness and symptoms; however the number of men reporting sensitive skin is substantial and appears to be growing (Berardesca 2012, Farage 2009). Studies in Europe, the US and Japan have reported skin sensitivity rates of 50 – 61 percent among women and 30 – 38 percent among male subjects (Berardesca 2012, Farage 2010, Willis 2001, Guinot 2006, Kligman 2006, Misery 2009, Misery 2011). If ‘slightly sensitive’ skin is considered, research has revealed reported sensitive skin rates as high as 84 percent globally (Farage 2010). In a recent study from the US, 68.4 percent of respondents self-reported sensitive skin with 77.3 percent claiming sensitive facial skin. Notably, there was no significant difference in results by gender in overall reports of sensitivity; however reported severity was somewhat higher in women (Farage 2009). 5 Male skin: an increasingly sensitive subjecT New global data In order to better understand the needs of the male sensitive skin population, Gillette® recently conducted a survey of unprecedented scale amongst men, polling 3,326 men from the US, UK, Spain, Italy, Germany, Poland, Turkey, Russia, Japan, Korea and Australia (Gillette® Consumer Survey). In this survey, 66 percent of men reported having sensitive facial skin (Gillette® Consumer Survey). Of these, 75 percent reported that their skin was ‘quite sensitive’ and 15 percent reported having ‘extremely sensitive’ skin (Gillette® Consumer Survey). Interestingly, nearly half of respondents (45 percent) reported that their skin had become more sensitive over the last 5 years (Gillette® Consumer Survey). This figure was substantially higher in Korea, Turkey and Poland, where 57 percent of respondents reported a change during this period (Gillette® Consumer Survey). Percentage of men have sensitive skin Australia Japan Korea Turkey Russia Poland Italy US UK Germany Spain 0 10 20 30 40 50 60 70 80 90 Figure 1: Percentage of men self-reporting sensitive skin (Gillette® Consumer Survey) When asking men in this survey what made them think they had sensitive skin, the main reported indicators were dryness (50 percent), redness (42 percent) and itchiness (32 percent) (Gillette® Consumer Survey). The indicators of sensitivity differ somewhat with geography, with Korean and German men most frequently noting dryness as a key indicator (62 percent and 63 percent) while 56 percent of Italian and Polish men report redness as a key indicator (Gillette® Consumer Survey). Burning and stinging were cited by only 22 percent of men globally, however in Turkey this figure increased to 36 percent (Gillette® Consumer Survey). 6 The dermatologist’s perspective As well as investigating consumer experiences of sensitive skin, Gillette® also investigated dermatologists’ experience of sensitive skin in a recent survey of 1,531 subjects conducted in Europe‡ and 300 subjects in a US internet survey (Gillette® Dermatologist Survey). When asked if they have seen an increase in cases of male sensitive skin over the last 5 years, 82 percent of respondents in the European study and 58.3 percent of the US study respondents agreed or strongly agreed. Percent responding for each level of agreement When asked to identify possible causes for this increase, the three most commonly cited reasons in the European study were environmental factors (53 percent), particularly exposure to UV light and extremes of temperature and humidity; increased acceptance in society (52 percent); and stress (52 percent) (Gillette® Dermatologist Survey). Of the reasons cited by US respondents, the most common were increased use of cosmetic products and procedures by men (66 percent), increased discussion of skin problems with physicians (64.7 percent) and increased acceptance in society (63.3 percent) (Gillette® Dermatologist Survey). In contrast to the European findings, response to stress was the least commonly cited reason in the US survey (36.3 percent) (Gillette® Dermatologist Survey). 82.0 58.3 57.5 47.0 29.3 24.4 12.1 11.3 12.0 3.1 Strongly Agree/ Agree Strongly Agree Agree Neither Agree nor Disagree European Survey (N=1531) 0.9 0.3 Disagree Strongly Disagree US Internet Survey (N=300) Figure 2: Increase in male patients reporting sensitive skin ‡ Survey conducted at 2012 meeting of European Academy of Dermatology and Venereology, Prague, Czech Republic. Not all respondents were EU-based. 7 Male skin: an increasingly sensitive subjecT Figure 3: Illustration of the shaving challenge - stiff beard hairs held within soft, undulating skin The shaving challenge The process of shaving represents a complex compromise, balancing robust removal of hair against minimized impact to the sensitive skin substrate (Cowley 2012). Close examination of the physiology of the male beard reveals that it can be compared to tough fibers embedded in a soft jelly-like matrix (Figure 3). This discrepancy in the relative properties of skin and hair results in a significant challenge when attempting to manipulate hairs for optimal, safe removal during shaving. The elastic modulus of dry beard hair has been measured to be around 3-4GPa, which decreases to around 1-2GPa when the hair is fully hydrated. The deformation of skin, in comparison, is highly non-linear and viscoelastic, with skin approximated to have an initial modulus of the order of 1MPa. This results in a relative ratio of around 1000 for the stiffness of hair/skin, resulting in tough hairs being relatively loosely supported in facial tissue (Cowley 2012). The cross-sectional size and profile of each individual hair is known to vary between individuals and across the facial sites of a single individual (Ertel 2010). The human hair follicle and the surrounding skin are richly innervated. Moreover, the topography of the skin is highly variable and combined with the presence of hairs, results in a very irregular terrain over which an incredibly sharp blade must safely traverse (Figure 4) (Ertel 2010). Figure 4: Electron micrograph of male facial skin 8 Shaving discomfort has been found to be proportional to the hair cutting force. It is hypothesized that discomfort associated with shaving is linked to localized skin displacement and/or the rotation and extension of the beard fiber in its follicle (Figure 5). Shaving can also cause irritation by the removal of irregular elevations of the skin by the razor blade, particularly around the follicular openings (Ertel 2010). Figure 5: Cutting forces impact shaving comfort The Neck as a Specific Problem Area The physiology of the face varies significantly between adjacent areas, even within an individual. Comparison of the properties of cheek and neck, for example, shows large differences in many of the key variables that will impact the quality of the shave. Hair elevation angles have been shown to be significantly lower on the neck than on the cheek; a factor which can make it more difficult for the blade to engage into the hairs when stroking with the hair growth direction. Skin properties also exacerbate the problem with, for example, greater skin roughness on the neck than on the cheek, as shown in Figure 6 (Cowley 2012). CHEEK NECK Figure 6: The difference in skin roughness observed for cheek and neck regions on a single individual In some cases, localized mounding of the skin on the neck can impede the beard hair from protruding freely from the follicular opening (Figure 7), described as a ‘trapped hair’. The majority of men report the neck as the area where they are most likely to experience soreness and irritation (Cowley 2012). 9 Male skin: an increasingly sensitive subjecT Figure 7: A trapped hair, characterised by localized mounding of the skin on the neck Shaving with sensitive skin As an incompletely understood condition, the care and management of sensitive skin can be challenging for sufferers. This challenge is particularly troublesome for men who need and desire to shave on a regular basis. Alongside the physical discomfort reported by those men with sensitive skin, in the survey from Gillette® (Gillette® Consumer Survey), more than half (52 percent) of men reported that they shave less often than they would want to because of their sensitive skin, with a particular issue being seen in Italy where two-thirds (66 percent) found they adjust their shaving schedule as a result of skin sensitivity. When asked whether they seek out products specifically designed for sensitive skin, nearly 6-in-10 (59 percent) men worldwide confirmed that they sought specialized skincare and shaving products in order to help manage their skin sensitivity (Gillette® Consumer Survey). Are these men taking the right approach? Dermatologists appear to think so. When asked about the role of shaving products in the management of sensitive skin, 92 percent of dermatologists responding to the European study and more than 95 percent of US dermatologists agreed that the selection of shaving products can play an important role for men with sensitive facial skin (Gillette® Dermatologist Survey). 10 The Gillette® sensitive skin range We know that roughly 1.3 billion men around the world shave with blades and razors—shaving is at the core of male grooming and Gillette® has developed a deep understanding of men’s skin and the grooming process over many years of research and product development. Gillette® understands that the ideal product range for sensitive skin is gentle on the skin, contains minimal potential irritants, lubricates the skin surface to minimize abrasion and friction, and minimizes cutting forces to reduce ‘tug and pull’. By developing a portfolio of products designed specifically to tackle sensitive skin issues, Gillette® has been able to produce a range of products that meet all the requirements identified by both consumers and dermatologists and offer full integration and synergies between elements in order to give optimal shaving results while protecting skin from irritation. Before shaving A successful shaving program for men with sensitive skin should begin with good preparation. Effective preparation with a face wash or scrub can help to reduce skin sensitivity by softening the beard hair, significantly reducing cutting forces, clearing the skin and hair of oil and debris and releasing trapped hairs. 12 Cutting Force (g) 11 10 9 Dry Hair Significant reduction in cutting force after 2 min hydration 8 7 6 5 4 3 2 Figure 8: Hydrated hair requires a lower cutting force than dry hair 1 0 01234510 HYDRATION TIME (min) 11 Male skin: an increasingly sensitive subjecT Figure 9: Scanning electron micrographs showing hair and skin before (left) and after (right) washing with a mild facial scrub Gillette’s range of pre-shave washes and scrubs include options for men with sensitive skin. These have been formulated to be mild, non-drying and soap-free and have been dermatologically tested and shown in clinical studies to be well-tolerated by men with self-assessed sensitive skin. During shaving Gillette’s range of shave gels includes items specifically formulated for use on sensitive skin. These gels have been developed with reduced levels of perfumes. They also combine a rich lather to hydrate beard hair and maintain hair softness throughout the shave with advanced lubricants (including highly hydrophilic linear polymers such as PEG-90M, PEG-23M ) to provide enhanced razor glide over a protective anti-friction layer. 12 The razor explained: Fusion® ProGlide™ Modern razors comprise multiple highly-advanced technological features that manage the skin and hair during the shaving process. These ensure that optimal closeness and comfort is attained by presenting the hairs in the most favorable manner for removal, whilst controlling and supporting the surrounding skin. Fusion® ProGlide™ razors use an array of Gillette’s most advanced technologies to offer a great shaving solution for all men, even on sensitive skin. 1 Blade technology The process of the blade cutting through the hair can lead to the sensation of tug and pull experienced by consumers (Figure 5). By employing a finer cutting edge, lower forces are required to progress the blade through the hair leading to an improvement in shaving comfort. One of ProGlide’s key innovations is the use of Gillette’s thinnest, finest blades*. They are treated with a low resistance coating to glide effortlessly over skin and through hair with lower cutting force and less tug and pull **- making the ProGlide™ range of razors great for men with sensitive skin. Figure 10 *First four blades **Versus Gillette® Fusion® 13 2 Blade spacing: the role of the blade stabilizer Figure 11: Multiple blade razors and skin management. Spacing 5 blades closer together (right) creates a shaving surface that helps spread shaving force for a more comfortable shave MACH3® Turbo 3 blades Fusion® 5 blades Figure 12: Five-blade razors with lower inter-blade distance reduce the height of the skin bulge (bottom) compared to three-bladed razors (top) Blade Stabilizer Fusion® Figure 13: The Blade Stabilizer on Fusion® ProGlide™ (right) Fusion® ProGlide™ The idea of utilizing multiple blades within a cartridge has existed for many years, with the first patent for a five-bladed razor granted in 1929 (US1920711). Historically, razors with many blades have been characterized by very high skin drag and hence have offered minimal consumer benefits (Cowley 2012). The key to comfortable multiple blade technology is not just the number of blades, but also the distance between the blades (blade span or blade spacing). The pressure exerted on the skin by the blades causes the skin to bulge between the blades (Figure 11). By spacing the blades closer together, the skin bulge is reduced and a more uniform stress is placed on the skin, resulting in a more comfortable shave (Figure 12) (Ertel 2010, Cowley 2012). When Gillette® developed Fusion®, five blades were introduced which were spaced closer together than the 3-bladed MACH3®: the blade span was reduced from 1.5mm in MACH3® to 1.05mm in Fusion®). In the development of Fusion® ProGlide™, Gillette® scientists have learnt that the irregularities of a man’s face can uncontrollably change that optimal blade distance during the shave. Fusion® ProGlide™ provides a Blade Stabilizer (Figure 13) which supports each of the 5 blades at the centre of the razor cartridge and helps to maintain an optimal blade span. 14 3 Mach3® The comfort guard From the invention of the safety razor in the late 18th century, razors have included a guard element at the front of the cartridge to protect the skin from the blades. In recent years, the guard has incorporated soft, flexible microfins (Figure 14). These aim to stretch the skin ahead of the first blade, thus presenting a smoother surface to be shaved for improved skin comfort and helping to present the hairs in a position to be cut more efficiently (Cowley 2012). Figure 15 shows scanning electron microscopy images of skin replica positives taken with and without stretch from a microfin guard, to illustrate the change in local topography achieved. Fusion® ProGlide™ has a re-engineered streamlined ‘Snowplow’ comfort guard, comprised of flexible microfins and ‘Snowplow ports’ at the front of the guard (Figure 16). These ports channel away excess shave prep to the back of the cartridge. This helps to prevent so-called “aquaplaning” (when the guard loses grip with the skin due to excess shave prep) and helps maintaining optimal skin contact. Fusion® Fusion® ProGlide™ Figure 14: The comfort guard on modern razors consists of soft, flexible microfins Skin Skin before before the the guard guard Skin Skin stretched stretched by by the the guard guard Figure 15: Scanning electron micrographs of skin, showing the impact of the guard in applying localised stretch to the skin surface. Static silicone dental rubber replicas were made of untreated skin and the skin immediately behind the guard of modified Gillette® Fusion® cartridges. Images were obtained using epoxy resin positives taken from the silicone replicas (Cowley 2012) Figure 16: The redesigned guard of Fusion® ProGlide™ with ‘Snowplow ports’ to channel away excess shave prep 15 4 Enhanced Lubrastrip feature Improved Lubricating Strip Figure 17: A larger and improved lubricating strip on Fusion® ProGlide™ (vs Fusion®) The lubrastrip is a matrix of water-soluble lubricant at the back of the cartridge which is distributed during the shave. Lubricating strips are typically composed of polymers, compounds with a high molecular weight. They are designed to dissolve out in a controlled manner when wet. The material is carefully engineered to deliver lubrication and glide with each razor stroke taken over the course of many shaves. This improves razor glide and comfort, helps to protect the skin during shaving and improves post-shave skin feel. Fusion® ProGlide™ provides an improved lubricating strip, which is now significantly larger compared to Fusion®. The lubricating polymers are complemented with mineral oil for great glide over the skin. 5 Oscillating razor systems (Power razors) M3Power® was Gillette’s first wet shaving system using battery powered technology. The razor’s gentle pulsations decrease the resistance to movement, resulting in significantly less drag. This has been confirmed in technical studies in which the amount of drag in each stroke is measured using miniature sensors and electronics. Reduced drag (resistance to movement) in turn can lead to better shaving comfort. 16 6 The microcomb (only on Fusion® ProGlide™ Power cartridges) The microcomb’s unique design helps guide hairs to the blade. Figure 18: The Fusion® ProGlide™ Power cartridge features a unique microcomb 17 Fusion® Solid Guard Bar Beard Hair Rotation of the hair in the follicle caused by the guard bar can cause discomfort (against the grain stroke) Guard Bar ProGlide™ Power Microcomb designed to allow the hair to pass through Figure 19: Benefits of the microcomb on ProGlide™ Power As mentioned previously, it is hypothesized that a key component of shaving discomfort arises from rotational movements of the beard fiber in its follicle, which can generate localised stresses in the surrounding skin (Figure 5). The microcomb on the ProGlide™ Power cartridge is designed to help guide the hairs to the blades. The slots in the Guard Bar (Figure 19 bottom) provide less interaction with the beard hairs compared to the solid guard bar found in traditional cartridges (Figure 19 top) and lead to less rotation of the hairs in the follicle. They allow the hairs to remain more upright at the point when the blade engages with the hair. Where the hairs pass through the slots, they are more optimally presented to the blades for cutting with low cutting force and hence improved comfort. This is particularly valuable for shaving against the grain (with hairs undergoing more rotations before they are cut than when they are shaved with the grain) and for those areas where the direction of the hair growth is often quite varied, such as the neck. 18 Razor technology validation The ultimate arbiter of any technology development in shaving is the consumer. Technologies are required to perform successfully across a huge range of physiologies and behaviors, hence the importance of large-scale consumer validation (Cowley 2012). New razor developments typically involve testing on more than 10,000 men, often consisting of panels of several hundreds of newly-recruited men, shaving for several weeks. Performance is evaluated through in-depth questionnaires, designed to explore the many different attributes of shaving comfort, irritation and closeness. The intention for technology development is always to significantly out-perform previous systems across a range of key shaving attributes (Cowley 2012). Testing on sensitive skin ProGlide™ and ProGlide™ Power were found to perform to a high standard on consumers with self-assessed sensitive skin (Data on File, 2011, Procter & Gamble). Both ProGlide™ and ProGlide™ Power have been evaluated by a dermatologist over a 28 day trial involving 52 men between the ages of 18 and 65 with self-assessed sensitive skin. The 52 men were randomized to receive one of the razors on a 1:1 basis and requested to shave daily*. The facial and neck skin of the panellists were examined by a dermatologist on day 1 (before the first shave) and day 28 (after the last shave) and graded on a 4 point scale (0–3, where 0 = none, 1=slight, 2=moderate and 3=severe) for visual signs of redness and dryness. The panellists graded their subjective symptoms of burning, stinging, itching and soreness on a similar scale and at the same time points. 3 ProGlide™ 2.5 AFTER 28 DAYS OF DAILY SHAVING Visible dryness rated 0 for all panelists 2 1.5 slight 1 .5 0 Redness Dryness Stinging Burning Itching Soreness Average Score Average Score The dermatologist concluded that both razors were well tolerated and safe to use for men with sensitive skin, even when used to remove facial hair on a daily* basis. There were no adverse events reported. None of the symptoms increased during the 28 day trial period and several attributes showed improvements during the course of the study. There were no signs of visible dryness in either group at day 28 (Graded 0 for all panellists). The subjects using ProGlide™ Power also experienced no symptoms of stinging, burning or itching at day 28 (graded 0 for all panellists). The average score across all indicators of sensitive skin remained below 0.5 in both groups, over the 28 day test period (Figure 20). 3 ProGlide™ Power 2.5 AFTER 28 DAYS OF DAILY SHAVING Visible dryness and sensation of stinging, burning and itching rated 0 for all panelists 2 1.5 slight 1 .5 0 Redness Dryness Stinging Burning Itching Soreness Figure 20: Results of dermatological testing after 28 days of use *Daily shave : ≥ 5 days per week and no more than once per day) over a 28 day period with replacement blades supplied every 7 days. 19 Male skin: an increasingly sensitive subjecT Post-shaving Gillette® also offers specialized sensitive skin post-shave skincare technologies. The combination of emollients and humectants in these products helps the skin to hydrate and retain moisture, reducing the impact of shaving on sensitive skin. Gillette® has also developed a specific moisturizer containing factor 15 UVA and UVB protection for daily protection. As with the other members of the Gillette® range of sensitive skin products, these products have also been extensively dermatologically tested to ensure they are well tolerated by men with sensitive skin. 20 Conclusions Sensitive skin is a significant problem for many men, impacting on their daily routines and impacting on quality of life. Based on both self-reported accounts and the experience of dermatologists, the problem is being reported with increasing frequency by men, and is quickly approaching the same levels reported in women. Shaving represents a particular problem for men with sensitive skin, with more than half of men finding shaving with sensitive skin to be a significant issue. Both men with sensitive skin and dermatologists agree that the selection of appropriate shaving products is a key element of managing sensitive skin. The range of sensitive skin-specific shaving products developed by Gillette® includes both pre- and post-shave skincare products and the ProGlide™ range of razors that utilise the latest in shaving technology to offer an unparalleled shaving package supported by dermatological trials. When discussing sensitive skin management with your male patients, you can be comfortable recommending the complete range of Gillette® range of products, safe in the knowledge that they combine proven excellence in shaving, even on sensitive skin. 21 Male skin: an increasingly sensitive subjecT Works cited Berardesca E, Cespa M, Farinelli N, et al. In vivo transcutaneous penetration of nicotinates and sensitive skin. Contact Dermatitis 1991; 25: 35–8. Berardesca E, Farage M, Maibach H. Sensitive skin: an overview. Int J Cosmet Sci 2012; Aug 29. doi: 10.1111/j.1468-2494.2012.00754.x. [Epub ahead of print] Cowley K and Vanoosthuyze K. Insights into shaving and its impact on skin. 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Seidenari S, Francomano M, Mantavoni L. Baseline biophysical parameters in subjects with sensitive skin. Contact Dermatitis 1998; 38: 311-5. Willis CM, Shaw S, de Lacharrière O, et al. Sensitive skin: an epidemiological study. Br J Dermatol 2001; 145: 258–63. 22