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. 2017 Jul-Aug;92(4):521–525. doi: 10.1590/abd1806-4841.201756111

Chart 2.

Sensitive Skin Questionnaire

1. Do you consider having sensitive facial skin?
2. Do you think you have sensitive facial skin that is prone to irritation?
3. Do you think you have reactive facial skin (which has a pungency, burning or itching, with or without redness)?
4. Do you avoid some cosmetics, which you think may cause reactive facial skin (which presents pungency, burning or itching, with or without redness)?
5. Do you consider your facial skin to be reactive (exhibiting pungency, burning or itching, with or without redness) as soon as you contact with cosmetics and toiletries?
6. Does any cosmetic or toiletry make your facial skin appear pungent, burning or itching?
7. Have you ever had any adverse reactions on the face due to the use of cosmetics or toiletries?
8. Does the expression "does not tolerate cold weather or cold environment" apply to your facial skin?
9. Does the expression "does not tolerate warm weather or warm environment" apply to your facial skin?
10. Does the expression "does not tolerate sudden changes in temperature" (e.g. leaving from a warm, indoor environment to a cold, outdoor environment) apply to your facial skin?
11. When coming into contact with the wind, does your facial skin show pungency, burning or itching?
12. When coming into contact with the sun, does your facial skin show pungency, burning or itching?
13. Is your facial skin reactive (pungency, burning or itching, with or without redness) to air pollution?

Source: Jourdain R, et al, 2005.20