Cooling the Skin: Understanding a Specific Cutaneous

A patient recently presented with long-standing severe itching originating from lichen sclerosus et atrophicus at the vulva area. We successively treated her using a topical formulation of TRPM8 agonist which produces a cooling sensation. The cooling sensation, an afferent sensory perception in various skin neuronal pathways, could be a useful mechanism to relieve an itchy sensation in various skin disorders. Mechanoreceptors are related to touch vibration and pressure sensations and have a special morphology where the nerve endings are optimized to receive sensory inputs. However, unmyelinated nerve fibers are believed to transfer nociception such as pain, itching, stinging and burning derived from chemical or thermal stimuli. Among them, the function of transient receptor potential (TRP) receptors is very unique because they transfer the signal not only in the neuronal perception pathway but also in the cellular signal pathway where it appears as an ion channel. This review explains the cooling sensation of skin which has not been evaluated thoroughly, and provides insights for further clinical applications