Which types of tissue damage can cause pain in the skin?

Pain in the skin is primarily mediated by specialized nerve endings that respond to three distinct categories of stimuli: mechanical, thermal, and chemical.1

• Mechanical stimuli: These include physical forces such as cutting, pressure, or trauma that damage the skin's structural integrity.12
• Thermal stimuli: Extreme temperatures, such as those experienced during burning, can excite pain receptors.13
• Chemical stimuli: Pain can be triggered by the release of specific substances in response to injury or inflammation. Key chemical mediators include bradykinin, serotonin, and histamine. Additionally, prostaglandins are released during inflammation and can heighten pain sensitivity, a condition known as hyperalgesia.14

These stimuli are detected by free nerve endings located in the skin, which transmit signals via A delta fibres (associated with sharp, localized pain) and C fibres (associated with lingering, poorly localized sensations). While the skin is highly sensitive to these forms of damage, it is important to note that pain perception is a complex process influenced by the brain and spinal cord, including the gate control system, which can modulate whether sensory input is ultimately perceived as painful.12