Annals of Medical and Surgical Dermatology

ABSTRACT

Background: Psychodermatology is a growing interdisciplinary field exploring the complex interactions between psychological factors and skin health. Psychological stress, anxiety, and depression are known to exacerbate or even initiate dermatological conditions, contributing to a cycle of mutual exacerbation between mental and skin health. The current study investigates these interactions within the framework of psychoneuroimmunology, emphasizing the physiological mechanisms involved and the impact of stress-related psychological states on skin conditions.

Methods: A comprehensive literature review examined the mechanisms linking psychological factors to dermatological outcomes. Key concepts such as the hypothalamic-pituitary-adrenal (HPA) axis, neurogenic inflammation, and the neuro-immuno-cutaneous-endocrine (NICE) model were analyzed to understand their roles in stress-related dermatological exacerbations. Furthermore, cognitive and behavioral models, including the biopsychosocial and cognitive-behavioral therapy (CBT) principles, were reviewed to assess their effectiveness in mitigating psychodermatological symptoms.

Results: Findings suggest that psychological stress activates the HPA axis, leading to cortisol release, which impairs immune function and skin barrier integrity. This process increases susceptibility to inflammation, as seen in conditions like psoriasis, eczema, and acne. Neurogenic inflammation triggered by stress-related neuropeptides further exacerbates skin inflammation, reinforcing the need for interdisciplinary treatment. Cognitive and behavioral therapies, including CBT and mindfulness, showed positive effects in reducing stress and alleviating dermatological symptoms. The biopsychosocial model effectively integrates biological, psychological, and social influences on skin health, supporting the development of holistic treatment approaches.

Conclusions: Psychodermatology underscores the importance of addressing both mental health and dermatological symptoms in patients with stress-related skin conditions. Integrative care models combining dermatological treatment with psychological support are essential for managing the bidirectional influence of skin health and mental well-being. Future research should focus on standardized protocols for interdisciplinary treatment to enhance patient outcomes in psychodermatology.

Article History

Received 12 September 2024; Revised 10 October 2024; Accepted 17 October 2024

KEYWORDS

1. Psychodermatology
2. Psychoneuroimmunology
3. HPA axis
4. Cognitivebehavioral therapy (CBT)
5. Neurogenic infammation