The mind–skin connection: A narrative review exploring the link between inflammatory skin diseases and psychological stress

• Published in: Journal of the European Academy of Dermatology and Venereology Vol. 38; no. 5; pp. 821 - 834
• Main Authors: Biazus Soares, G., Mahmoud, O., Yosipovitch, G., Mochizuki, H.
• Format: Journal Article
• Language: English
• Published: England 01.05.2024
• Subjects: Brain - physiopathology; Cytokines - metabolism; Dermatitis - physiopathology; Dermatitis - psychology; Humans; Hypothalamo-Hypophyseal System - physiopathology; Pituitary-Adrenal System - physiopathology; Skin; Skin Diseases - physiopathology; Skin Diseases - psychology; Stress, Psychological - physiopathology
• ISSN: 0926-9959; 1468-3083
• DOI: 10.1111/jdv.19813

Inflammatory skin diseases are known to negatively impact patient psychology, with individuals experiencing higher rates of stress and subsequent diminished quality of life, as well as mental health issues including anxiety and depression. Moreover, increased psychological stress has been found to exacerbate existing inflammatory skin diseases. The association between inflammatory skin diseases and psychological stress is a timely topic, and a framework to better understand the relationship between the two that integrates available literature is needed. In this narrative review article, we discuss potential neurobiological mechanisms behind psychological stress due to inflammatory skin diseases, focusing mainly on proinflammatory cytokines in the circulating system (the brain‐gut‐skin communications) and the default mode network in the brain. We also discuss potential descending pathways from the brain that lead to aggravation of inflammatory skin diseases due to psychological stress, including the central and peripheral hypothalamic–pituitary–adrenal axes, peripheral nerves and the skin barrier function.