A new article published in Dermatology Practical & Conceptual discussed that stress confers an array of physiologic and clinical impacts on skin disease. The stress response stimulates the endocrine, neurologic and immune systems, which trigger a cascade of impacts – both systemic and cutaneous. 

The two main arms of the stress response are – sympathetic nervous system and hypothalamic-pituitary-adrenal axis. These lead to release of cortisol, catecholamines and neuropeptides causing multiple effects, such as – skin inflammation, increased itching, impaired skin barrier function, impaired wound healing, and suppression of immunity.

Mind-body therapies focus on the interaction between the mind and the body, with the goal to influence physical function and health. Such interventions may ameliorate harmful physiologic changes attributed to stress and may even aid in reducing harmful behaviors. In some cases—with biofeedback—they may also result in beneficial physiologic changes.

Treatments like meditation, biofeedback, hypnosis and guided imagery have shown benefits in treating skin diseases, especially for symptomatic relief in itching and psychosocial outcomes, and for attenuating severity. These interventions have also been evaluated in diseases such as atopic dermatitis, psoriasis and trichotillomania. 

Given the potential benefits, improvements in psychosocial outcomes and a low-risk profile of such alternative therapies, referral to qualified practitioners must be considered in appropriate cases.

Source: Dermatology Practical & Conceptual. 2021 Sep; 11(4): e2021091. doi: 10.5826/dpc.1104a91