The impact of stress on epidermal barrier function: an evidence‐based review
Summary Background The epidermal barrier functions to limit skin infection and inflammation by inhibiting irritant and immunogen invasion. Abundant evidence suggests that psychological stress stemming from crowding, isolation, nicotine smoking, insomnia, mental arithmetic tasks, physical pain, real‐...
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Veröffentlicht in: | British journal of dermatology (1951) 2019-12, Vol.181 (6), p.1129-1137 |
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creator | Maarouf, M. Maarouf, C.L. Yosipovitch, G. Shi, V.Y. |
description | Summary
Background
The epidermal barrier functions to limit skin infection and inflammation by inhibiting irritant and immunogen invasion. Abundant evidence suggests that psychological stress stemming from crowding, isolation, nicotine smoking, insomnia, mental arithmetic tasks, physical pain, real‐life stressors (examinations and marital strain) and lack of positive personality traits may impart both acute and chronic epidermal dysfunction.
Objectives
To review the relationship between stress and epidermal barrier dysfunction.
Methods
A review of the PubMed and Embase databases was conducted to identify all English‐language case–control, cross‐sectional and randomized control trials that have reported the effect of stress on epidermal barrier function. The authors’ conclusions are based on the available evidence from 21 studies that met the inclusion and exclusion criteria.
Results
Psychological stressors upregulate the hypothalamic–pituitary–adrenal axis to stimulate local and systemic stress hormone production. This ultimately leads to aberrant barrier dysfunction, characterized by decreased epidermal lipid and structural protein production, decreased stratum corneum hydration and increased transepidermal water loss.
Conclusions
This evidence‐based review explores the adverse effects of psychological stressors on epidermal barrier function. Future investigations using more real‐life stressors are needed to elucidate further their impact on skin physiology and identify practical stress‐relieving therapies that minimize and restore epidermal barrier dysfunction, particularly in at‐risk populations.
What's already known about this topic?
The literature reports the negative effect of stress on prolonged wound healing.
Less is known about the relationship between stress and epidermal barrier dysfunction, a chronic, superficial wound involving the upper epidermal layers.
What does this study add?
Psychological stressors impact epidermal barrier function by activating the hypothalamic–pituitary–adrenal axis to stimulate local and systemic stress hormone production.
Stress hormones negatively affect the epidermal barrier by decreasing epidermal lipids and structural proteins, decreasing stratum corneum hydration and increasing transepidermal water loss.
Identification of such stressors can promote stress‐avoidance and stress‐reduction behaviours that protect epidermal barrier function and prevent certain dermatological conditions.
Plain language summary availab |
doi_str_mv | 10.1111/bjd.17605 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2164550290</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2321262093</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4195-320ee3decbe90229ab17dd5b18966b04186d7295c2504ea4da82f7004489e52c3</originalsourceid><addsrcrecordid>eNp1kMtKBDEQRYMoOj4W_oAE3OiitZJ00hN3vh-IbnQd0kk19tCPMZlW3PkJfqNfYnTUhWBtCuoeLsUhZJPBHkuzX078HisUyAUyYkLJjDMhFskIAIoMtBIrZDXGCQATIGGZrAhQLJe8GJGbuwekdTu1bkb7isZZwBhp31Gc1h5Daxta2hBqDLQaOjer--6A2hQ_pbhz-P76VtqInoZ0wed1slTZJuLG914j92end8cX2fXt-eXx4XXmcqZlJjggCo-uRA2ca1uywntZsrFWqoScjZUvuJaOS8jR5t6OeVUA5PlYo-ROrJGdee809I8Dxplp6-iwaWyH_RANZyqXEriGhG7_QSf9ELr0neGCM644aJGo3TnlQh9jwMpMQ93a8GIYmE_JJkk2X5ITu_XdOJQt-l_yx2oC9ufAc93gy_9N5ujqZF75AYCVhMA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2321262093</pqid></control><display><type>article</type><title>The impact of stress on epidermal barrier function: an evidence‐based review</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><source>Oxford University Press Journals All Titles (1996-Current)</source><creator>Maarouf, M. ; Maarouf, C.L. ; Yosipovitch, G. ; Shi, V.Y.</creator><creatorcontrib>Maarouf, M. ; Maarouf, C.L. ; Yosipovitch, G. ; Shi, V.Y.</creatorcontrib><description>Summary
Background
The epidermal barrier functions to limit skin infection and inflammation by inhibiting irritant and immunogen invasion. Abundant evidence suggests that psychological stress stemming from crowding, isolation, nicotine smoking, insomnia, mental arithmetic tasks, physical pain, real‐life stressors (examinations and marital strain) and lack of positive personality traits may impart both acute and chronic epidermal dysfunction.
Objectives
To review the relationship between stress and epidermal barrier dysfunction.
Methods
A review of the PubMed and Embase databases was conducted to identify all English‐language case–control, cross‐sectional and randomized control trials that have reported the effect of stress on epidermal barrier function. The authors’ conclusions are based on the available evidence from 21 studies that met the inclusion and exclusion criteria.
Results
Psychological stressors upregulate the hypothalamic–pituitary–adrenal axis to stimulate local and systemic stress hormone production. This ultimately leads to aberrant barrier dysfunction, characterized by decreased epidermal lipid and structural protein production, decreased stratum corneum hydration and increased transepidermal water loss.
Conclusions
This evidence‐based review explores the adverse effects of psychological stressors on epidermal barrier function. Future investigations using more real‐life stressors are needed to elucidate further their impact on skin physiology and identify practical stress‐relieving therapies that minimize and restore epidermal barrier dysfunction, particularly in at‐risk populations.
What's already known about this topic?
The literature reports the negative effect of stress on prolonged wound healing.
Less is known about the relationship between stress and epidermal barrier dysfunction, a chronic, superficial wound involving the upper epidermal layers.
What does this study add?
Psychological stressors impact epidermal barrier function by activating the hypothalamic–pituitary–adrenal axis to stimulate local and systemic stress hormone production.
Stress hormones negatively affect the epidermal barrier by decreasing epidermal lipids and structural proteins, decreasing stratum corneum hydration and increasing transepidermal water loss.
Identification of such stressors can promote stress‐avoidance and stress‐reduction behaviours that protect epidermal barrier function and prevent certain dermatological conditions.
Plain language summary available online</description><identifier>ISSN: 0007-0963</identifier><identifier>EISSN: 1365-2133</identifier><identifier>DOI: 10.1111/bjd.17605</identifier><identifier>PMID: 30614527</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Case-Control Studies ; Cross-Sectional Studies ; Epidermis - pathology ; Humans ; Hydration ; Hypothalamo-Hypophyseal System - physiopathology ; Hypothalamus ; Lipids ; Nicotine ; Pituitary ; Pituitary-Adrenal System - physiopathology ; Randomized Controlled Trials as Topic ; Reviews ; Sleep disorders ; Stratum corneum ; Stress, Psychological - pathology ; Stress, Psychological - physiopathology ; Structural proteins ; Water loss ; Water Loss, Insensible - physiology ; Wound healing ; Wound Healing - physiology</subject><ispartof>British journal of dermatology (1951), 2019-12, Vol.181 (6), p.1129-1137</ispartof><rights>2019 British Association of Dermatologists</rights><rights>2019 British Association of Dermatologists.</rights><rights>Copyright © 2019 British Association of Dermatologists</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4195-320ee3decbe90229ab17dd5b18966b04186d7295c2504ea4da82f7004489e52c3</citedby><cites>FETCH-LOGICAL-c4195-320ee3decbe90229ab17dd5b18966b04186d7295c2504ea4da82f7004489e52c3</cites><orcidid>0000-0003-2732-6492 ; 0000-0001-6303-1822</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fbjd.17605$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fbjd.17605$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30614527$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Maarouf, M.</creatorcontrib><creatorcontrib>Maarouf, C.L.</creatorcontrib><creatorcontrib>Yosipovitch, G.</creatorcontrib><creatorcontrib>Shi, V.Y.</creatorcontrib><title>The impact of stress on epidermal barrier function: an evidence‐based review</title><title>British journal of dermatology (1951)</title><addtitle>Br J Dermatol</addtitle><description>Summary
Background
The epidermal barrier functions to limit skin infection and inflammation by inhibiting irritant and immunogen invasion. Abundant evidence suggests that psychological stress stemming from crowding, isolation, nicotine smoking, insomnia, mental arithmetic tasks, physical pain, real‐life stressors (examinations and marital strain) and lack of positive personality traits may impart both acute and chronic epidermal dysfunction.
Objectives
To review the relationship between stress and epidermal barrier dysfunction.
Methods
A review of the PubMed and Embase databases was conducted to identify all English‐language case–control, cross‐sectional and randomized control trials that have reported the effect of stress on epidermal barrier function. The authors’ conclusions are based on the available evidence from 21 studies that met the inclusion and exclusion criteria.
Results
Psychological stressors upregulate the hypothalamic–pituitary–adrenal axis to stimulate local and systemic stress hormone production. This ultimately leads to aberrant barrier dysfunction, characterized by decreased epidermal lipid and structural protein production, decreased stratum corneum hydration and increased transepidermal water loss.
Conclusions
This evidence‐based review explores the adverse effects of psychological stressors on epidermal barrier function. Future investigations using more real‐life stressors are needed to elucidate further their impact on skin physiology and identify practical stress‐relieving therapies that minimize and restore epidermal barrier dysfunction, particularly in at‐risk populations.
What's already known about this topic?
The literature reports the negative effect of stress on prolonged wound healing.
Less is known about the relationship between stress and epidermal barrier dysfunction, a chronic, superficial wound involving the upper epidermal layers.
What does this study add?
Psychological stressors impact epidermal barrier function by activating the hypothalamic–pituitary–adrenal axis to stimulate local and systemic stress hormone production.
Stress hormones negatively affect the epidermal barrier by decreasing epidermal lipids and structural proteins, decreasing stratum corneum hydration and increasing transepidermal water loss.
Identification of such stressors can promote stress‐avoidance and stress‐reduction behaviours that protect epidermal barrier function and prevent certain dermatological conditions.
Plain language summary available online</description><subject>Case-Control Studies</subject><subject>Cross-Sectional Studies</subject><subject>Epidermis - pathology</subject><subject>Humans</subject><subject>Hydration</subject><subject>Hypothalamo-Hypophyseal System - physiopathology</subject><subject>Hypothalamus</subject><subject>Lipids</subject><subject>Nicotine</subject><subject>Pituitary</subject><subject>Pituitary-Adrenal System - physiopathology</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Reviews</subject><subject>Sleep disorders</subject><subject>Stratum corneum</subject><subject>Stress, Psychological - pathology</subject><subject>Stress, Psychological - physiopathology</subject><subject>Structural proteins</subject><subject>Water loss</subject><subject>Water Loss, Insensible - physiology</subject><subject>Wound healing</subject><subject>Wound Healing - physiology</subject><issn>0007-0963</issn><issn>1365-2133</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kMtKBDEQRYMoOj4W_oAE3OiitZJ00hN3vh-IbnQd0kk19tCPMZlW3PkJfqNfYnTUhWBtCuoeLsUhZJPBHkuzX078HisUyAUyYkLJjDMhFskIAIoMtBIrZDXGCQATIGGZrAhQLJe8GJGbuwekdTu1bkb7isZZwBhp31Gc1h5Daxta2hBqDLQaOjer--6A2hQ_pbhz-P76VtqInoZ0wed1slTZJuLG914j92end8cX2fXt-eXx4XXmcqZlJjggCo-uRA2ca1uywntZsrFWqoScjZUvuJaOS8jR5t6OeVUA5PlYo-ROrJGdee809I8Dxplp6-iwaWyH_RANZyqXEriGhG7_QSf9ELr0neGCM644aJGo3TnlQh9jwMpMQ93a8GIYmE_JJkk2X5ITu_XdOJQt-l_yx2oC9ufAc93gy_9N5ujqZF75AYCVhMA</recordid><startdate>201912</startdate><enddate>201912</enddate><creator>Maarouf, M.</creator><creator>Maarouf, C.L.</creator><creator>Yosipovitch, G.</creator><creator>Shi, V.Y.</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2732-6492</orcidid><orcidid>https://orcid.org/0000-0001-6303-1822</orcidid></search><sort><creationdate>201912</creationdate><title>The impact of stress on epidermal barrier function: an evidence‐based review</title><author>Maarouf, M. ; Maarouf, C.L. ; Yosipovitch, G. ; Shi, V.Y.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4195-320ee3decbe90229ab17dd5b18966b04186d7295c2504ea4da82f7004489e52c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Case-Control Studies</topic><topic>Cross-Sectional Studies</topic><topic>Epidermis - pathology</topic><topic>Humans</topic><topic>Hydration</topic><topic>Hypothalamo-Hypophyseal System - physiopathology</topic><topic>Hypothalamus</topic><topic>Lipids</topic><topic>Nicotine</topic><topic>Pituitary</topic><topic>Pituitary-Adrenal System - physiopathology</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Reviews</topic><topic>Sleep disorders</topic><topic>Stratum corneum</topic><topic>Stress, Psychological - pathology</topic><topic>Stress, Psychological - physiopathology</topic><topic>Structural proteins</topic><topic>Water loss</topic><topic>Water Loss, Insensible - physiology</topic><topic>Wound healing</topic><topic>Wound Healing - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Maarouf, M.</creatorcontrib><creatorcontrib>Maarouf, C.L.</creatorcontrib><creatorcontrib>Yosipovitch, G.</creatorcontrib><creatorcontrib>Shi, V.Y.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of dermatology (1951)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Maarouf, M.</au><au>Maarouf, C.L.</au><au>Yosipovitch, G.</au><au>Shi, V.Y.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The impact of stress on epidermal barrier function: an evidence‐based review</atitle><jtitle>British journal of dermatology (1951)</jtitle><addtitle>Br J Dermatol</addtitle><date>2019-12</date><risdate>2019</risdate><volume>181</volume><issue>6</issue><spage>1129</spage><epage>1137</epage><pages>1129-1137</pages><issn>0007-0963</issn><eissn>1365-2133</eissn><abstract>Summary
Background
The epidermal barrier functions to limit skin infection and inflammation by inhibiting irritant and immunogen invasion. Abundant evidence suggests that psychological stress stemming from crowding, isolation, nicotine smoking, insomnia, mental arithmetic tasks, physical pain, real‐life stressors (examinations and marital strain) and lack of positive personality traits may impart both acute and chronic epidermal dysfunction.
Objectives
To review the relationship between stress and epidermal barrier dysfunction.
Methods
A review of the PubMed and Embase databases was conducted to identify all English‐language case–control, cross‐sectional and randomized control trials that have reported the effect of stress on epidermal barrier function. The authors’ conclusions are based on the available evidence from 21 studies that met the inclusion and exclusion criteria.
Results
Psychological stressors upregulate the hypothalamic–pituitary–adrenal axis to stimulate local and systemic stress hormone production. This ultimately leads to aberrant barrier dysfunction, characterized by decreased epidermal lipid and structural protein production, decreased stratum corneum hydration and increased transepidermal water loss.
Conclusions
This evidence‐based review explores the adverse effects of psychological stressors on epidermal barrier function. Future investigations using more real‐life stressors are needed to elucidate further their impact on skin physiology and identify practical stress‐relieving therapies that minimize and restore epidermal barrier dysfunction, particularly in at‐risk populations.
What's already known about this topic?
The literature reports the negative effect of stress on prolonged wound healing.
Less is known about the relationship between stress and epidermal barrier dysfunction, a chronic, superficial wound involving the upper epidermal layers.
What does this study add?
Psychological stressors impact epidermal barrier function by activating the hypothalamic–pituitary–adrenal axis to stimulate local and systemic stress hormone production.
Stress hormones negatively affect the epidermal barrier by decreasing epidermal lipids and structural proteins, decreasing stratum corneum hydration and increasing transepidermal water loss.
Identification of such stressors can promote stress‐avoidance and stress‐reduction behaviours that protect epidermal barrier function and prevent certain dermatological conditions.
Plain language summary available online</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>30614527</pmid><doi>10.1111/bjd.17605</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-2732-6492</orcidid><orcidid>https://orcid.org/0000-0001-6303-1822</orcidid></addata></record> |
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source | MEDLINE; Access via Wiley Online Library; Oxford University Press Journals All Titles (1996-Current) |
subjects | Case-Control Studies Cross-Sectional Studies Epidermis - pathology Humans Hydration Hypothalamo-Hypophyseal System - physiopathology Hypothalamus Lipids Nicotine Pituitary Pituitary-Adrenal System - physiopathology Randomized Controlled Trials as Topic Reviews Sleep disorders Stratum corneum Stress, Psychological - pathology Stress, Psychological - physiopathology Structural proteins Water loss Water Loss, Insensible - physiology Wound healing Wound Healing - physiology |
title | The impact of stress on epidermal barrier function: an evidence‐based review |
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