From the Guidelines
Stress-induced dermatitis should be managed with a combination of stress reduction techniques, proper skin care, and topical corticosteroids, as this approach has been shown to reduce morbidity, mortality, and improve quality of life in patients with atopic dermatitis, a condition closely related to stress-induced dermatitis 1. To manage stress-induced dermatitis, it is essential to address both the psychological and dermatological aspects of the condition.
- Use gentle, fragrance-free cleansers and apply moisturizers containing ceramides or colloidal oatmeal immediately after bathing to lock in moisture.
- For flare-ups, topical corticosteroids like hydrocortisone 1% cream can be applied twice daily for up to two weeks, as recommended for atopic dermatitis 1.
- More severe cases may require prescription-strength corticosteroids or calcineurin inhibitors like tacrolimus or pimecrolimus. Stress management is crucial, and techniques such as meditation, deep breathing exercises, or yoga for 15-20 minutes daily can help reduce stress levels, as supported by the British Association of Dermatologists' guidelines for the investigation and management of generalized pruritus in adults without an underlying dermatosis 1.
- Getting adequate sleep (7-8 hours nightly) and regular exercise also helps reduce stress levels.
- Avoid known skin irritants, wear loose cotton clothing, and maintain cool ambient temperatures to prevent sweating that can worsen symptoms. The relationship between stress and skin conditions is well-established, with stress triggering inflammation in the body by increasing cortisol levels, which can disrupt skin barrier function and immune response, making the skin more reactive and susceptible to irritation and inflammation 1.
From the Research
Diagnosis of Stress-Induced Dermatitis
- The diagnosis of stress-induced dermatitis, also known as atopic dermatitis (AD), involves evaluating the patient's psychological state and its impact on the skin condition 2, 3.
- Reliable psychological tests are an important additional parameter for assessing a patient's psychological state 2.
- The measurement of plasmatic cortisol or salivary cortisol can be used to evaluate the patient's stress level 2, 4.
- Skin keratinocytes contain receptors for neurotransmitters and hormones, which can actively participate in psychoneuroimmunological pathways 2.
Treatment of Stress-Induced Dermatitis
- Stress management techniques, such as cognitive behavioral stress management, can be a useful addition to standard treatment in patients with atopic dermatitis 4.
- Psychological interventions have been shown to have positive effects on skin status, itch, and scratching behavior 4, 5.
- The combination of traditional AD treatments with natural compounds (flavonoids, alkaloids, terpenes, isothiocyanates) may be useful in improving the effectiveness of therapy and reducing chronic inflammation 6.
- Reducing stress and anxiety can help improve the patient's quality of life and reduce the severity of AD symptoms 3, 5.