Psychological Stress Perturbs Epidermal Permeability Barrier Homeostasis

Abstract

Background: A large number of skin diseases, including atopic dermatitis and psoriasis, appear to be precipitated or exacerbated by psychological stress. Nevertheless, the specific pathogenic role of psychological stress remains unknown. In 3 different murine models of psychological stress, it was recently shown that psychological stress negatively impacts cutaneous permeability barrier function and that coadministration of tranquilizers blocks this stressinduced deterioration in barrier function. Objectives and Methods: The relationship between psychological stress and epidermal permeability barrier function was investigated in 27 medical, dental, and pharmacy students without coexistent skin disease. Their psychological state was assessed with 2 well-validated measures: the Perceived Stress Scale and the Profile of Mood States. Barrier function was assessed simultaneously with the stress measures at periods of presumed higher stress (during final examinations) and at 2 assumed, lower stress occasions (after return from winter vacation [approximately 4 weeks before final examinations] and during spring vacation [approximately 4 weeks after final examinations]). Results: The subjects as a group demonstrated a decline in permeability barrier recovery kinetics after barrier disruption by cellophane tape stripping, in parallel with an increase in perceived psychological stress during the higher vs the initial lower stress occasions. During the follow-up, presumed lower stress period, the subjects again displayed lower perceived psychological stress scores and improved permeability barrier recovery kinetics, comparable to those during the initial lower stress period. Moreover, the greatest deterioration in barrier function occurred in those subjects who demonstrated the largest increases in perceived psychological stress. Conclusion: These studies provide the first link between psychological status and cutaneous function in humans and suggest a new pathophysiological paradigm, ie, stress-induced derangements in epidermal function as precipitators of inflammatory dermatoses.

Psychological stress and wound healing in humans: A systematic review and meta-analysis

“…The methodological and measurement heterogeneity across the studies may have also contributed to variance in effect sizes in the meta-analysis. Interestingly, clinical and tape-stripping studies were the only wound types to report nonsignificant findings [61,66] in the meta-analysis. In addition, it is worth noting that none of the tape stripping studies formally discussed the validity and reliability of their transepidermal water loss measurements, although one study [48] did state that procedural guidelines were followed.…”

The effect of Mindfulness-Based Stress Reduction on wound healing: a preliminary study

“…Broadbent and Koschwanez 2012;House 2015). Most of these studies focused on the effects of psychosocial distress on wound healing and consistently reported impaired wound healing across different wound models and different stressors (Bosch et al 2007;ColeKing and Harding 2001;Ebrecht et al 2004;Garg et al 2001;Kiecolt-Glaser et al 2005;Maple et al 2015). A meta-analysis revealed a robust association between stress and impaired healing (Walburn et al 2009).…”

Stress-induced enhancement of leukocyte trafficking into sites of surgery or immune activation

“…Introducing LTN and TNF-␣ in sponges also provides a model for examining the effects of stress on leukocyte trafficking into sites of preexisting immunopathological conditions like psoriasis or dermatitis. Such an examination is important because psoriasis and other dermal inflammatory conditions are exacerbated by stress (17,18).…”