The Influence of Anxiety Disorders on Dermatological Diseases: A Vicious Cycle of Stress and Skin Symptoms

• DOI: https://doi.org/10.22533/at.ed.1594972405114

• Palavras-chave: Psychodermatology; Anxiety disorders; Dermatological diseases; Skin inflammation; Stress-induced skin conditions.

• Keywords: Psychodermatology; Anxiety disorders; Dermatological diseases; Skin inflammation; Stress-induced skin conditions.

• Abstract: INTRODUCTION This review begins by highlighting the significant prevalence of anxiety disorders in patients with dermatological conditions and the severe impact of this comorbidity on quality of life. It discusses the classification of anxiety disorders, including their specific psychological manifestations in dermatological settings. Biological mechanisms, including the HPA axis, are explored as key pathways through which anxiety exacerbates skin inflammation and barrier dysfunction, setting the stage for a cycle of psychological and physical symptoms that reinforce one another. OBJETIVE The main objective of this work was to investigate the complex bidirectional relationship between anxiety disorders and dermatological conditions, with a focus on understanding the underlying mechanisms and identifying potential treatment approaches. METHODS This is a narrative review which included studies in the MEDLINE – PubMed (National Library of Medicine, National Institutes of Health), COCHRANE, EMBASE and Google Scholar databases, using as descriptors: “Psychodermatology and anxiety” OR “Stress-related dermatological disorders” AND “Immune response in anxiety-driven skin conditions” OR “HPA axis and skin health” OR “Self-inflicted skin injury in anxiety disorders” in the last  years. RESULTS AND DISCUSSION The results section details the specific dermatological conditions most commonly associated with anxiety, including atopic dermatitis, psoriasis, and acne. The section explores how chronic anxiety affects skin hydration, barrier function, and immune responses, emphasizing the role of cytokines and oxidative stress in skin aging and inflammation. Behavioral patterns like scratching and skin-picking are discussed as maladaptive responses that worsen skin conditions, highlighting the need for treatment approaches addressing both mental health and skin health. CONCLUSION The review concludes by emphasizing the necessity of an integrated treatment model that combines psychological and dermatological care. Addressing both the physiological and behavioral aspects of anxiety is essential for breaking the vicious cycle of stress-induced skin damage. A multidisciplinary approach that includes immune-modulating therapies, psychological support, and dermatological treatment holds promise for improving outcomes in patients with anxiety-related dermatological conditions.