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Anxiety, sensitive skin and erythema linked

Researchers have identified a strong association between anxiety and sensitive skin syndrome, as well as a strong positive correlation between anxiety scores and erythema index (EI) in patients with sensitive skin.

These findings come from a paper published online ahead of print in Skin Research and Technology (April 13, 2022).

The authors note that in patients with sensitive skin (SS), neurosensory disorders accompany epidermal barrier dysfunction. However, they write that it is not well understood how anxiety might impact biophysical parameters of the skin in patients with SS.

To investigate this question and the relationship between anxiety, facial neurosensitivity, EI, sebum content, and sensitive skin scale scores, researchers recruited 35 individuals with SS and 40 without SS.

In this sample, the researchers found that hospital anxiety and depression scale (HADS) anxiety scores were significantly higher in patients with sensitive skin. However, there was no significant difference in the HADS-Depression scores. They also found a strong positive correlation between the HADS-Anxiety scores and EI in patients with sensitive skin.

“Anxiety disrupts both the innate and adaptive immunity of the epidermis, disturbing the integrity of the SC [stratum corneum] and leading to skin barrier dysfunction,” the authors write. “The mechanism of the effect of anxiety on the skin is not fully understood, but psychological stressors may activate the hypothalamic/pituitary/adrenal axis and lead to the secretion of stress hormones. Furthermore, it has been shown that these secreted stress hormones may cause epidermal barrier dysfunction by decreasing SC hydration, increasing transepidermal water loss, and altering epidermal lipids and structural proteins.”

“Our study found that the significant increase in erythema and sebum levels in those with SS may be due to barrier dysfunction triggered by anxiety. Remarkably, a correlation was found between anxiety and EI but no correlation between sebum levels in patients with SS.”

The authors conclude that it is important for physicians to evaluate skin sensations and anxiety levels when working with patients who have sensitive skin.

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