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Stress, steroids and dry skin
From Panconesi (Editor) 1984
Experiments with both rodents and students, show that stress - confined spaces for rodents, and sitting exams for students - causes skin to dry out.
The important usual water-conserving barrier in skin fails as stress builds up and natural steroid hormones are released by the adrenal glands. The steroid response is part of the general defence reaction in both animal and man to any perceived threat.
This helps us to understand what nearly everyone we see with eczema knows: stress can make eczema worse. Stress can trigger acute flare-ups. Stress causes an increase in rubbing and scratching, leading to chronic eczema.
Underlying both these processes is the drying effect of stress: atopic dry skin is prone to acute eczema, and dry skin itches!
Steroids and stress dry the skin. Both need accounting for to get the best results when treating atopic eczema.
The Combined Approach to atopic eczema recommends always combining moisturizers with topical steroid use, and always consider having stress management as part of the treatment programme.
Remember to use moisturisers often on their own, but always when topical steroids are used....topical steroids dry the skin!
Orion,E Wolf,R Psychological Stress and epidermal barrier function
Clinics in Dermatology 30:3, 280-285. 2012