Adult skin acute stress responses to short‐term environmental and internal aggression from exposome factors

Abstract

Exposome factors that lead to stressed skin can be defined as any disturbance to homeostasis from environmental (meteorological factors, solar radiation, pollution or tobacco smoke) and/or internal exposure (unhealthy diet, hormonal variations, lack of sleep, psychosocial stress). The clinical and biological impact of chronic exposome effects on skin functions has been extensively reviewed, whereas there is a paucity of information on the impact of short‐term acute exposure. Acute stress, which would typically last minutes to hours (and generally no more than a week), provokes a transient but robust neuroendocrine‐immune and tissue remodelling response in the skin and can alter the skin barrier. Firstly, we provide an overview of the biological effects of various acute stressors on six key skin functions, namely the skin physical barrier, pigmentation, defences (antioxidant, immune cell‐mediated, microbial and microbiome maintenance), structure (extracellular matrix and appendages), neuroendocrine and thermoregulation functions. Secondly, we describe the biological and clinical effects on adult skin from individual exposome factors that elicit an acute stress response and their consequences in skin health maintenance. Clinical manifestations of acutely stressed skin may include dry skin that might accentuate fine lines, oily skin, sensitive skin, pruritus, erythema, pale skin, sweating, oedema and flares of inflammatory skin conditions such as acne, rosacea, atopic dermatitis, pigmentation disorders and skin superinfection such as viral reactivation. Acute stresses can also induce scalp sensitivity, telogen effluvium and worsen alopecia.

Sleep loss and the skin: Possible effects of this stressful state on cutaneous regeneration during nocturnal dermatological treatment and related pathways

“…The biotransformation capacity depends on several factors, such as age, gender, topographic area of the skin, as well as environmental events (including ultraviolet radiation, that can increase levels of reactive oxygen species; and air pollution) 13 . The exposome 1,2 may play a role in the enzymatic ability of the skin. As sleep and stress are components in the skin exposome, 1,2 sleep distress should be raised as a factor that interferes with the enzymatic function of the tegument as a biochemical barrier.…”

“…Skin aging ought to be considered in respect of factors related with integumentary function, therapeutic efficacy and sleep loss. The oxidative stress that can be increased by chronic sleep disturbance accelerates the process of cutaneous senescence, associated with reduced hydration and elasticity of the tegument 1,2 . This can impair the physiology of this organ over time, in addition to lowering the production of collagen and increasing its degradation 10 .…”

“…12 As a consequence, the skin microbiome can suffer dysbiosis. 1,2 It may be further modified by changes in the exposome, a term which comprises a group of factors that can have an impact on cutaneous homeostasis; this includes environmental aspects and life habits, in particular poor sleep. 1,2 The results of stress (which can be generated by sleep deprivation) possibly injure the tegument micropopulation by inducing cutaneous inflammation.…”

“…Chronic sleep deprivation and poor sleep are already known to lead to a deleterious state of stress 1,2 . This is further compounded by the current Covid‐19 pandemic, which has been shown to interfere on anxiety levels, as well as on circadian rhythm 3 .…”

Impact of Exposome Factors on Epidermal Barrier Function in Patients with Obstructive Sleep Apnea Syndrome

“…It has been observed that sleep deprivation is associated with an increased risk of chronic diseases such as cardiovascular disease, hypertension, obesity, and diabetes [ 7 , 10 ]. Moreover, several skin disease flares have been linked to sleep disturbances and psychological disorders, such as depression, anxiety, and a lower self-stem [ 11 ]. Poor sleep quality has also been related to skin barrier impairment [ 12 ].…”