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Yosipovitch G, Canchy L, Ferreira BR, Aguirre CC, Tempark T, Takaoka R, Steinhoff M, Misery L. Integrative Treatment Approaches with Mind-Body Therapies in the Management of Atopic Dermatitis. J Clin Med 2024; 13:5368. [PMID: 39336855 DOI: 10.3390/jcm13185368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2024] [Revised: 08/22/2024] [Accepted: 08/26/2024] [Indexed: 09/30/2024] Open
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease with a complex pathophysiology characterized by intense pruritus, often associated with psychological stress and atopic and non-atopic comorbidities that significantly reduce quality of life. The psychological aspects of AD and the interaction between the mind and body via the skin-brain axis have led to an interest in mind-body therapies (MBT). The aim of this article is, therefore, to reinforce the importance of psychodermatological care in AD. We performed a focused literature review on holistic practices or integrative MBT in AD, including education, cognitive behavioral therapy, habit reversal, meditation, mindfulness, hypnotherapy, eye movement desensitization and reprocessing, biofeedback, progressive muscle relaxation, autonomous sensory meridian response, music therapy, massage, and touch therapy. A multidisciplinary holistic approach with MBT, in addition to conventional pharmacologic antipruritic therapies, to break the itch-scratch cycle may improve AD outcomes and psychological well-being. Although there is a paucity of rigorously designed trials, evidence shows the potential benefits of an integrative approach on pruritus, pain, psychological stress, anxiety, depressive symptoms, and sleep quality. Relaxation and various behavioral interventions, such as habit reversal therapy for replacing harmful scratching with massaging with emollient 'plus', may reduce the urge to scratch, while education may improve adherence to conventional therapies.
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Affiliation(s)
- Gil Yosipovitch
- Miami Itch Center, University of Miami, Miami, FL 33130, USA
| | - Ludivine Canchy
- La Roche-Posay Laboratoire Dermatologique, 92300 Levallois-Perret, France
| | - Bárbara Roque Ferreira
- Laboratoire Interactions Epithéliums Neurones (LIEN), University of Brest, 29200 Brest, France
- Department of Dermatology, Algarve University Hospital Centre, ULS Algarve, 8000-386 Faro, Portugal
| | | | - Therdpong Tempark
- Department of Pediatrics, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok 10330, Thailand
| | - Roberto Takaoka
- Division of Dermatology, Medical School Hospital, University of Sao Paulo, Sao Paulo 05403-000, SP, Brazil
| | - Martin Steinhoff
- Department of Dermatology, Weill Cornell Medicine, New York, NY 10065, USA
- Department of Medicine, Weill Cornell Medicine-Qatar, Doha 3050, Qatar
- College of Health and Life Sciences, Hamad-Bin Khalifa University-Qatar, Doha 5825, Qatar
- Department of Dermatology & Venereology, Hamad Medical Corporation, Doha 3050, Qatar
- Translational Research Institute, Hamad Medical Corporation, Doha 3050, Qatar
| | - Laurent Misery
- Laboratoire Interactions Epithéliums Neurones (LIEN), University of Brest, 29200 Brest, France
- Department of Dermatology, University Hospital of Brest, 29200 Brest, France
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Zhang H, Wang M, Zhao X, Wang Y, Chen X, Su J. Role of stress in skin diseases: A neuroendocrine-immune interaction view. Brain Behav Immun 2024; 116:286-302. [PMID: 38128623 DOI: 10.1016/j.bbi.2023.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 10/16/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Abstract
Psychological stress is a crucial factor in the development of many skin diseases, and the stigma caused by skin disorders may further increase the psychological burden, forming a vicious cycle of psychological stress leading to skin diseases. Therefore, understanding the relationship between stress and skin diseases is necessary. The skin, as the vital interface with the external environment, possesses its own complex immune system, and the neuroendocrine system plays a central role in the stress response of the body. Stress-induced alterations in the immune system can also disrupt the delicate balance of immune cells and inflammatory mediators in the skin, leading to immune dysregulation and increased susceptibility to various skin diseases. Stress can also affect the skin barrier function, impair wound healing, and promote the release of pro-inflammatory cytokines, thereby exacerbating existing skin diseases such as psoriasis, atopic dermatitis, acne, and urticaria. In the present review, we explored the intricate relationship between stress and skin diseases from a neuroendocrine-immune interaction perspective. We explored the occurrence and development of skin diseases in the context of stress, the stress models for skin diseases, the impact of stress on skin function and diseases, and relevant epidemiological studies and clinical trials. Understanding the relationship between stress and skin diseases from a neuroendocrine-immune interaction perspective provides a comprehensive framework for targeted interventions and new insights into the diagnosis and treatment of skin diseases.
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Affiliation(s)
- Hanyi Zhang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, China
| | - Mi Wang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, China; Department of Mental Health Center, Xiangya Hospital, Central South University, Changsha, China
| | - Xue Zhao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, China
| | - Yujie Wang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, China
| | - Xiang Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, China.
| | - Juan Su
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, China.
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Kennelly NR, Ray S. Efficacy of a Brief Mindfulness Intervention in Underserved Individuals Receiving Inpatient Treatment for Opioid Use Disorder: A Pilot Study. Cureus 2023; 15:e40525. [PMID: 37461794 PMCID: PMC10350319 DOI: 10.7759/cureus.40525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2023] [Indexed: 07/20/2023] Open
Abstract
Introduction A mindfulness intervention is a mind-body complementary health approach that focuses on the relationships between mind, body, brain, and behavior. Mindfulness-Based Stress Reduction (MBSR) and similar mindfulness programs have been shown to decrease drug craving and relapse and improve emotional regulation, stress, pain, and anxiety. To our knowledge, a very limited number of studies have examined its efficacy in individuals from underserved populations. Underserved populations experience disparities in healthcare access, and as a result, see poorer addiction-related outcomes. The goal of this pilot study was to utilize an evidence-based, neuroscience-informed brief mindfulness intervention to improve mental health and decrease substance use behavior in a vulnerable, underserved population in New Jersey suffering from opioid use disorder (OUD). Methods We implemented a brief MBSR intervention in 15 underserved individuals undergoing inpatient medication-assisted treatment (MAT) for OUD. Individuals received weekly intervention sessions lasting one hour over six weeks. Furthermore, they practiced mindfulness for 10 minutes daily. Participants completed pre-and post-mindfulness intervention surveys to examine their mental well-being, drug craving, perceived stress, and emotional regulation. Results Within-subjects t-test results showed that compared to pre-intervention, participants showed significantly decreased perceived stress (t(14) =2.401, p=.015) and significantly decreased difficulty in emotional regulation (t(13) =3.426, p=.002 ) at post-intervention. They also showed significantly decreased drug craving post-intervention (t(14) =5.501, p=.<001). Anxiety decreased post-intervention but was not statistically significant (t(14) =1.582, p=.068). Conclusion This pilot study demonstrates that a brief mindfulness intervention can be effective for underserved individuals with OUD. Consistent with our hypothesis, results showed that a six-week mindfulness intervention could reduce everyday stress, drug craving, and difficulties in emotional regulation. In the future, a large-scale randomized control trial should be conducted with a control group to demonstrate the efficacy of this useful intervention.
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