'Does the Skin Remember?' A Systematic Review on the Association Between Stressful and Traumatic Experiences and...

Dermatological conditions are a major contributor to global nonfatal disease burden. Evidence suggests that psychological stress and trauma, including adverse childhood experiences (ACEs), stressful life events (SLEs), and post-traumatic stress disorder (PTSD), may affect the onset and severity of inflammatory and stress-responsive skin diseases, though findings remain fragmented. This systematic review aimed to synthesise evidence on associations between stress- and trauma-related exposures and dermatological conditions across the lifespan, focusing on timing, chronicity, and cumulative stress. The review followed PRISMA 2020 guidelines. Searches were conducted in Scopus, PubMed, and PsycINFO (from January 2000 to November 2025). Eligible studies were peer-reviewed empirical investigations of stress- or trauma-related exposures and dermatological outcomes in children or adults. Risk of bias was assessed using the Newcastle-Ottawa Scale and Joanna Briggs Institute checklists; only low- and moderate-risk studies were included. Thirty studies met inclusion criteria. Stress- and trauma-related exposures were associated with increased risk, earlier onset, or greater severity of conditions, particularly psoriasis, atopic dermatitis, alopecia areata, and chronic urticaria. Associations were strongest for early-life adversity and cumulative stress. Results support an association between trauma-related exposures and dermatological outcomes. Longitudinal studies are needed to clarify temporal relationships and inform psychosocial assessment.