What does hormonal dermatitis look like? Symptoms of hormonal dermatitis

Hormonal dermatitis is a skin inflammation caused by long-term improper use of hormone drugs. It is the most troublesome type of dermatitis and is difficult to cure. Hormonal dermatitis can cause thinning of the epidermis and dermis, hypopigmentation, and folliculitis infection.

1. Thinning of the epidermis and dermis

Long-term local application of hormones can interfere with the differentiation of the epidermis, induce changes in the structure and function of the skin, and inhibit the proliferation of keratinocytes. This results in a decrease in the formation of stratum corneum granules, ultimately causing the stratum corneum to become thinner. The thinning of the dermis is due to the change in the viscoelasticity of glycoproteins and proteoglycans, which weakens the adhesion between collagen fibrils and reduces collagen synthesis.

2. Hypopigmentation/deposition

As the number of stratum corneum layers decreases, less melanin migrates to keratinocytes, causing hypopigmentation. Pigmentation may be related to glucocorticoids activating melanocytes to regenerate pigment.

3. Vascular exposure

The weakening of the adhesion between collagen fibers in the blood vessel wall can lead to widening of the blood vessels, and the disappearance of dermal collagen leads to the exposure of surface blood vessels.

4. Rosacea/acne-like dermatitis

In hormone-induced rosacea-like lesions, the density of Demodex mites in the hair follicles increases significantly. Demodex mites block the exit of the sebaceous glands in the hair follicles, act as carriers, and cause inflammatory or allergic reactions. Potent hormones can also cause sebaceous gland hyperplasia, leading to a unique rosacea-like rash. Hormones can cause the hair follicle epithelium to degenerate and become blocked, leading to acne-like rashes or worsening of existing acne.

5. Folliculitis infection

Due to the immunosuppressive effect of hormones, local infected hair follicles may become infected and primary folliculitis may worsen.

6. Hormone dependence

Hormones have powerful anti-inflammatory properties and can inhibit many symptoms of skin diseases, such as inhibiting the development of papules and alleviating itching, vasoconstriction, and disappearance of erythema. However, hormones cannot eliminate the cause of the disease, and discontinuation of use can often cause the original disease to worsen, with rebound phenomena such as inflammatory edema, redness, burning sensation, discomfort, and acute pustular rash. This phenomenon often occurs 2 to 10 days after stopping hormones and lasts for several days or about 3 weeks. Due to the rebound phenomenon, patients continue to use topical hormones, which causes hormone dependence.