What are the symptoms of hormone-dependent dermatitis?

Glucocorticoid-dependent dermatitis is a particularly harmful skin disease, which is mainly related to excessive medication. After suffering from skin diseases, patients frequently and excessively abuse glucocorticoids, which will aggravate the condition. After stopping the medication, the patient will experience worsening inflammatory damage, which will make treatment more difficult and cause great physical and psychological harm to the patient.

1. Thinning of the epidermis and dermis

Long-term local application of hormones can lead to reduced granule formation in the stratum corneum and thinning of the stratum corneum. The elastic changes in glycoproteins and proteoglycans in the dermis weaken the adhesion between collagen fibrils, reducing collagen synthesis and causing thinning.

2. Hypopigmentation and pigmentation

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 and 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, causing 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

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

6. Hormone dependence and rebound phenomenon

The anti-inflammatory properties of hormones can inhibit the development of papules and relieve itching, cause vasoconstriction, and eliminate erythema. However, hormones cannot eliminate the cause of the disease, and discontinuation of use can often cause the original disease to worsen, which can manifest as 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.

Use should generally be discontinued after the condition improves. However, some patients will experience a relapse of their condition after stopping the drug, and they will use it repeatedly on their own. Over time, they will become dependent on hormones. Especially for skin diseases occurring on the face and genitals, long-term and large-area use of strong hormone preparations can easily cause adverse reactions such as skin atrophy, thinning, capillary dilation, pigmentation, hirsutism, and skin aging.