The role of sex hormones in the development of atopic dermatitis in women

Atopic dermatitis (AD) is a chronic inflammatory skin disease that is widespread throughout the world. The disease is more common in women than in men. This difference can be explained by the influence of sex hormones on the functioning of the skin barrier and the immune system. Fluctuations in the concentration of sex hormones correlate with the incidence of AD. During the luteal phase of the menstrual cycle, AD exacerbation or worsening of the disease is more common, which is associated with the production of progesterone and estrogens, and during the follicular phase, AD improves due to the predominant effect of estrogens. During the menstrual cycle, women experience a change in the barrier function of the skin, characterized by dryness, impaired sensitivity, and increased transepidermal water loss, which indicates a pronounced effect of sex hormones on the skin. Sex hormones can stimulate the production of a number of cytokines involved in the formation of skin inflammation and itching. During pregnancy, the immune system is modified to achieve immune tolerance; these changes occur both at the mother-fetus level and in the systemic bloodstream, primarily due to an increase in progesterone concentration during pregnancy. Changes in hormonal levels during pregnancy shift the balance in the immune system, which can be a trigger for the development of AD. Studying hormonal status during AD exacerbation, including during pregnancy, is promising and can contribute to the development of preventive and therapeutic measures.