Redox Imbalance and the Skin: A Clinical Indicator of Hidden Systemic Risk

Abstract

Oxidative stress (OxS) is a key pathological mechanism in many dermatologic
and systemic disorders. As the largest and most exposed organ, the skin
mirrors systemic redox imbalance and early signs of mitochondrial dysfunction,
chronic inflammation, and immune dysregulation. This review examines
the interplay between oxidative stress, mitochondrial damage, and impaired
autophagy, highlighting their reflection in skin diseases and systemic
comorbidities. Conditions such as atopic dermatitis, psoriasis, vitiligo, and
chronic urticaria share oxidative and mitochondrial alterations that contribute
to inflammation, premature aging, and cardiovascular or neurodegenerative
risk. In atopic dermatitis, mitochondrial hyperactivity and defective autophagy
connect barrier dysfunction with systemic vascular disease. The skin thus
serves as a sentinel organ for redox imbalance. Evidence suggests that single,
high-dose antioxidants may be ineffective or even pro-oxidant, while multi-
antioxidant approaches—including vitamin D, folate, polyphenols, selenium,
zinc, and magnesium—support mitochondrial resilience and immune
balance. Recognizing cutaneous oxidative stress as both a biomarker and driver
of systemic disease underscores the value of integrative antioxidant strategies
for preventing and managing dermatologic and age-related disorders.