Digital Exposure and Skin Health in Children and Adolescents: A State-of-the-Art Review.

Abstract

The rapid expansion of digital technology has led to unprecedented levels of screen exposure among children and adolescents, raising concerns regarding its potential impact on dermatologic health. This state-of-the-art review aims to synthesize current evidence regarding the pathophysiological mechanisms, clinical manifestations, and preventive strategies associated with digital exposure in pediatric populations. A comprehensive literature search was conducted across PubMed, Scopus, and Google Scholar from inception through January 2026 using terms related to digital exposure, screen time, blue light, pediatric dermatology, circadian rhythm disruption, and psychodermatology. Evidence from experimental, clinical, and epidemiological studies was thematically analyzed. Available evidence suggests that excessive digital exposure may influence skin health through multiple interconnected mechanisms, including reactive oxygen species-mediated oxidative stress, mitochondrial dysfunction, circadian rhythm disruption, impaired skin barrier integrity, and neuroendocrine activation. Indirect lifestyle factors associated with prolonged screen use, such as sleep disturbance, psychological stress, sedentary behavior, unhealthy dietary patterns, poor hydration habits, and reduced outdoor activity, may further contribute to systemic inflammation and metabolic dysregulation. Pediatric skin, characterized by an immature epidermal barrier, evolving immune responses, and heightened sensitivity to environmental stimuli, appears particularly susceptible to these cumulative effects. Clinically, digital exposure has been linked to a spectrum of dermatologic conditions, including acne vulgaris, atopic dermatitis exacerbations, contact dermatitis, frictional dermatoses, xerosis associated with prolonged screen use and inadequate hydration, pigmentary disorders, and lifestyle-associated metabolic changes that may indirectly affect dermatologic outcomes. Psychodermatologic interactions and social media-driven behaviors may additionally influence disease perception and management. Current evidence remains heterogeneous and largely associative; however, the convergence of mechanistic and epidemiological findings highlights digital exposure as an emerging environmental factor in pediatric dermatology. Further longitudinal studies are needed to clarify causal relationships, evaluate long-term outcomes, and develop evidence-based preventive strategies that support healthy digital engagement while minimizing dermatologic risk.