Psychodermatology is the treatment of skin disorders using psychological and psychiatric techniques by addressing the interaction between mind and skin. Though historically there has not been strong scientific support for its practice, there is increasing evidence that behavioral treatments may be effective in the management of chronic skin disorders.[1]

The practice of psychodermatology is based on the complex interplay between neurological, immunological, cutaneous and endocrine systems, known alternatively as the NICE network, NICS, and by other similar acronyms. The interaction between nervous system, skin, and immunity has been explained by release of mediators from network. In the course of several inflammatory skin diseases and psychiatric conditions, the neuroendocrine-immune-cutaneous network is destabilized.

Concept

The disorders that proponents classify as psychodermatologic fall into three general categories: psychophysiologic disorders, primary psychiatric disorders and secondary psychiatric disorders.[2] Proponents frequently claim treatment for psoriasis, eczema, hives, genital and oral herpes, acne, warts, skin allergies, pain, burning sensations, and hair loss. Psychodermatological treatment techniques include psychotherapy, meditation, relaxation, hypnosis, acupuncture, yoga, tai chi, and anti-anxiety drugs.[3][4][5][6]

Psychophysiologic disorders are conditions that are precipitated by or worsened by experiencing stressful emotions.[7] These conditions are not always related to stress and in many cases respond to medication but stress can be a contributing factor in some cases.[8]

Diagnoses Associated with Psychodermatologic Disorders[9]
Major Categories Examples
Psychophysiologic Disorders Acne, Alopecia Areata, Atopic Dermatitis, Psoriasis, Psychogenic Purapura, Rosacea, Seborrheic Dermatitis, Urticara (Hives)
Primary Psychiatric Disorders Bromosiderophobia, Delusions of Parasitosis, Dysmorphophobia, Facticial Dermatitis, Neurotic Excoriations, Trichtillomania
Secondary Psychiatric Disorders Alopecia Areata, Cystic Acne, Hemangiomas, Ichthyosis, Kaposi’s Sarcoma, Psoriasis, Vitiligo

Controversy

In a 2013 paper published in the Clinics in Dermatology, the official journal of the International Academy of Cosmetic Dermatology, the facts and controversies of this topic were examined with the conclusion:[1]

Although clinical experience is often in concordance with this notion, apparently scientific proof can sometimes be challenging rather than straight forward. Although many data have been published, it appears that not enough good statistical evidence exists to support them. The difficulty in validating beyond a doubt the stress-skin interactions has rendered some skepticism among physicians.

Harriet Hall notes that the specialty may not be needed at all because medicine already takes a holistic approach to treating a patient.[10] A 2007 review of the literature generated from 1951 to 2004 finds that most dermatologists and psychologists recommend a synthesis of treatment rather than seeing another specialist.[11]

See also

Association for Psychoneurocutaneous Medicine of North America (APMNA)

References

  1. 1 2 Orion, Edith; Wolf, Ronni (2013). "Psychological factors in skin diseases: Stress and skin: Facts and controversies". Clinics in Dermatology. Clinics in Dermatology, The official journal of the International Academy of Cosmetic Dermatology (IACD). 31 (6): 707–11. doi:10.1016/j.clindermatol.2013.05.006. PMID 24160274. Retrieved 9 February 2017.
  2. ↑ Koo, John (1995-11-01). "Psychodermatology: A practical manual for clinicians". Current Problems in Dermatology. 7 (6): 204–232. doi:10.1016/S1040-0486(09)80012-4. ISSN 1040-0486.
  3. ↑ SINGER, NATASHA. "SKIN DEEP; If You Think It, It Will Clear". query.nytimes.com. NYT. Retrieved 9 February 2017.
  4. ↑ Jafferany M (2007). "Psychodermatology: a guide to understanding common psychocutaneous disorders". Prim Care Companion J Clin Psychiatry. 9 (3): 203–13. doi:10.4088/pcc.v09n0306. PMC 1911167. PMID 17632653.
  5. ↑ DeWeerdt Sarah (2012). "Psychodermatology: An emotional response". Nature. 492 (7429): S62–S63. doi:10.1038/492S62a. PMID 23254976. S2CID 44617423.
  6. ↑ Mapes, Diane (2007-02-12). "Does your skin need a shrink?". NBC News. Retrieved 2013-08-03.
  7. ↑ Griesemer, Robert D (1978-08-01). "Emotionally Triggered Disease in a Dermatologic Practice". Psychiatric Annals. 8 (8): 49–56. doi:10.3928/0048-5713-19780801-08. ISSN 0048-5713. Retrieved 2019-06-26.
  8. ↑ Gaston, Louise; Lassonde, Michel; Bernier-Buzzanga, Jeannine; Hodgins, Sheilagh; Crombez, Jean-Charles (1987-07-01). "Psoriasis and stress: A prospective study". Journal of the American Academy of Dermatology. 17 (1): 82–86. doi:10.1016/S0190-9622(87)70176-5. ISSN 0190-9622. PMID 3611457.
  9. ↑ Koo, John; Lebwohl, Andrew (2001-12-01). "Psychodermatology: The Mind and Skin Connection". American Family Physician. 64 (11): 1873–1879.
  10. ↑ "Psychodermatology?". Science-Based Medicine – Exploring issues and controversies in the relationship between science and medicine. 2018-04-17. Retrieved 2019-06-26.
  11. ↑ Jafferany M (2007). "Psychodermatology: a guide to understanding common psychocutaneous disorders". Prim Care Companion J Clin Psychiatry. 9 (3): 203–13. doi:10.4088/pcc.v09n0306. PMC 1911167. PMID 17632653.


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