Psychodermatology

Psychodermatology is the treatment of skin disorders using psychological and psychiatric techniques by addressing the interaction between mind and skin. Existent statistical evidence does not appear to support these claims.[1]

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Psychiatry is more focused on the “internal” invisible disease, and dermatology is focused on the “external” visible disease. Connecting the two disciplines is a complex interplay between neuroendocrine and immune systems that has been described as the NICS, or the neuro-immuno-cutaneous system. The interaction between nervous system, skin, and immunity has been explained by release of mediators from NICS.1 In the course of several inflammatory skin diseases and psychiatric conditions, the NICS 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]

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:

"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."[1]

Harriet Hall notes that the specialty may not be needed at all because medicine already takes a holistic approach to treating a patient.[9] 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.[10]

See also

Association for Psychoneurocutaneous Medicine of North America (APMNA)

References
  1. Orion, Edith; Wolf, Ronni. "Psychological factors in skin diseases: Stress and skin: Facts and controversies". Clinics in Dermatology, The official journal of the International Academy of Cosmetic Dermatology (IACD). 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.
  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 (inactive 2019-08-20). 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. "Psychodermatology?". Science-Based Medicine – Exploring issues and controversies in the relationship between science and medicine. 2018-04-17. Retrieved 2019-06-26.
  10. 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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