Psychodermatology


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.
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. 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. Additionally, cosmetics companies may offer products utilizing terms such as "psychodermatology" or "neurocosmetics" in their marketing, though these terms are not regulated.
Psychophysiologic disorders are conditions that are precipitated by or worsened by experiencing stressful emotions. 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.
Major CategoriesExamples
Psychophysiologic DisordersAcne, Alopecia areata, Atopic dermatitis, Psoriasis, Psychogenic purpura, Rosacea, Seborrheic dermatitis, Urticara
Primary Psychiatric DisordersOlfactory reference syndrome, Delusional parasitosis, Body dysmorphic disorder, Dermatitis artefacta, Dermatillomania, Trichotillomania
Secondary Psychiatric DisordersAlopecia areata, Cystic acne, Hemangiomas, Ichthyosis, Kaposi’s sarcoma, Psoriasis, Vitiligo

Controversy

A 2013 paper concluded that:
Harriet Hall says that the specialty may not be needed at all because medicine already takes a holistic approach to treating a patient. A 2007 review found that most dermatologists and psychologists recommend a synthesis of treatment rather than seeing another specialist.