Therapeutic management of psychodermatological disorders.

The skin and the brain interact through psychoneuroimmunoendocrine mechanisms and through behaviors that can strongly influence the initiation or flaring of skin disorders. OBJECTIVE: To obtain knowledge of these factors to assist in designing treatment plans for specific skin disorders. METHODS: Psychocutaneous disease literature for the past 80 years was reviewed. RESULTS/CONCLUSION: Therapeutic options include standard psychotropic drugs and alternative herbs and supplements, the placebo effect, suggestion, cognitive-behavioral methods, biofeedback, and hypnosis. When simple measures fail to produce the desired results, combinations of drugs or addition of nonpharmacological therapies may produce better results. Psychophysiological skin disorders may respond well to nonpharmacological therapies that counteract stress, supplemented when indicated by anxiolytic or antidepressant drugs. Treatment of primary psychiatric disorders that affect the skin often results in improvement of the associated skin disorders. Psychiatric disorders secondary to skin disorders may also require treatment.

Expert Opin Pharmacother. 2008 Apr;9(6):973-85. Shenefelt PD. Department of Dermatology and Cutaneous Surgery, University of South Florida, Tampa, FL 33612, USA. pshenefe@health.usf.edu