Therapeutic management of psychodermatological disorders.
BACKGROUND
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.


CONCLUSIONS
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.
Shenefelt
Philip D
PD
Department of Dermatology and Cutaneous Surgery, University of South Florida, Tampa, FL 33612, USA. pshenefe@health.usf.edu
D001676:Biofeedback, Psychology; D015928:Cognitive Behavioral Therapy; D000529:Complementary Therapies; D003376:Counseling; D006801:Humans; D011602:Psychophysiologic Disorders / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012871:Skin Diseases / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D013315:Stress, Psychological / Q000150:complications / Q000503:physiopathology / Q000628:therapy*
D011619:Psychotropic Drugs