Update on psychodermatological disorders

The skin and the nervous system develop side-by-side in the embryo. They continue to stay intimately interconnected and interact throughout life via psycho–neuroimmuno–endocrine mechanisms and through behaviors that can strongly influence the initiation or flaring of skin disorders. Updated knowledge of these factors is important for understanding the pathophysiology and choosing treatment plans for specific skin disorders. Therapeutic drug options include standard psychotropic drugs and alternative herbs and supplements. Nondrug options include biofeedback, cognitive–behavioral methods, hypnosis, the placebo effect and suggestion. Combinations of drugs or addition of nondrug therapies may produce better results when simple measures fail. Skin disorders with a psychophysiological aspect may respond well to nondrug therapies that counteract stress. Treatment of primary psychiatric disorders that affect the skin often results in improvement of the skin disorders. Treating secondary psychiatric disorders such as anxiety or depression that are triggered by the skin disorders may also be necessary.