Dermatology And Psychology, What Is The Connection

Dermatology is the field deals which offers many facets in the treatment, but it is difficult to accept that dermatological conditions can occur due to the psychological condition. Apparently, many dermatologists have reported clinical conditions like depression and anxiety causes hair loss increases blemishes and responsible for the alopecia and other skin disorders. What are the conditions where dermatological conditions can be monitored with the help of psychological therapy lets find out in this article. 
Approximately 30-40% patients seeking treatment for skin disorders have an underlying psychiatric or a psychological problem that either causes or exacerbates skin problems. In the past, when a doctor MD, Ph.D. explained the associations of dermatology and psychology in the conference of Dermatologists, many dermatologists were sceptical about the approach he discussed. 
Today dermatologists are much more open to the idea of accepting psychological treatment in the Dermatological disorders. They’re treating the social anxiety, depression and other psychological issues that can arise when people have skin conditions. They’re also developing interventions, whether to help dermatology patients deal with psychological issues or to help people avoid melanoma and other skin problems in the first place.
Minding The Skin: 
The skin is the most noticeable part of our body that could be impacted by psychological factors, yet very few psychologists are studying it, It’s classic health psychology, just in a different area. The conditions in which a Psychologists play part in the treatment of dermatological disorder are:
Skin problems associated with stress of other emotional disorders.

Psychological problems caused by disfiguring skin disorders.

Psychiatric disorders that manifests.

Diagnosis:
Diagnosing an underlying psychiatric component in a patient who has skin disease involves several dimensions. The evaluation of these dimensions plays a major role in creating an effective treatment plan and includes:
Establishing a good physician-patient relationship

Evaluating the patient’s level of functioning as well as different physical and psychosocial stressors that may influence the level of functioning

Evaluating concurrent affective components that influence the level of functioning

Weighing the presence of secondary gain

Considering the real and authentic quality of consultation

Several psychological test instruments have been used to evaluate a patient with psychocutaneous disease:
Symptom Checklist, Beck Depression Inventory, Hospital Anxiety and Depression Scale, Dysmorphic Concern Questionnaire, Dermatology Life Quality Index, Skindex Questionnaire, and Marburg Skin Questionnaire.
There is no universally accepted classification of psychodermatological diseases. However, Koo and Lee4 describe the most commonly used classification, which includes the following:
Psychophysiological disorders: Skin diseases are precipitated or exacerbated by psychological stress. Patients experience a clear and chronological association between stress and exacerbation. Examples in this category include atopic dermatitis, psoriasis, and acne.

Psychiatric disorders with dermatological symptoms: There is no skin condition and everything is seen on the skin is self-inflicted. These disorders are always associated with underlying psychopathology and are known as stereotypes of psychodermatological diseases. Examples include dermatitis artefacta, trichotillomania, body dysmorphic disorder, and neurotic excoriations.

Dermatological disorders with psychiatric symptoms: Emotional problems are more prominent as a result of having the skin disease, and the psychological consequences are more severe than the physical symptoms. Examples include vitiligo, alopecia areata, acne excorie, and ichthyosis.

Miscellaneous: Several other disorders have been described and grouped under miscellaneous conditions. The medication-related adverse effects of both psychiatric and dermatological medications have also been included in the broad classification of psychodermatological disorders

Pathogenesis:
The complex interrelationship between mind and skin has been investigated at both molecular and cellular levels and has been studied extensively. It has been recorded that patients with depression suffer more from physical illness and patients with chronic illness suffer more often from major depressive illness, suggesting that the state of mind has a marked bearing not only on how an illness is perceived but also on its severity and content.
Preventive Problems:
Researchers are investigating the best ways to prevent melanoma and other problems caused by excessive tanning, for instance.”Tanning is one of those areas where even though people know how bad it is for them, they still do not take precautions to avoid it. Studies also suggest exacerbation has seen occurs in the skin disorders such as vitiligo and psoriasis if they feel anxiety or depression at the same time. 
Psychodermatology is expanding rapidly for the new research ideas for the complete treatment of the skin diseases, by the addition of new treatment modalities to the existing ones. It is recommended that Dermatologists should perform the comprehensive analysis of their patient’s psychological profile. If the criteria are matching they can refer their patients to the psychiatrists depending upon the treatment. 
Source: 
John Koo, MD, Psychodermatology: The Mind and Skin Connection, university of California.

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