Psychodermatology

In the journal American Family Physician, Dr. John Koo and Andrew Lebwohl of the University of California defined a psychodermatologic disorder as a skin problem that involves an interaction between mind and skin. To simplify things, a skin illness is thought to be always associated either with heightened emotional states or with maladaptive psychological challenges. As Dr Koo explains, psychodermatology focuses on the boundary between psychiatry and dermatology, requiring a thorough understanding of both the internal psychological factors and the environmental causes to cure the ailment.

A psychodermatological treatment begins by analyzing the skin disorder and then connecting it with the over-all mental and emotional issues of the client. For example, diagnosing a skin lesion is done in tandem with determining the current psychological profile of the one being tended to, the object of which is to have more information that could be used for determining the most likely psychological causes of the problem. From psychodermatology's point of view, the history of one's skin problems is a roadmap of the most troubling events (or at least most troubling interpretation of events) in one's life. Taken simply, every skin problem *should* point to a psychological imbalance and diagnosis should always include these two perspectives.

Given its nature, the treatment then follows a two-prong path, one psychological and the other dermatological. Starting from the opposite ends of the spectrum, it assumes a more holistic solution than what two separate fields of study could do on their own. For example, if it was determined that undue stress caused a client's rashes, a treatment plan would probably include both a stress management program and a prescribed topical treatment to manage the illness.

Does your skin need a therapist?

On the onset, curing skin illnesses with a combination of these two approaches seems to be a good idea but there are some issues that need to be examined. For example, what if the skin problem is just what it is: a disease without a co-existing psychological imbalance? If we must find a psychological problem for every skin rash or lesion then we are required to come up with a psychological diagnosis even if it doesn't merit it. Thinking this way, maybe it is our mental health that would need examining.

We may also need to consider that given that out of the two treatment approaches being prescribed, we wouldn't know which of the two made the most contribution to the client's wellness. This is important to know because not all treatments that have a psychological component should be necessarily the same. It's also a waste of resources to try to cure two illnesses when we should have been devoting our resources to a single one.

Of course, how we choose to take care of our skin is a personal choice, and psychodermatology might emerge worthy in the future. For the meantime, it costs nothing to think like sunshine; why not try to do so, skin problems or otherwise?