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Patients who are referred by a history or family physician to a few or psychologist often refuse the referral or pharmacist to keep the appointment.
Other options include biofeedback, cognitive-behavioral medicines, hypnosis, meditation, progressive relaxation, the placebo effect, and suggestion.
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A recent review of psychodermatology covered the relevant literature from 1951 to. Skin disorders with psychophysiologic aspects Stress and emotion Inflammatory and sensory skin disorders are significantly influenced by stress and emotion.

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Griesemer, who trained both as a dermatologist and as a psychiatrist, estimated the effect that emotions had on skin disease for each patient he saw during one year in his practice.

From these data he developed an index 6 of the effects of emotions on specific skin disorders. Drugs that reduce anxiety or depression can be helpful in those individuals. No direct anti-stress drug had yet been developed.

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The non-drug modalities of relaxation, biofeedback, meditation, or self-hypnosis can counteract stress and emotion. Stress and emotion reduction in skin conditions Inflammatory, immune-mediated, and behavioral skin disorders are influenced by psychosomatic factors.

Associated anxiety or depression can be treated with anxiolytic drugs or antidepressants.

Acne Acne vulgaris often flares with stress and premenstrually. Alopecia areata Alopecia areata usually occurs as patchy bald spots where immune dysregulation results in the hair follicles being attacked by inflammatory T-lymphocytes.

Alexithymia with difficulty recognizing and describing feelings and dissociative somatization has been reported to be more common in adults with alopecia areata than in controls.

  • Self-hypnosis with suggestions for soothing can reduce pruritus or itching and give the patient a sense of greater control, which in turn can improve the depression.
  • Alexithymia with difficulty recognizing and describing feelings and dissociative somatization has been reported to be more common in adults with alopecia areata than in controls.
  • These effects occur through actions of drugs, the autonomic nervous system, local hormones, and neuropeptides, resulting in neurogenic modulation of cutaneous inflammation.
  • Atopic dermatitis Atopic dermatitis is produced mainly by scratching and flares with stress though psychoneuroimmunomechanisms. Often the patient denies self-inflicting the trauma and frequently is noncompliant in obtaining a psychiatric evaluation.

    Hyperhidrosis Hyperhidrosis of hands, feet, axillae, or forehead has a clear rapid onset correlation with stress.

    Overview of psychocutaneous disorders

    Lichen planus Lichen planus, an inflammatory pruritic dermatosis, is often triggered or exacerbated by stress. The intense itching and discoloration with hyperpigmentation that typically occur with lichen planus can further fuel the stress.

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