Intended for healthcare professionals


The neglected psychological aspects of skin disease

BMJ 2017; 358 doi: (Published 06 July 2017) Cite this as: BMJ 2017;358:j3208
  1. Anthony Bewley, consultant dermatologist
  1. Barts Health NHS Trust, London, UK
  1. anthony.bewley{at}

Properly trained and well resourced multidisciplinary teams are long overdue

Skin conditions can have a detrimental effect on most aspects of a person’s life, including relationships, work, social functioning, sporting activities, and ultimately their mental health.

Psychodermatology (or psychocutaneous medicine) is a professional marriage of dermatology, psychiatry, and psychology—a truly multidisciplinary team approach. Potential patients include those with primary psychiatric diseases who present to dermatology healthcare professionals with, for example, delusional infestation, body dysmorphic disease, or dermatitis artefacta; those with primary skin diseases such as psoriasis, alopecia areata, and vitiligo who have associated anxiety, depression, or even suicidal ideation; those with skin conditions secondary to psychotropic drugs (for example, psoriasis induced by lithium or β blockers); and those with psychiatric disease following drug treatment for dermatological disease (for example, suicidal ideation which may be associated with isotretinoin treatment for acne vulgaris).

Skin disease may elicit psychosocial comorbidities, and psychosocial stresses may elicit skin disease; a perfect …

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