Hypnosis for Dermatologic Conditions
Clinical Briefs-With Comments from John La Puma, MD, FACP
Hypnosis for Dermatologic Conditions
June 2000; Volume 3; 71-72
Source: Shenefelt PD. Hypnosis in dermatology. Arch Dermatol 2000;136:393-399.
Hypnosis is an alternative or complementary therapy that has been used since ancient times to treat medical and dermatologic problems. To describe the various uses for hypnosis as an alternative or complementary therapy in dermatologic practice, a MEDLINE search was conducted from January 1966 through December 1998 on key words related to hypnosis and skin disorders. A wide spectrum of dermatologic disorders may be improved or cured using hypnosis as an alternative or complementary therapy, including acne excoriée, alopecia areata, atopic dermatitis, congenital ichthyosiform erythroderma, dyshidrotic dermatitis, erythromelalgia, furuncles, glossodynia, herpes simplex, hyperhidrosis, ichthy-osis vulgaris, lichen planus, neurodermatitis, nummular dermatitis, postherpetic neuralgia, pruritus, psoriasis, rosacea, trichotillomania, urticaria, verruca vulgaris, and vitiligo. Appropriately trained clinicians may successfully use hypnosis in selected patients as alternative or complementary therapy for many dermatologic disorders.
COMMENT
This University of South Florida scholar carefully reviews the evidence for and against hypnosis. Its psychophysiological effects—including its ability to regulate blood flow and other autonomic functions—are briefly reviewed. Eighty-four references are included. Characteristic procedures, qualifications, and costs have been reviewed previously. (See Alternative Medicine Alert, March 2000, pp. 30-34.)
Holistic dermatology, the author explains, understands the whole patient, not unlike integrative medicine, and may make sense of a rash or blemish that a primary physician and patient may not.
The author suggests that physicians think of hypnosis as a tool, not a therapy. Hypnosis, he maintains, can improve outcomes with direct suggestion to diminish physical discomfort or reduce hyperhidrosis or warts. Hypnosis also uses symptom substitution through meditation, artwork, or exercise for scratching, for example. Hypnoanalysis (psychoanalysis in conjunction with hypnosis) and ego strengthening (positive suggestions for self-worth) are two other useful hypnotic tools.
Though few randomized, controlled trials were found, refractory atopic dermatitis, psoriasis, verruca vulgaris, and chronic urticaria are conditions that have been studied.
No adverse effects were reported in this review; however, the extensive training required, the lower reimbursement rates, and the low hypnotizability of some patients make it a specialized endeavor.
Recommendation
Hypnosis in the hands of a skilled dermatologist may help patients with a variety of conditions. It is worth a try in patients who have dermatoses with a large psychosomatic component and who are interested in it and strongly motivated.
June 2000; Volume 3; 71-72
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