Alternative Psychotherapeutic Approaches to the Treatment of Eczema

Abstract

Introduction Patients with eczema suffer from high psychological burden, often caused and exacerbated by chronic pruritus, which leads to a vicious itch-scratch cycle. Although much of the literature focuses on treating the physiological factors that lead to pruritus, little attention has been given to the cognitive, behavioral, and social factors associated with the itch-scratch cycle. We conducted a literature review to investigate whether treatments aimed at psychosocial factors could be effective for patients with eczema. Methods A systematic literature review was conducted through PubMed and EMBASE. Original investigative articles that focused on psychotherapeutic interventions for eczema and/or eczema-related psychological morbidities were reviewed. Results Psychotherapeutic interventions alongside standard medical care are shown to be beneficial compared to conventional treatments alone, both for eczema and for eczema-associated psychological symptoms. Such interventions include meditation and mindfulness, stress-reduction, habit-reversal training, hypnotherapy, music therapy, massage therapy, and standard psychological treatments such as cognitive behavioral therapy. Conclusion It is important to recognize the reciprocal relationship between eczema and psychosocial distress. Alternative treatment options to address psychological factors associated with eczema can improve disease trajectory and quality of life.

Exploring Innovative Applications of Behavioral Economic Theories to Enhance Eczema Care and Outcomes

“…The interventions explored in these studies majorly centered on financial incentives, which were often paired with other behavioral economic concepts such as framing, social influences, reinforcement, and feedback. While the interventions showcased promising results, the effectiveness varied, indicating a complex interplay of factors influencing medication adherence [6]. The review identified a total of thirty-four relevant studies, with a predominant focus on chronic conditions including diabetes mellitus, human immunodeficiency virus (HIV), and cardiovascular and renal diseases.…”

“…Considering the implications of these findings in the context of eczema management, Nurchis et al's study underscores the potential of nudging interventions as potent tools for shaping positive behaviors among individuals affected by eczema [6]. Given the established role of alcohol and tobacco consumption as triggers for eczema flare-ups, the integration of successful nudging strategies holds promise as a cornerstone in comprehensive eczema care frameworks.…”

“…This concept was deeply rooted in the theory of operant conditioning, a fundamental psychological principle positing that behaviors followed by gratifying consequences were more likely to be repeated. In the realm of financial incentives, this principle translated into the deliberate incorporation of monetary rewards or penalties to shape decision-making and behavior [6,7]. This practice capitalized on humanity's intrinsic inclination toward pursuing gains and avoiding losses [7,8].…”

The skin‐brain connection and pleasant touch as supportive care for psychocutaneous disorders

“…Furthermore, it has been suggested that itch cognitive distortion from prefrontal cortex disturbance may be associated with some neuropsychiatric symptoms 29 . Hence, therapeutic interventions to reduce stress may be beneficial for reducing pruritus and skin lesions in AD, as well as related psychological symptoms 31,32 …”

“…29 Hence, therapeutic interventions to reduce stress may be beneficial for reducing pruritus and skin lesions in AD, as well as related psychological symptoms. 31,32 The role of psychosocial factors, such as psychosocial stress or negative expectations, might also be relevant in "sensitive skin", characterised by unpleasant symptoms (e.g., stinging, burning, pain, pruritus, tightness and tingling sensations) but no objective clinical features, where changes in the cutaneous free nerve endings could play a role. 33,34 Elucidation of the pathophysiological mechanisms and the interaction between the central nervous system and the skin underlying these psychocutaneous disorders is required to help understand the interactions between mental state, dermatoses, and skin symptoms to find the most suitable holistic therapies to improve patients' well-being and QoL.…”