New lifestyle drugs and somatoform disorders in dermatology

Abstract

An increasing number of healthy individuals make use of 'lifestyle' drugs, such as nootropics, psychopharmaca, hormones and eco-drugs. In this respect, the fact that many people try to improve their outer appearance, solve their 'cosmetic problems', influence their rate of hair growth and altogether delay, halt or even reverse the natural ageing process has become a relevant matter for the practising dermatologist. Lifestyle drugs in dermatology are taken in an attempt to increase personal life quality by means of attaining a certain, psychosocially defined beauty ideal. They are not taken to manage a medically identifiable, well-defined disease. Often, patients suffering from somatoform disorders, such as hypochondriac disorders, body dysmorphic disorders, somatization disorders or persistent somatoform pain disorders, may spontaneously ask physicians, in particular dermatologists and plastic surgeons, to prescribe them lifestyle drugs. Typically, patients repeatedly present with alleged 'physical symptoms' that turn out to be subjective complaints without any underlying identifiable medical disease. The use of lifestyle drugs without any proper medical indication may lead to a chronification of the emotional disorders that had ultimately been the cause of the patients' request for such drugs. Such disorders may need to be treated promptly with psychotherapy and/or appropriate psychopharmacotherapy, and the choice of the treatment requires an accurate differential diagnostic approach.

Body dysmorphic disorder among dermatologic patients: Prevalence and clinical features

“…Dermatologists frequently hear their patient saying, for example, ''I'm here for a lip filling,'' ie, treatment on demand. 50 Therefore, doctors, particularly dermatologists and plastic surgeons, need to be aware of BDD, to identify and refer these patients to mental health professionals. Nonpsychiatric treatments seem to be primarily sought 56 by those with BDD and the dermatologist is the specialist who is in most often in contact with these patients, 19 who are frequently unsatisfied with the results of cosmetic treatments.…”

“…50 In 4 studies with clinical dermatology patients, the rates varied from 8.5% to 14.4%, 19,51-53 two of these 52,53 specifically evaluated patients with different acne severity levels, observing BDD frequencies of 14.0% 52 and 8.8%. 53…”

Current standards in the diagnostics and therapy of hair diseases – hair consultation

“…The limited effects of various therapies, the chronic course of the disease, multiple unsuccessful attempts at self-treatment before consulting a specialist and the fear of side effects are only some reasons. Taking the objective findings and the subjective perception seriously is an important task and contributes significantly to treatment results [25]. The psychosocial burden of hair loss should not be underestimated.…”

Körperdysmorphe Symptome, soziale Anpassung und Motivation zu psychotherapeutischer Beratung bei ambulanten dermatologischen Patienten

“…B. Rhinoplastik, Facelifting) und differentiell dermatologische Behandlungen (z. B. Lifestyle‐Medikamente) werden von den Betroffenen bevorzugt in Anspruch genommen, sind jedoch kontraindiziert und tragen zu einer Chronifizierung der Störung bei . Nach diesen Behandlungen kann sich die übermäßige Beschäftigung vom primären, behandelten Defekt auf andere Körperregionen verlagern oder sich Unzufriedenheit bezüglich der behandelten Körperteile einstellen, die weiterhin als hässlich angesehen werden .…”