Psychosomatic Care for Maintenance of Remission

Abstract

Various stressors including dermatitis itself are expressed as physical symptoms such as itching, and are sometimes dispersed by actions such as scratching, tapping, and rubbing. Continuation of these behaviors, that could be stress-coping, leads them to habitual behavior. These behaviors become the vicious itch-scratch-cycle that makes it much harder for the patients to stop scratching, and leads to the advance of dermatitis and cause a chronic and intractable state. Most of the patients who have reached that state are obsessed by scratching, sensations of itching, or atopic dermatitis, and some of them develop an addiction to scratching.
In order to develop a psychological treatment, we must try, first of all, to improve dermatitis by medication, and to search and remove antigens, because it's necessary to remove patients' physical pain caused by skin symptoms as much as possible. Then we can try to prevent and treat patients scratching becoming habitual. If the patients already have strong psychological dependency on scratching, it is better to give them psychological guidance for the purpose of changing their ways of life or thinking rather than to tell them not to scratch.
It's well known that maintaining skin barrier function and giving the patients appropriate skincare at an early stage is very important to prevent skin conditions from getting worse in the future. Similarly, in my opinion, it is just as important to help the patients develop psychological barrier functions, and we need to give patients' mothers advice how to help them to do that.Skin Research, Suppl. 18: 31-35, 2012