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Hypnosis in Dermatology
Abstract
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, ichthyosis 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.
... It can be differed from other states of consciousness by electroencephalography (EEG) and imaging modalities. A hypnotic state can be induced by a therapist or an individual can induce hypnotic trace in himself or herself (self-hypnosis) [119,120]. ...
... Nowadays, medical hypnosis is performed by physicians whom have received appropriate training in many countries all over the world. For some selected skin disorders, with proper training and selection of appropriate patients, medical hypnosis can relieve symptoms and in some cases can cure the illness [119,120]. ...
... Hypnosis is a cost-effective and nontoxic therapy and can be used in dermatological treatment especially in patients with psychosomatic component [119,120]. In a preliminary study, hypnotic sessions including relaxing suggestions and symptoms-oriented suggestions were held as a complementary or the only treatment once every 3 weeks in patients with severe AA, alopecia totalis, or alopecia universalis. ...
... The benefits of a healthy lifestyle in AD patients have been investigated in the fields of conventional medicine and complementary medicine (CM). To date, positive effects of exercise [14][15][16], relaxation hypnotherapy [17][18][19][20][21] and dietary or nutritional adjustments, such as time-restricted eating and the application of a low-calorie vegetarian/vegan diet [22][23][24][25], have been reported in case reports and mostly explorative studies. However, few data are available about self-application of lifestyle behaviors in Germany. ...
... Vieira et al. [49] conducted a literature review and found limited evidence that hypnosis and perhaps other stressrelieving techniques play at least an adjunctive role in the management of AD. It was reported that hypnosis may improve wellbeing and skin conditions by activating a relaxation response, regulating autonomic functions, regulating immunological mechanisms, reducing scratching behaviors, altering dysfunctional habits, promoting skin healing and improving skin comfort [19,21]. In our population, most respondents who applied at least one relaxation technique found it to be helpful. ...
Background:
The severity of atopic dermatitis (AD) is associated with lifestyle behaviors such as exercise, relaxation techniques, and dietary or nutritional adjustments.
Objective:
To investigate the frequency of self-initiated exercise, relaxation techniques, and dietary or nutritional adjustments and their perceived benefits in patients with AD.
Methods:
An exploratory cross-sectional study was performed in May 2019 with 115 AD patients who participated in a three-armed randomized controlled trial (the CAMATOP study). Data on lifestyle behaviors in the three domains of exercise, relaxation techniques, and dietary or nutritional adjustments and their perceived benefits were collected anonymously by a questionnaire and exploratively evaluated.
Results:
A total of 58 (50.4%) patients responded and were included in the analyses. Within the previous four months, 54 (93.1%) respondents had performed exercise, and 24 (41.4%) respondents had used a relaxation technique. A total of 44 (75.9%) respondents had adjusted their diet or nutrition intake due to AD. Exercise, relaxation techniques, and dietary or nutritional adjustments were rated as helpful by most respondents (57.4%, 87.0%, and 95.1%, respectively). Overall, 54 (93.1%) respondents adopted at least one lifestyle factor, and 13 (22.4%) adopted a lifestyle factor in all three domains.
Conclusion:
In our sample, AD patients often adopted lifestyle behaviors such as exercise, relaxation techniques, diet and nutrition; and perceived relaxation techniques and nutritional adjustments as helpful. Further high-quality cohort studies and prospective clinical trials should evaluate the benefits and possible risks of potentially healthy lifestyle behaviors in AD patients.
... Hypnosis is interesting as it has already shown its efficiency on both physical and psychological symptoms in several clinical domains (e.g., [42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58]). Moreover, it works on dysfunctional thoughts or negative beliefs with more unconscious material, which does not mobilize language capacities and in which implicit learning is allowed, even in the event of memory deficits [59]. ...
... However, positive expectations, professional endorsement, and the feasibility of using hypnosis for medical purposes are three factors that perhaps counterbalance the negative representations of hypnosis. In recent years, studies showing the use and effectiveness of clinical hypnosis in different fields of health have given a more reassuring image of the practice [42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58]. Most of the couples in our study were reassured and took the study seriously, as it was proposed by a professional they trusted. ...
Background:
Dementia has a negative impact on the quality of life of the person with dementia and their spouse caregivers, as well as on the couple's relationship, which can lead to high levels of distress for both partners. Hypnosis has been shown to be effective in managing distress and increasing the quality of the relationship.
Objective:
The aim was to develop a standardized hypnosis intervention for couples confronted with Alzheimer's disease and evaluate its feasibility, acceptability, and helpfulness in managing the distress of both partners and increasing the quality of the relationship.
Methods:
In a single-arm study, sixteen couples received the 8-week intervention. Qualitative and quantitative assessments were conducted pre- and post-intervention as well as three months after.
Results:
88.9% of couples (n = 16) of the final sample (n = 18) completed the intervention. Despite the negative representations of hypnosis, several factors led couples to accept to participate in this study: positive expectations, professional endorsement, medical application, non-drug approach, home-based, free, flexible, and couple-based intervention. The results showed a significant decrease in distress for both partners. These effects were maintained three months after the intervention. Couples felt more relaxed, had fewer negative emotions, accepted difficulties more easily, were more patient, and reported better communication and more affection in the relationship.
Conclusion:
Overall, this pilot study shows the feasibility and acceptability of hypnosis with couples confronted with Alzheimer's disease. Although measures of the preliminary pre- and post-intervention effects are encouraging, confirmatory testing with a randomized controlled trial is needed.
... It is believed that through accessing the subconscious mind, an individual's emotions, behaviors, and physiological responses can be influenced. While it may represent a useful adjunct therapy, it requires access to trained practitioners as well as careful subject selection, as some subjects exhibit greater hypnotic susceptibility than others [40]. ...
... Hypnosis has been employed in dermatology to reduce pain and pruritus from skin disorders, to reduce procedure-related anxiety, to reduce harmful behaviors, and as an aid for healing skin disease [40,41]. ...
Stress has multiple and wide-ranging physiologic and clinical impacts on skin disease. This has led to an interest in mind body therapies as potential adjunct treatments for skin disease. The stress response results in the activation of the endocrine, neurologic, and immune systems, with a resulting cascade of impacts, that are both systemic and cutaneous. The 2 main arms of the stress response are the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis. The resultant release of cortisol, catecholamines, and neuropeptides has multiple effects. Clinically, these have been shown to increase skin inflammation, increase itching, impair skin barrier function, impair wound healing, and suppress immunity.
Mind body therapies are those that focus on the interaction between the mind and the body, with the goal to influence physical function and impact health. These have been shown to ameliorate some of the harmful physiologic changes attributed to stress or to reduce harmful behaviors. In some cases, such as with biofeedback, they may also result in beneficial physiologic changes. Treatments such as meditation, biofeedback, hypnosis, guided imagery, and others have been evaluated in the treatment of skin disease and have shown some benefits. Although randomized controlled trials are limited, these interventions have shown beneficial effects on itching, psychosocial outcomes, and even skin severity. These interventions have been evaluated in diseases such as atopic dermatitis, psoriasis, trichotillomania, and others. Given the potential benefits, improvements in psychosocial outcomes, and a low risk profile, referral to qualified practitioners or multidisciplinary clinics should be considered for some patients.
... Hypnosis is a method of treatment that is considered effective on physical and psychological symptoms in the following settings: emergency care (Iserson, 2014), depression (Shih et al., 2009;Yapko, 2001;Yapko, 2013), anxiety (Hammond, 2010), sleep disorders (Becker, 2015;Cordi et al., 2015), chronic pain (Morone & Greco, 2007), obesity (Cherniack, 2008), cancer (Cramer et al., 2015;Liossi & White, 2001;Richardson et al., 2007), as an adjunct during colonoscopy (Elkins et al., 2006), substance abuse disorders (Green & Lynn, 2000;Potter, 2004), dermatology (Shenefelt, 2000) and sexual dysfunctions (Stanley & Burrows, 2001). This method consists in "a state of consciousness involving focused attention and reduced peripheral awareness characterized by an enhanced capacity for response to suggestion" (Elkins et al., 2015). ...
... Hypnosis may help in improving the physical and psychological symptoms of patients with dementia. These results are consistent with the effects obtained in other health domains (Becker, 2015;Cherniack, 2008;Cordi et al., 2015;Cramer et al., 2015;Green & Lynn, 2000;Hammond, 2010;Iserson, 2014;Liossi & White, 2001;Morone & Greco, 2007;Potter, 2004;Richardson et al., 2007;Shenefelt, 2000;Shih et al., 2009;Stanley & Burrows, 2001;Yapko, 2001;Yapko, 2013). Moreover, the Duff and Nightingale study (2007) showed improved performance on concentration, immediate memory and memory of significant life events, even after the hypnosis sessions had ended. ...
Background
Dementia has negative implications for the quality of life of person and lead to situations of distress. Hypnosis is effective in several health domains but its use in people with dementia is debated.
Objective
The aim was to scope the research activity on the use of hypnosis with persons with dementia to manage their distress, symptoms or daily life.
Method
We used five international databases: PubMed/Medline, the Cochrane Library, ScienceDirect, PsycINFO, and Google Scholar.
Results
Only seven articles were listed and three articles described the same longitudinal pilot study. Hypnosis was used either in one or several sessions, alone or as an adjunct and reinforced with daily self-hypnosis with or without audio tapes in people with dementia. The results show that they experienced moderate-to-high hypnotizability, but some adaptations were needed given their attention disabilities. They showed benefit on symptoms. Nevertheless, some methodological weaknesses such as small heterogeneous samples, the use of non-validated tools for hypnotizability or outcomes, or the insufficient definition of the content of sessions limit the scope of the results.
Conclusion
Hypnosis seems feasible and acceptable for people with dementia and could provide interesting clinical benefits, but a randomized controlled trial with a large homogeneous sample would be highly informative.
... It is suggested capable of aiding in the attenuation of burn wounds' depth, size, inflammation, and complications possibly by inhibiting inflammatory reactions [530,532,[540][541][542][543][544][545][546][547][548][549] although this should be investigated more strictly [532]. Additionally, uses of hypnosis in removal of warts [550] or certain other dermatological diseases such as eczema [551], ichthyosis [552], herpes simplex [553], and psoriasis [463,554] have been documented [550][551][552][553][554][555][556]. There have also been attempts to induce medical conditions by hypnosis, confirming its involuntary influences [21]: hypnosis is suggested to be able to induce autonomic reactions such as migraine headaches, Raynaud's disease, duodenal ulcers, asthma, or eczema and allergic reactions [21, 499,557]. ...
... It is suggested capable of aiding in the attenuation of burn wounds' depth, size, inflammation, and complications possibly by inhibiting inflammatory reactions [530,532,[540][541][542][543][544][545][546][547][548][549] although this should be investigated more strictly [532]. Additionally, uses of hypnosis in removal of warts [550] or certain other dermatological diseases such as eczema [551], ichthyosis [552], herpes simplex [553], and psoriasis [463,554] have been documented [550][551][552][553][554][555][556]. There have also been attempts to induce medical conditions by hypnosis, confirming its involuntary influences [21]: hypnosis is suggested to be able to induce autonomic reactions such as migraine headaches, Raynaud's disease, duodenal ulcers, asthma, or eczema and allergic reactions [21, 499,557]. ...
https://link.springer.com/chapter/10.1007/15695_2018_134 Wound healing is a complex process formed of various overlapping stages, namely, clot formation, inflammation, proliferation, and remodeling, which depend on the systemic health and a competent immune system. Negative cognitive processes such as pain and stress can induce the stress response, which delays wound healing by deteriorating health and modulating the immune function through the activation of the hypothalamus-pituitary-adrenal and sympathetic-adrenal-medullary axes. Hence, it seems that practices capable of mitigating stress or pain might accelerate wound healing. This chapter reviews the effects of relaxation and meditation, music therapy, expressive writing, hypnosis, and placebo on physiological health and wound recovery.
... In der Literatur werden zur psychosozialen Therapie der AA häufig Hypnotherapien eingesetzt und beschrieben, so dass Hypnotherapie geeignet schien, bei einer therapieresistenten Patientin eingesetzt zu werden (Shenefelt 2000). So konnten Willemsen et al. (2011) Sie hielt über viele Jahre ihre Haarlosigkeit mit hohem psychischem Aufwand geheim. ...
Zusammenfassung
Thema
Alopecia areata (AA) ist eine Form des Haarverlusts mit kahlen kreisrunden Arealen am Kopf ausgelöst durch auto- und/oder psychoneuroimmunologische Mechanismen. Sekundär leiden Betroffene unter der Haarlosigkeit. Trotz Fortschritten in den dermatologischen medikamentösen Therapien (z. B. durch JAK-Inhibitoren) und Biologica gibt es keine Standard-Therapien. Auch Psychotherapie kann Wirksamkeit nicht belegen. Der Verlauf kann nicht vorhergesagt werden, oft kommt es zur spontanen Remission.
Ziel
Mit dieser Einzelfallstudie sollen psychosomatische Ursachen aufgezeigt und Ansätze zu einem kombinierten medizinisch-psychotherapeutischen Behandlungsprocedere entwickelt werden.
Methode
Eine Patientin mit dermatohistologisch verifizierter AA wurde nach frustranen dermatologischen Lokaltherapieversuchen (a) verhaltens- und (b) hypnotherapeutisch in jeweils 15 Sitzungen behandelt. Vor Beginn der Behandlung wurde eine psychologische Diagnostik mit Instrumenten zur Körperwahrnehmung, Depression und Selbstakzeptanz durchgeführt.
Ergebnis
Die Psychotherapie führte zu positiven Veränderungen im Selbstwert und Körperbild und verbessertem Coping mit der Erkrankung, aber nicht zum Nachwachsen der Haare.
Diskussion
Obwohl Alopecia areata durch Stressoren ausgelöst werden kann, ist nicht erwiesen, dass psychosomatische Herangehensweisen zur Durchbrechung des Auslösemechanismus geeignet sind, auch wenn sich in der Literatur Hinweise auf positive Auswirkungen von Hypnotherapie und Verhaltenstherapie auf Autoimmunkrankheiten finden. Die Autor:innen entwickelten im Falle der Patientin verhaltenstherapeutische, mit Hypnotherapie kombinierte Vorgehensweisen für die Therapie der Alopecia areata. Auf dieser Basis könnten weitere Studien mit einem größeren Kollektiv an Betroffenen möglicherweise den Benefit dieser Therapieformen untermauern.
... Meta-analyses indicated the efficacy of hypnosis for obesity [111], depression [112], post-traumatic stress disorder [113], and anxiety associated with medical procedures [9,93]. Additionally, reviews offered preliminary evidence of the benefits of hypnosis for smoking cessation [114,115] and varied dermatological problems such as pruritus [5,116]. ...
Background and purpose: Hypnosis, a mind-body treatment dating back to early human history, has regained attention in the last decade, with research suggesting its effectiveness for varied physiological and psychological ailments such as distress, pain, and psychosomatic disorders. However, myths and misconceptions have prevailed among the general public and clinicians, hindering the adoption and acceptance of hypnosis. It is important to distinguish myths from facts and discern what is hypnosis and what is not to enhance the understanding, acceptance, and adoption of hypnotic interventions.
Methods: This narrative review traces the history of myths surrounding hypnosis in contrast to the evolution of
hypnosis as a treatment modality. In addition to comparing hypnosis to other interventions with similar procedures and features, the review unravels misconceptions that have impeded the adoption and acceptance of hypnosis in clinical and research settings and presents evidence to demystify this intervention.
Results: This review examines the roots of myths while presenting historical facts and evidence that support hypnosis as a treatment modality and alleviate misconceptions depicting it as mystical. Further, the review distinguishes hypnotic and non-hypnotic interventions with overlapping procedures and phenomenological
features to enhance our understanding of hypnotic techniques and phenomena.
Conclusion: This review enhances the understanding of hypnosis in historical, clinical, and research contexts by disproving related myths and misconceptions to promote the adoption of hypnosis in clinical and research contexts. Further, this review highlights knowledge gaps requiring further investigations to steer research toward an evidence-based practice of hypnosis and optimise multimodal therapies embedding hypnosis.
... 13 Therefore, the authors decided to further investigate related lifestyle behaviors. In animal models, case reports, and in a few mostly nonrandomized clinical trials, they found indications for benefits related to AD for hypnotherapy, [14][15][16][17][18] intermittent fasting, plant-based or arachidonic acidrestricted food, [19][20][21][22][23][24][25][26][27][28][29][30][31] and exercise. [32][33][34][35] Treatments in a group setting might reduce costs, have beneficial group effects, and may improve quality of life (QoL) and dermatological symptoms. ...
Background
Patients with atopic dermatitis (AD) frequently use healthy lifestyle behaviors, although their benefits are unclear. This study's aim was to investigate the effectiveness of hypnotherapy, fasting with diet adjustments, and exercise in AD patients.
Methods
In a four-armed randomized controlled monocenter open explorative clinical trial, adult patients with mild-to-moderate severe AD underwent, over 16 weeks, a five-session hypnotherapy group program (HTP), a five-session intermittent fasting with diet adjustment group program (IFDP), a five-session exercise group program (EP), or no study intervention (control) as add-on to topical corticosteroid use if required. Endpoints included subjectively perceived itching on a visual analogue scale (VAS, 0–100 mm); disease severity by SCORing Atopic Dermatitis (SCORAD); and adverse events (AEs). Endpoints were analyzed descriptively in the Full Analysis Set (FAS). Due to the coronavirus disease 2019 (COVID-19) pandemic, relevant changes to the study protocol included online in addition to “in-presence” group interventions, closing the study arm EP and premature trial termination before randomization of 120 intended patients.
Results
During the COVID-19 pandemic, study recruitment was poor. The FAS included 20 patients (17 female) with 35.0 ± 12.1 (mean ± standard deviation [SD]) years of age. At baseline, mean ± SD for HTP (n = 6), IFDP (n = 4), EP (n = 1), and control (n = 9) were VAS itching 63.2 ± 18.0, 65.0 ± 13.9, 43.0 mm, 62.1 ± 17.3; SCORAD 43.0 ± 13.6, 47.0 ± 21.0, 60.3, 39.1 ± 15.6. After 16 weeks, endpoints were VAS itching 26.0 ± 16.4, 31.7 ± 9.9, 23.0 mm, 39.3 ± 27.0; SCORAD 24.1 ± 12.2, 29.1 ± 19.1, 49.1, 25.5 ± 14.4. No serious AEs related to the interventions were observed.
Conclusion
Despite very small groups, study results indicated potential beneficial changes to baseline in perceived itching intensity, disease severity, and disease-specific quality of life for HTP and IFDP. Therefore, further clinical trials should be performed investigating the effectiveness and safety of all interventions.
Clinical Trial Registration
January 31, 2020 German Clinical Trials Register (DRKS): DRKS00020557, Universal Trial Number (UTN): U1111-1247-1512.
... For example, a recent study failed to establish any conclusive relation between urticaria and some microelement levels including vitamins B12 and D(4). Fourth effectiveness of hypnotherapy in the treatment of different allergic skin disorders is also noted by different authors (7,1). ...
Chronic urticaria (CU) is a condition characterized by the development of wheals, angioedema, or both, lasting longer than six weeks. The wheals vary in size and appear and fade repeatedly as the reaction runs its course. CU carries a substantial burden on the patients and the healthcare system. The relation of CU to psychological factors and stressors seems to be obvious. Life stressors and impairment of psychological well-being can play a role of sensitizing trigger consequently launching the whole chain of mastcell reactions. This is the reason why psychological interventions can be considered as alternative treatment options especially when the conventional treatment modalities previously tried, failed in the achievement of satisfactory results.
... Although promising, these studies are few in number, are small in size, and some of them are steadily becoming outdated. Furthermore, despite no obvious risk tied to meditation or hypnotherapy, some argue that there is little evidence to support them as financially justifiable treatment methods [109]. Nevertheless, this may prove an advantageous complementary treatment method of psoriasis in the future. ...
Objective:
Conventional therapeutic methods for psoriasis include topical and systemic drugs, phototherapy, and biologic agents. Despite the fact that these treatment methods, and especially biologic agents, are met with a considerable reduction in disease activity, they can sometimes be costly and are nonetheless accompanied by high risks of adverse events, ranging from mild to debilitating. Therefore, complementary and alternative medicine (CAM), especially mind-and-body interventions, such as acupuncture, psychotherapy, climatotherapy, and cupping may provide a cheaper and potentially beneficial outcome for these patients.
Methods:
We performed a systematic review of articles pertaining to acupuncture, cupping, psychotherapy and meditation, as well climatotherapy and balneotherapy in the management of psoriasis, by using the PubMED, Medline and Google Academic research databases and reference cross-checking.
Results:
12 articles on acupuncture, 9 on dry or wet cupping, 27 concerning meditation, hypnosis or psychotherapy, and 34 regarding climate therapy or balneotherapy were found.
Discussion and conclusions:
Currently, there is a lack of evidence in the English literature to support acupuncture as an effective alternative therapy for psoriasis, whereas cupping has been described in the majority of instances to result in Koebner phenomenon and clinical worsening. Stress management therapies such as psychotherapy, hypnosis, and meditation have shown promising results as complementary treatment methods. Climatotherapy and balneotherapy have already been proven as effective means of achieving clinical improvement in psoriasis. Further research is still needed to verify the usefulness of the lesser studied treatment methods.
... Diversos estudios señalan la eficacia de la psicoterapia con hipnosis en el tratamiento de verrugas (Lankton S. 2007, Goldstein R.H. 2005, Shenefelt P.D. 2000, Noll R.B. 1994, Ewin D.M. 1992, Spanos N.P. et al 1990, Chandrasena 1982, Dreaper R. 1978. La descripción habitual de casos severos y con múltiples verrugas justifica probablemente la necesidad de más de una sesión clínica para conseguir un tratamiento efectivo. ...
Chema Nieto (2009), Estudio de caso único; hipnosis en el tratamiento de verrugas digitales. Hipnológica 1, 29-32 www.hipnologica.org
La psicoterapia con hipnosis ha demostrado, en diversos estudios, evidencia esperanzadora en el tratamiento de verrugas de distinta localización y severidad (...). El presente estudio describe el tratamiento de verrugas digitales en una única sesión psicoterapéutica con hipnosis. Además de la brevedad y eficacia del tratamiento, el caso resulta significativo por dos motivos. En primer lugar, por la utilización, como sugerencia hipnótica, de las propias imágenes curativas desarrolladas por el paciente. En segundo lugar, por el modo original con que el sujeto estructura los ejercicios autohipnóticos, de manera que se descarta la posibilidad de una curación espontánea. Además, la baja sugestibilidad de este paciente servirá de base para una reflexión final en torno a las escalas de sugestionabilidad y susceptibilidad hipnótica.
... Although the most recognized use of hypnosis is in the treatment or management of pain, such as in surgical contexts (Faymonville et al., 1995), there is reliable evidence for its efficacy in treating a range of conditions including acute and chronic pain (Patterson and Jensen, 2003;Tome-Pires and Miro, 2012), post-menopausal hot flashes (Elkins et al., 2013), irritable bowel syndrome (Schaefert et al., 2014) and enhancement of immunological functions (Miller and Cohen, 2001). Although less robust, promising, albeit preliminary, evidence suggests that hypnosis constitutes a potentially valuable option for treating depression (Alladin and Alibhai, 2007), anxiety (Hammond, 2010), nicotine addiction (Hasan et al., 2014), symptoms inherent to neurodegenerative disorders such as amyotrophic lateral sclerosis (Kleinbub et al., 2015) and dermatological problems (Shenefelt, 2000; for reviews, see Elkins, 2017;. Moreover, when hypnosis is used as an adjunct to nonhypnotic methods, such as cognitive behavioural therapy, therapeutic outcomes are often strongly amplified (Kirsch et al., 1995). ...
Abstract
Background: Recent research on psychedelics and hypnosis demonstrates the value of both methods in the treatment of a range of psychopathologies with overlapping applications and neurophenomenological features. The potential of harnessing the power of suggestion to influence the phenomenological response to psychedelics toward more therapeutic action has remained unexplored in recent research and thereby warrants empirical attention.
Aims: Here we aim to elucidate the phenomenological and neurophysiological similarities and dissimilarities between psychedelic states and hypnosis in order to revisit how contemporary knowledge may inform their conjunct usage in psychotherapy.
Methods: We review recent advances in phenomenological and neurophysiological research on psychedelics and hypnosis, and we summarize early investigations on the coupling of psychedelics and hypnosis in scientific and therapeutic contexts.
Results/outcomes: We highlight commonalities and differences between psychedelics and hypnosis that point to the potential efficacy of combining the two in psychotherapy. We propose multiple research paths for coupling these two phenomena at different stages in the preparation, acute phase and follow-up of psychedelic-assisted psychotherapy in order to prepare, guide and integrate the psychedelic experience with the aim of enhancing therapeutic outcomes.
Conclusions/interpretation: Harnessing the power of suggestion to modulate response to psychedelics could enhance their therapeutic efficacy by helping to increase the likelihood of positive responses, including mystical-type experiences.
Keywords
Consciousness, hypnosis, psychedelics, psychotherapy, suggestion
... There are anecdotal reports of hypnotherapy improving alopecia areata. 38 Tacrolimus: ...
... [57][58] Hypnosis is a technique with proven effects on the brain and capable of producing unexpected results, besides being usable in a large number of dermatoses. 59 It could be put into practice by a greater number of doctors because of its vast reach. There is also self-hypnosis and self-massage, which are self-applying techniques, as well as yoga and tai chi chuan, originating in India and China, the former being a philosophy of life, which integrates mind and body, and the second, originated from Martial arts, producing effects on the body's energizing. ...
The mind-skin connection has been studied since the nineteenth century. The last 40 years have set the development of new research areas which allowed the clarifying of how these two dimensions interact. The diseases that involve skin and mind constitute the field of psychodermatology and require that specialists in dermatology, psychiatry and psychology together and integrated take part in it, since skin, nervous system and mind are simultaneously affected. This paper aims to expose how psychodermatoses are currently conceptualized and the need of integration of these three specialties for conveniently treating the patients.
... Relaxation therapies affect the autonomic nervous system and the immune system, thus improving psoriasis [176]. Hypnosis and biofeedback have been used in psoriasis patients with beneficial results [177,178]. Hypnosis may also enhance the effects obtained by biofeedback [179]. Thermal biofeedback was used in one patient with success [180]. ...
Psoriasis is a chronic immune-mediated genetic disease affecting approximately 120 million patients worldwide. Over 40 genes are associated with psoriasis. Common trigger factors include infections, trauma, medications and stress. There is substantial literature describing the link between psychosocial stress and the exacerbation of psoriasis. We conducted a comprehensive review of the literature regarding pathophysiology, personality traits, quality of life, anxiety, depression, sexual dysfunction, alcohol, smoking and the treatment of psoriasis with respect to stress. Our understanding of the brain-skin axis may help alleviate the suffering of our psoriatic patient population and shed light on the pathophysiology of psoriasis.
The dominant paradigm in biomedicine focuses on genetically‐specified components of cells and their biochemical dynamics, emphasizing bottom‐up emergence of complexity. Here, I explore the biomedical implications of a complementary emerging field: diverse intelligence. Using tools from behavioral science and multiscale neuroscience, we can study development, regenerative repair, and cancer suppression as behaviors of a collective intelligence of cells navigating the spaces of possible morphologies and transcriptional and physiological states. A focus on the competencies of living material—from molecular to organismal scales—reveals a new landscape for interventions. Such top‐down approaches take advantage of the memories and homeodynamic goal‐seeking behavior of cells and tissues, offering the same massive advantages in biomedicine and bioengineering that reprogrammable hardware has provided information technologies. The bioelectric networks that bind individual cells toward large‐scale anatomical goals are an especially tractable interface to organ‐level plasticity, and tools to modulate them already exist. This suggests a research program to understand and tame the software of life for therapeutic gain by understanding the many examples of basal cognition that operate throughout living bodies.
Often psychiatric co-morbidity has been observed in dermatology patients. Apart from regular dermatologic therapy employed in treating them; certain psychiatric drugs, along with other non-pharmacological measures, if combined in managing these patients, would certainly yield superior results. This comprehensive review throws light on various psychiatric drugs along with other adjuvant treatment modalities that could serve as a ready reckoner to skin specialists while encountering patients who apart from having cutaneous problems, also manifest with an associated psychological component that may need scrupulous evaluation in order to obtain a proper solution.
Hypnosis is an ancient mind-body intervention that has regained interest with the surge of research in the last decade documenting its clinical validity. Yet, theoretical controversies and misconceptions prevail among theorists, clinicians, and the general public, impeding the understanding, acceptance, replication, and use of hypnosis. Providing adequate information, which dispels misconceptions and promotes more balanced views, is warranted to facilitate the implementation and adoption of hypnosis in clinical and research settings. This review re-examines the conceptualisation of hypnosis throughout history and the theoretical controversies surrounding it while highlighting their meeting points and clinical implications. Despite dichotomies, a broad agreement appears across theoretical approaches regarding hypnotic analgesia effects, key components, and vocabulary. Further, theories highlight key factors of hypnotic responding. For instance, social theories highlight social and contextual variables, whereas state theories highlight biopsychosocial mechanisms and individual factors. Based on theories, the terms hypnotherapy or clinical hypnosis are recommended to refer to the therapeutic use of hypnosis in psychotherapeutic and medical contexts, respectively. This review concludes with a model that integrates various theories and evidence and presents hypnosis as a complex multifaceted intervention encompassing multiple procedures, phenomena, and influencing factors. This review intends to deepen our understanding of hypnosis, and promote its more rapid adoption and adequate implementation in research and clinical contexts, in addition to steering research towards evidence-based hypnotic practice. The review can have important research and clinical implications by contributing to advancing knowledge regarding hypnotic procedures, phenomena, and influencing factors.
There is a well-established connection between the skin and the mind. Based on current evidence, many dermatological conditions are triggered or exacerbated by stress. Therefore, intervention needs to target stress, anxiety, and other psychiatric comorbidities which may be secondary to skin conditions or may lead to aggravation of the illness. Psychological interventions should be based on the underlying emotional issues that may affect the way skin problems respond to medical treatment. Before starting the intervention, it is very important to know which psychodermatological conditions will be targeted. In primary psychocutaneous illness (delusion of parasitosis, obsessive-compulsive disorder, dysmorphophobia, etc.) the target is to modify or eliminate the symptoms of illness with specific models and approaches. If stress is playing an active role in the etiology and course of skin conditions (e.g., psoriasis, atopic dermatitis, and urticaria) or it is delaying the improvement, then the aim should be to apply stress reduction techniques. In some skin conditions (pemphigus vulgaris, Hansen’s disease, etc.), the aim of the intervention should be to strengthen the defenses and teach new and better mechanisms to maintain control. The common psychotherapy procedures useful in dermatology practice include psychoeducation, behavior therapy, habit reversal, relaxation procedures, biofeedback, cognitive behavior therapy, hypnotherapy, and group therapy.
Among special therapeutic options, anti-inflammatory treatment using topical glucocorticosteroids (TCS) or topical calcineurin inhibitors (TCI) are core elements. Antimicrobial therapy using preferably antiseptics can help against microbial colonization or infection. Antipruritic therapy includes also systemic antihistamines although with limited evidence. New topical substances include phosphodiesterase inhibitors and opioid receptor antagonists.Phototherapy with UVB or UVA1 is often used. Allergen-specific immunotherapy (ASIT) has no routine place however has been tried successfully in some studies.Greatest progress has been made in new immunomodulatory therapy already beyond immunosuppressives like ciclosporin A, methotrexate, azathioprine, or mycophenolate.Inhibitors of the janus kinase (JAK) are registered, as well as specific biologics like anti-interleukin 4/interleukin 13 (Dupilumab) or interleukin 13 (Tralokinumab). With anti-interleukin 31 (Nemolizumab), new antipruriginous strategies may be possible. Besides pharmacotherapy, also psychosomatic counseling and behavioral therapy have been proven helpful. Few diseases are characterized by the use of so many unconventional procedures like atopic eczema. Most of them have limited or no proven efficacy, but are very popular with the patients. Among “alternative” strategies for phytotherapeutic approaches, acupuncture may be tried. There was no effect in several controlled trials for bioresonance, homeopathy, or kinesiology. There is a high degree of placebo responders in controlled clinical trials in atopic eczema possibly due to a high suggestibility in this disease.KeywordsAnti-inflammatory treatmentTopical glucocorticoidsTopical calcineurin inhibitorsSystemic immunomodulatorsJAK inhibitorsBiologicsDupilumabTralokinumabUnconventional procedures
The mind–skin interaction has been progressively clarified by recent research that has focussed on psychoneuroimmunology. This article focusses on brain–cell communication by means of chemical messengers and the changes in the skin they provoke under stress, providing an origin to dermatoses linked to the mind, called psychodermatoses. The author refers to three types of psychodermatoses: those caused by prior psychiatric disturbances, those that cause psychologic disturbances by their aspect, and those that are influenced by emotional states. This article highlights the four simple and natural mind–body anti-stress techniques of posture, diaphragmatic breathing, muscle relaxation, and meditation that every doctor can teach to patients, which will enable them to face stressful situations and therefore protect themselves against the negative psychological effects of stress. Several therapeutic behaviours in the doctor–patient relationship are recommended to build a patient’s trust in their doctor and to encourage the patient to play an important part in their treatment process. It is emphasised that the treatment of psychodermatoses needs to be co-operative, integrating specialists in dermatology, psychiatry, and psychology. Dermatologists take care of the skin alterations, while psychiatrists are involved with the associated mental disturbances and are able to prescribe a large range of psychopharmaceuticals to treat anxiety, depression, post-traumatic stress disorder, and compulsive states. Psychotherapists try to correct erroneous behaviours and false feelings, employing cognitive-behavioural therapy, analytic and reprogramming techniques, and also hypnosis, in order to rid patients of psycho-emotional perturbations and facilitate successful outcomes in the skin.
The psychological aspect of dis-ease, which is indeed a lack of 'ease' is generally overlooked in the management of myriad maladies that affect the human body. The concept of mindfulness meditation, which is an interesting hybrid born from the meditative discipline of the east and the intellectual discipline of the west is gaining attention in the past two decades for its benefits in the holistic development of individuals. When individuals with ailments are trained under therapists supervised by the clinicians, significant results can be seen in alleviating symptoms like pain, stress, anxiety and an improvement in the quality of life is observed. This review article focuses on the structure and basics of mindful meditation and the mechanisms of mindfulness and its positive effects on various diseases like lichen planus, urticaria, psoriasis, eczema, myofacial pain dysfunction syndrome, to name a few. There are various arenas within the discipline of oral and maxillofacial medicine where mindfulness-based techniques can be explored for its effectiveness in combating psychosomatic conditions. The article highlights the importance of holistic approach in treating diseases in which mindfulness meditation techniques play an important role.
Psychological factors might be involved in some oral mucosal diseases, such as recurrent aphthous stomatitis (RAS) and oral lichen planus (OLP). However, there is little information about the psychosomatic approaches to manage these oral mucosal diseases. This review summarizes the reports on the psychological statuses of patients with oral mucosal diseases, including RAS and OLP and others, and discusses the appropriate psychosomatic approaches for the management of these diseases. The psychosomatic background is probably involved in onset and course of inflammatory oral mucosal diseases, and can be called as “psychosomatic diseases”. The field of psychosomatic medicine for oral mucosal diseases may be termed “psychostomatology”.
In an age that demands empirically sound methodology, yet seeks new and innovative methods for treatment, the latest blend of cognitive-behavioural therapy and hypnosis can just be the creative solution practitioners have been looking for. The integration of the much older hypnosis and relatively younger cognitive-behavioural therapy paired with various relaxation techniques are important tools in the armamentarium of any inspiring psychodermatologist.
Stomatodynia is an oral dysesthesia with a psychosomatic component. Twelve consecutive patients with stomatodynia were offered hypnosis sessions. Measures of anxiety, depression, and pain were administered before the first and after the last hypnosis session. Pain severity was assessed with a Numeric Rating Scale (NRS). Anxiety and depression were assessed with the Hospital Anxiety and Depression Scale (HADS). The data were collected retrospectively from medical records on the 12 patients. The difference between NRS pain ratings and HADS scores before and after hypnosis was significant (p < .05). Six patients reported receiving treatment for stomatodynia before hypnotherapy; 3 of them stopped treatment for stomatodynia before completion of the hypnosis intervention. Results provide support for potential positive effects of hypnosis intervention for stomatodynia and point to the need for additional research on this issue.
Hypnosis may sound mysterious and inapplicable to the aesthetic practitioner. Informed use of hypnotic techniques can assist the patient in ways not otherwise available. It is equally important to refrain from giving negative suggestions (nocebos) during the encounter and to investigate whether the patient has been given a nocebo by someone else. In other situations a more formal trance induction may be needed. The hypnotizability trait remains quite stable throughout life. However, even those who are low hypnotizable can often benefit from trance when their motivation is high, as is often the case in medical situations. Hypnosis training typically is done starting at the basic level with training extending over about 20 or more hours over one or several weekends. Having this training can give the aesthetic practitioner a competitive advantage over others not so trained in terms of offering patients more pleasant encounter and procedure experiences.
Atopic dermatitis (AD) is a multifactorial disease that may have a psychosomatic component. In this study, the authors aimed to measure the effect of hypnosis on AD in a clinical setting. Patients with AD who never had systemic treatment were offered hypnosis sessions. Twenty-seven patients with AD and a mean age of 34.5 years participated in a mean of six hypnosis sessions (range 2 to 16). AD severity can be assessed with the Eczema Area and Severity Index (EASI). EASI score was calculated during the first and last hypnosis sessions for 21 patients. Eczema improved or resolved in 26 of the 27 patients. Mean EASI score for the 21 patients evaluated was 12 at the first session and 2.8 at the last session. Hypnosis may be useful in AD and may overcome the need for systemic treatments for some patients.
Analysis of the leaf and stem essential oils from three Brazilian Lauraceae species showed that the major constituent of O. odorifera was safrole (57.1 and 88.5% for leaves and stems, respectively) while for O. indecora leaves the major ones were the α-pinene (12.8%) and β-pinene (12.4%) andβ-bisabolol (12.2%) in the stems. For the third species, Persea venosa, the main components of leaf and stem oils were spathulenol (27.8 and 14.7%, respectively) and humulene epoxide II (11.3 and 5.1%, respectively). The bioactivity results indicated that the leaf essential oil from O. indecora was the most active for both radical scavenging activity (IC50=0.142mg/mL) and cytotoxicity against human tumor cells, with growth inhibitions for the colon tumoral line HCT-116 (100%)and breast cancer cell line MCF-7 (99.2%), at 5 μg/mL concentration. This activity might be related to the presence ofα-pinene and β-pinene in the leaf essential oil of O. indecora. However, further studies with the isolated compounds are necessary to fully understand these bioactivites.
Lichen planus (LP) is the prototype of a group of inflammatory dermatoses, referred to as lichenoid disorders, characterized clinically by small, often pruritic papules, and histologically by a dense, band‐like lymphocytic infiltrate in the papillary dermis, that often obscures the dermoepidermal junction (DEJ). Cutaneous lichen planus (CLP) typically involves the flexural skin surfaces of the extremities. Oral lichen planus (OLP) usually manifests clinically with bilateral white striations, papules, or plaques that may become erythematous or erosive. Psychosomatic factors such as emotional stress play a substantial role in triggering LP and OLP. Topical corticosteroids (TCSs) are proven to reduce the size of the lesions in LP and improve the clinical status, and are currently the mainstay treatment of OLP. Systemic therapy with oral glucocorticoids (GCs) is indicated in cases of severe mucocutaneous LP. Oral lichenoid contact reactions (OLCRs) can be induced by delayed immune‐mediated hypersensitivity to dental restorative materials, such as amalgam.
Meditation, hypnosis, and psychotherapy all have ancient roots. Both focused meditation and mindfulness meditation utilize trance phenomena to help produce centering and specific improvements in skin disorders through psycho‐neuro‐endocrine‐immuno‐logic mechanisms. Integration of these techniques into mindfulness‐based cognitive hypnotherapy provides a multifaceted approach to promoting healing of skin disorders. The promotion of healing of skin disorders can be attained by using meditation, hypnosis, cognitive‐behavioral psychotherapy, cognitive hypnotherapy, or their combination into mindfulness‐based cognitive hypnotherapy. While Freudian psychoanalysis and Jungian analysis provide earlier forms of psychotherapy, cognitive‐behavioral methods have been the main psychotherapeutic approach to skin disorders. Cognitive‐behavioral methods attempt to alter dysfunctional thought patterns (cognitive) or actions (behavioral) that damage the skin or interfere with dermato‐logic therapy. This chapter also provides an excellent example of how the multifaceted approach of mindfulness‐ based cognitive hypnosis can help to reduce inflammatory skin conditions over both the short and long term.
Purpose. A lack of awareness about hypnosis and, as a result, widespread misconceptions that provoke a fear of this method of psychotherapy do not prevent from active use of this method in various disciplines of medicine.
The aim of our research is the study of efficiency of Erickson hypnotherapy methods in cosmetology using the procedure of sculpture face massage based on the Tibetan technique as an example.
Methodology. 22 women aged 22 to 69 (the average age is 43,52 ±10,34 years old) participated in the study. The control group consists of 22 women aged 35 to 66 (the average age is 48,81 ±10,33 years old). The participants were voluntarily divided into the control and experimental groups. During the study each participant had 3 sessions of sculpture massage based on the Tibetan technique in combination with Erickson hypnotherapy.
The criterion for assessing the efficiency of the method was the analysis of the change of the brow line which is calculated according to the formula: “outer cantus-point of nasion” (CN)/ the length of “outer cantus-brow (CB)” (Sergienko V.I., Kulakov A.A., Petrosyan N.E., Petrosyan E.A.), as well as WAM questionnaire: well-being, activity, mood (Doskin V.A., Lavrentjeva N.A., Sharay V.B., Miroshnikov M.P.).
Results. The use of hypnotic induction during quite painful technique of face massage has an effect of anesthesia, the patients undergo the procedure more smoothly with subjectively positive emotions. Objective results of the study evaluated with the Mann-Whitney U-test were in the zone of irrelevance. According to the objective indicators of the psychological well-being of the participants there is no difference between sessions with hypnotic induction and without it. However according to the subjective feedback, the participants of the experimental group far less frequently met the painfulness of the procedure (14%), while all the participants of the control group suffer from the painfulness of the procedure (100%).
Conclusion. Subjective feedback of the participants suggests the necessity of further study of the possibilities of use of Erickson hypnotherapy in modern cosmetology and dermatovenereology, or the elaboration of specialized toolkit to assess the results of hypnotic induction.
The aim of our research is the study of efficiency of Erickson hypnotherapy methods in cosmetology using the procedure of sculpture face massage based on the Tibetan technique as an example. Subjective feedback of the participants suggests the necessity of further study of the possibilities of use of Erickson hypnotherapy in modern cosmetology and dermatovenereology, or the elaboration of specialized toolkit to assess the results of hypnotic induction.
Mindfulness-based cognitive hypnotherapy integrates mindfulness, cognitive-behavioral therapy, and hypnotherapy to improve physical, emotional, mental, and/or spiritual aspects of skin disorders. Meditation, including mindfulness meditation, and hypnosis both utilize trance phenomena to help produce focalization and specific improvements in skin disorders through psycho-neuro-endocrine-immunologic mechanisms. Hypnosis, cognitive hypnotherapy, focused meditation, and mindfulness meditation are discussed with respect to improving various skin disorders including acne, acne excoriée, alopecia areata, atopic dermatitis, congenital ichthyosiform erythroderma, dyshidrotic dermatitis, erythema nodosum, erythromelalgia, furuncles, glossodynia, herpes simplex, hyperhidrosis, ichthyosis vulgaris, lichen planus, neurodermatitis, nummular dermatitis, postherpetic neuralgia, prurigo nodularis, pruritus, psoriasis, rosacea, trichotillomania, urticaria, verruca vulgaris, and vitiligo. Their integration into mindfulness-based cognitive hypnotherapy is then discussed and illustrated with improvement in a patient with systemic lupus erythematosus.
Background: Nummular eczema (NE) is predominantly a disease of adulthood that presents as coin-shaped plaques from coalescing papulovesicles. Clinical manifestations vary from minimal to severe. The pathogenesis of NE is still unknown. Objective: In this retrospective study, we sought to investigate the epidemiology, clinical manifestation, and abnormal laboratory findings in patients with NE. Methods: We identified patients with NE who had visited the department of dermatology in National Medical Center between 2012 and 2015. The clinical charts and laboratory tests from each patients' medical record were reviewed. Results: Overall, 244 patients with a median age was 52 years were identified; two-thirds were men. The onset of lesions predominantly occurred in patients' fifties and sixties. Predominant sites were the lower limbs, followed by the trunk and upper limbs. Twenty-six patients had a history of atopic diseases and 50 patients had elevated serum Ig E levels. The multiple allergosorbent test (MAST) was performed in 21 patients with an elevated serum Ig E level using an immunoblot assay. Dermatophagoides farinae, D. pteronyssinus, and house dust were common allergens found in MAST (76.2%, 76.2%, and 47.6%, respectively). Conclusion: In this study, we found that NE developed mainly in elderly patients and that lesions were distributed on the lower limbs. In addition, 44% of the patients had an elevated serum Ig E level and 76.2% of patients had a positive response to house dust mites on the MAST. We hope that these data will help to understand the characteristic of nummular eczema.
Background
The use of psychological therapies in dermatology is being increasingly recognized because stress and negative emotions are major factors in a wide range of dermatologic disorders. Eye movement desensitization and reprocessing (EMDR) is a relatively new psychological intervention which was first described to be effective in post-traumatic stress disorder, a condition associated with extremely stressful life situations.
Objective
We evaluated the efficacy of EMDR in primary dermatologic disorders where psychological stress plays an important part in the pathogenesis of the disorder, and in clinical situations where the dermatologic symptom is the feature of a stress-related psychiatric disorder.
Methods
Four patients (two patients with atopic dermatitis and psoriasis, respectively, whose symptoms were exacerbated by stress, one patient with acne excoríee associated with body image pathology as a result of childhood emotional abuse, and one patient with generalized urticaria associated with post-traumatic stress disorder) were treated using the standard EMDR protocol with 3–6 sessions for a period ranging from 4 to 12 weeks, and followed up for 6–12 months after the end of EMDR therapy.
Results
All 4 patients experienced a marked improvement in their symptoms after 3–6 sessions of EMDR, within a period of ⩽3 months, and maintained improvement during followup periods of 6–12 months.
Conclusion
Our preliminary findings suggest that EMDR may be beneficial in the treatment of a wide range of stress-mediated dermatologic symptoms.
Although sometimes maligned and often misunderstood, clinical hypnosis can be utilized as a powerful adjunct for the treatment of mind–body conditions, including cancer. Unlike customary medical regimens that treat diseases of the body and psychotherapies that address disorders of the psyche, hypnosis is a uniquely customizable multi-tool that can augment the treatment of both physical and emotional disorders as well as their complex interactions. This article presents a longitudinal, phase-oriented, clinical model that uses hypnosis in a series of sequential interventions that incorporate targeted suggestions to address the unfolding phases of the cancer continuum. Five such phases of the cancer patient’s trajectory, along with their associated medical and psychological challenges, are conceptualized. Each phase is illustrated by case examples from the author’s clinical practice and by a discussion of relevant hypnotic approaches. On the somatic level, the intrinsic capacities of hypnotic phenomena, paired with suggestions, can be harnessed to effect perceptual and functional changes to offer symptom relief, re-establishment of systemic homeostasis, amelioration of cellular chemistry, and the acceleration of tissue healing. In the psychological realm, hypnotic strategies can be used to provide a much needed continuity of emotional support, a sense of mastery and self-agency, emotional regulation, and behavioral change.
For many years, the therapy field was dominated by a focus on the past. In this context, many clinicians were trained to use hypnosis as a tool to explore the past, and there is a rich literature documenting the use of hypnosis as a tool to induce age regression and the uncovering of traumatic memories. This article presents a therapeutic paradigm that focuses on the future. Hypnosis is used to induce creativity, flexibility, and openness to the future. In the context of health care, hypnosis is used to explore the best possible treatment outcome, which may be pharmacological, surgical, or a combination of both as well as other nonsurgical interventions. This article elaborates on the effective use of a therapeutic hypnosis strategy and technique focused on the future.
IntroductionEmotional factors in diseases of the skinPsychological importance of the skinBody imagePsychoneuroimmunologyEmotional reactions to skin diseaseDisability and quality of lifeClassificationDermatological delusional symptomsCutaneous phobiasGroup and mass population reactionsSelf-inflicted and simulated skin diseaseFactitious skin diseaseCutaneous disease and alcohol misuseAIDS, HIV infection and psychological illnessSuicide in dermatological patientsTreatment of psychocutaneous disordersPsychiatric problems caused by dermatological treatmentSkin disease in patients with learning disability
The introduction of glucocorticosteroids in dermatology was the greatest progress for eczema patients in the second half of the twentieth century. For atopic dermatitis, mostly mild to moderate strength steroids are adequate. The application of topical glucocorticosteroids in the correct vehicle should be timely limited and ended via a “tandem therapy.” Proactive strategies with once or twice weekly applications of the effective substance have proven helpful. The most important side effects of topical glucocorticosteroids include skin atrophy and the common manifestation of perioral rosacea-like dermatitis which occurs especially in young women after topical corticosteroids.
Hypnosis utilizes trance to access otherwise inaccessible repressed or unconscious memories and features of the psyche and control of physiology not attainable in the ordinary conscious waking state. Medical uses of hypnosis in dermatology include reducing discomfort from itching or skin pain, altering ingrained dysfunctional habits such as scratching, promoting healing of skin disorders, searching for psychosomatic aspects of skin disorders and alleviating them, and reframing cognitive and emotional dysfunctional patterns related to skin disorders. Meditation uses trance to center and balance. Medical uses of meditation in dermatology include relaxation to promote healing of skin disorders and refocusing with respect to the meaning and emotional negative valance of skin disorders. Biofeedback in dermatology employs instrumentation with visual or auditory feedback to permit conscious awareness and alteration of physiologic phenomena such as sweating as measured by galvanic skin resistance and skin temperature measured by temperature detecting devices, promoting relaxation and healing. These methods and techniques permit access to and intervention in otherwise inaccessible areas that can influence skin disorders. With proper use, they are very safe with minimal, if any, side effects and sometimes produce significant results, where other methods have failed.
Vitiligo is a depigmenting skin disorder. Depend on location of lesions Vitiligo could cause severe psychological distress for patients.
Vitiligo is a multifactorial disease and has different clinical presentations. Autoimmunity plays an important role and it could be associated with other autoimmune problems. Stress has a role in triggering and aggravating the disease in some patients.
This chapter will review Vitiligo, its current treatments, as well as how to deal with psychological aspects of it.
Excess stress and strain on a physical, emotional, mental, or spiritual level can impair the patient’s response to treatment for many skin disorders. The skin and the nervous system form adjacent to each other in the ectoderm of the fetus and remain interconnected physically and biochemically and interact throughout life. The skin-nervous system interactions result in significant psychosomatic or behavioral influences on many dermatologic conditions. Psychoneuroimmunology elucidates the biological basis of how the brain and nerves alter immune responses in common skin disorders such as atopic dermatitis, psoriasis, and urticaria. These interactions and influences allow non-pharmacologic interventions such as acupressure or tapping on meridian points, aromatherapy, autogenic training, biofeedback, breathing rate slowing techniques, brief psychodynamic therapy, cognitive-behavioral therapy, energy acupressure techniques, guided imagery, hypnosis, meditation, music, placebo, shamanic drumming, and suggestion to produce positive effects on many dermatologic diseases through stress and strain reduction.
Erythromelalgia is an unusual condition characterized by attacks of burning pain in the hands and feet with local congestion and increased skin temperature. We report a case of erythromelalgia, with transient hypertension and elevated urinary catecholamines successfully treated by hypnotherapy. Such an association has not to our knowledge been previously reported in English language publications.
The effect of psychological pain reduction on the cutaneous inflammatory process was investigated by studying the effect of hypnotically induced analgesia on the flare reaction of cutaneous histamine prick tests. Ten highly hypnotically susceptible volunteers had their cutaneous reactivity against histamine prick tests on both arms measured before hypnosis. Their pain-related brain potentials were measured on the basis of eight argon laser stimulations. These measurements were repeated in the hypnotic condition, where subjects were given repeated suggestions of analgesia in one arm. Final measurements were performed in the post-hypnotic condition. Subjectively felt pain was measured on a visual analogue scale. Results showed a mean reduction in subjectively felt pain of 71.7% compared to the baseline condition. A significant (P less than 0.01) mean reduction of the evoked potentials was found in the hypnotic analgesic condition compared to both the pre-hypnotic (49.9%) and the post-hypnotic condition (36.9%). A significant difference was measured in the histamine flare area between the pre-hypnotic and the hypnotic analgesic condition (P = 0.01-0.02) and between the hypnotic analgesic and the post-hypnotic condition when compared with the control arm. The mean ratio of flare area between the analgesic arm and the control arm was 1.04 (SD, 0.16) in the pre-hypnotic condition, 0.78 (SD, 0.22) in the hypnotic analgesic condition, and 1.37 (SD, 0.49) in the post-hypnotic condition. The results support the hypothesis that higher cortical processes can be involved in the interaction of inflammatory and pain processes.
Subjects with warts on their hands and/or feet were randomly assigned to a hypnotic suggestion, topical salicylic acid, placebo, or no treatment control condition. Subjects in the three treated groups developed equivalent expectations of treatment success. Nevertheless, at the six-week follow-up interval only the hypnotic subjects had lost significantly more warts than the no treatment controls. Theoretical implications are discussed.
Hypnosis was used to treat a 7-year-old female with 82 common warts. The lesions had been present for 12-18 months and were refractory to routine dermatologic treatment. Hypnotic suggestions were given for the facial warts to disappear before warts from the rest of the body. After 2 weeks, eight of 16 facial warts were gone, with no other changes. After three additional biweekly sessions, all 82 warts were gone. To the author's knowledge, this is the first reported case of systematic wart removal in children. Discussion focuses on the relationship between psychological mechanisms and the immune system.
Die Hyperhidrosis ist eine funktionelle Störung der ekkrinen Drüsen; auch bei extremer Achselnässe sind die apokrinen Drüsen nicht ursächlich beteiligt. Diese liefern lediglich das Substrat zur Bildung des typischen apokrinen Körpergeruchs. Erst die bakterielle Zersetzung geringster Mengen apokrinen Schweißes läßt dann geruchsaktive Substanzen entstehen [14].
This study was designed to test the hypothesis that warts are treatable by hypnotherapy. Seventeen experimental patients with bilateral common or flat warts were hypnotized weekly for five sessions and were told that the warts would disappear on one side only. They were reexamined three months from the time of the first hypnotic session. Seven patients who were untreated were also reexamined at the end of three months.
Fifty-three percent of the experimental group improved. No improvement was observed among untreated controls. These findings support the hypothesis that warts respond to hypnotherapy. Whereas specific lesions could not be influenced selectively, the findings suggest that hypnosis has a general effect on host response to the causative virus.
Objective.
—To determine whether individuals selected for good general health, high hypnotizability, and the ability to alter skin temperature under hypnotic suggestion can influence the delayed-type hypersensitivity (DTH) response to varicella-zoster (VZ) antigen under hypnotic suggestion.Design.
—A blinded clinical trial using a repeated measures design with subjects serving as their own controls. Subjects were randomly assigned to undergo a predetermined sequence of four different experimental conditions, occurring at weekly intervals, with each condition including VZ skin testing: (1) hypnosis with suggestions to enhance the DTH response to VZ antigen; (2) hypnosis with suggestions to suppress the DTH response; (3) hypnosis with suggestions for relaxation only; and (4) skin testing without hypnosis.Setting.
—A National Institutes of Health—supported clinical research center in a teaching hospital.Subjects.
—A stratified sample of 24 ambulatory, healthy, highly hypnotizable, volunteer college students selected for their above-average ability to alter skin temperature after hypnotic suggestions and their positive baseline responses to VZ antigen. There were 11 males and 13 females with a mean±SD age of 22±6 years. The mean±SD hypnotizability score (Harvard Group Scale of Hypnotic Susceptibility) was 11±1.Interventions.
—Intradermal skin testing with VZ antigen (Mantoux method) and hypnotic suggestion.Main Outcome Measures.
—Areas of induration of the DTH response measured at 24 and 48 hours after injection of antigen.Results.
—The area of the DTH response was not affected by the experimental interventions. The area of erythema was likewise unaffected.Conclusions.
—Our subjects were unable to alter their DTH responses using hypnotic suggestion.(JAMA. 1994;272:47-52)
Relaxation mental imagery (RMI), standard topical treatment (TopTx), and equal time-control interventions were compared on measures of wart regression in sixty one, 6–12-year-old children. Subjects chose one common (“index”) wart and attended 4 visits over 8 weeks. At each visit, total and “index” extremity wart number were counted and a photo was taken of the “index wart” for later measurement. On average, total wart number decreased by 10% and “index wart” area decreased by 20% with no significant group differences during the first eight weeks. Phone follow was conducted 6 to 18 months from study entry. At phone follow up, there was a trend for more RMI and TopTx subjects to report complete wart resolution (p = 0.07) with a majority of RMI children reporting use of RMI or no specific treatment pursuit. We conclude there was no significant short-term benefit for RMI in this randomized controlled trial of wart regression in children. However, longer term benefits for RMI and TopTx groups are suggested.
This study used hypnosis to treat seven consecutively referred patients with warts that had been refractory to numerous treatments with conventional therapies. The hypnotic techniques used with these cases focused on the patient as the active agent in collaboration with the therapist, working in tandem to obtain the desired outcomes. All of the patients had warts that were causing social problems. Nearly all patients (86%) were completely cured of their warts within 3 months of the onset of therapy. Results are discussed in terms of needed research examining the psychologic and physiologic mechanisms connected with the involution of warts and possible mind-body connections that could be scrutinized using the treatment of warts as a paradigm. J Dev Behav Pediatr 15:170-173, 1994. Index terms: hypnosis, warts, psychosomatics, psychoneuroimmunology.
A case of experimental hypnotherapy of a chronic neurodermatitis has been presented within which the resistance of the patient was accepted as reasonable. Therapy was structured by the patient's limitations and the results, at least in this one case, justified the procedure. It is suggested that a more global perception of resistance be recognized apart from its unconscious meaning and that cognitive aspects of resistance be evaluated and utilized in treatment planning. The problem of an artifact neurotic reaction in resistance oriented therapy is discussed.
The Journal of Investigative Dermatology publishes basic and clinical research in cutaneous biology and skin disease.
Venereal warts (condyloma acuminata) are reported to be increasing in frequency along with other venereal "infections." They can be difficult to treat by methods other than suggestion. They are caused by the same virus that causes wart infections in other parts of the body and are just as amenable to suggestion therapy, except that there is more emotional energy invested in these warts than others. 4 cures are reported: 1 by direct suggestion, 1 by hypnoanalysis, 1 by waking suggestion, and 1 cured following a dream that was readily interpreted by the patient. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The patient was 56 years of age and had already had the warts for about a year. The warts were large, ugly, numerous and mainly on the dorsal aspect of both hands. A trial of hypnosis was suggested. The simple suggestion was given that the warts would gradually shrivel up. The treatment was given weekly at first and then fortnightly, each session lasting about 10 minutes. Within 3 months the warts were less fleshly and possibly smaller. After 10 months' treatment the only wart remaining was the suggested one on the ring finger. After another 2 months the remaining wart had gone, following appropriate hypnotic suggestion.
A 20-year-old single woman was treated for persistent and severe neurodermatitis. The use of Erickson's pseudo-orientation in time technique was used to consolidate and extend partial therapeutic gains resulting in complete system remission which was maintained at a four-year follow-up. While re-oriented, the client also successfully predicted the time at which the dermatitis would disappear.
It was suggested to 22 subjects that their warts would disappear if they imagined them tingling for a few minutes each day. Half the subjects received the suggestion after they had been exposed to a formal hypnotic induction procedure and the remaining half (controls) received the same suggestion after they were told simply that they were to be treated by a method called “focused contemplation.” Three of the 11 hypnotic subjects and none of the 11 “focused contemplation” subjects lost their warts during the experimental period. It is suggested that the relatively greater effectiveness of the hypnotic treatment may have been due to its believed-in efficacy; that is, subjects who lost their warts strongly believed that warts could be cured by hypnosis whereas the “focused contemplation” subjects did not believe that their treatment was especially effective in curing warts.
The effects of psychosocial events on the natural history of warts and the physiological mechanisms that mediate them are observed in two case studies. Psychosocial factors not only accelerate the remission of warts but may also reinforce their presence and proliferation as in Case No. 1. Vasomotor changes during and following nonspecific hypnotic suggestions in Case No. 2 lend confirmation to earlier speculations and hypotheses on the nature of one mediating physiological mechanism in wart remission. The merits of an operant conditioning paradigm of so called “hypnotic” behaviors were discussed.
Three children with an immunologic deficit developed multiple warts which proved refractory to all therapy. The Verrucae Vulgaris disappeared in response to hypnosis in all three cases. There was no recurrence after eight months of follow-up.
Case histories show that hypnosis can control massive bleeding and pain, and it can remove warts, probably by stopping blood flow to them. We propose that blood flow to cancerous tumors can likewise be controlled, which could destroy them outright, or which control could be a useful adjunct to chemo- or radiotherapy.
Published, controlled studies of the use of hypnosis to cure warts are confined to using direct suggestion in hypnosis (DSIH), with cure rates of 27% to 55%. Prepubertal children respond to DSIH almost without exception, but adults often do not. Clinically, many adults who fail to respond to DSIH will heal with individual hypnoanalytic techniques that cannot be tested against controls. By using hypnoanalysis on those who failed to respond to DSIH, 33 of 41 (80%) consecutive patients were cured, two were lost to follow-up, and six did not respond to treatment. Self-hypnosis was not used. Several illustrative cases are presented.
Since most clinicians and researchers agree that stress affects the course of psoriasis, consideration should be given to advocating adjunctive therapies aimed at reducing psychophysiological stress. Biofeedback training, psychotherapy, and hypnosis are examples of adjuncts to traditional medical treatment that can reduce stress levels and have been shown to have a positive effect on the course of psoriasis.
Cutaneous reactivity against histamine skin prick test (Type I) and purified tuberculin protein derivative (Mantoux reaction, Type IV) was studied in eight volunteers under hypnosis. Types I and IV immunoreactivity were modulated by direct suggestion (Type I) and guided imagery (Type IV). The volunteers were highly susceptible subjects, selected by means of the Harvard Group Scale of Hypnotic Susceptibility, Form A. When the volunteers underwent hypnotic suggestion to decrease the cutaneous reaction to histamine prick test, a significant (P less than 0.02) reduction of the flare reaction (area of erythema) was observed compared with control histamine skin prick tests. The wheal reaction did not respond to hypnotic suggestion. Neither wheal nor flare reaction could be increased in size by hypnotic suggestion compared with control histamine skin prick tests. A hypnotic suggestion of increasing the Type IV reaction on one arm and decreasing the reaction on the other revealed a significant difference in both erythema size (P less than 0.02) and palpable induration (P less than 0.01). In two cases the reactions were monitored by laser doppler blood flowmetry and skin thickness measurement by ultrasound. The difference between the suggested increased and decreased reaction was 19% for the laser doppler bloodflow (in favor of the augmented side), and 44% for the dermal infiltrate thickness. This study objectively supports the numerous uncontrolled case reports of modulation of immunoreactivity in allergic diseases involving both Type I and Type IV skin reactions following hypnotic suggestions.
Psychologic factors play a role in many dermatologic disorders, giving rise to the possible use of psychotherapeutic modalities in treatment. Regarding psoriasis, emotional factors have a strong correlation with onset and flare-ups. The psychophysiologic mechanisms involved are not known; however, stress and its effect on the autonomic nervous system and the immune system may play a significant role in the onset and course of psoriasis. Relaxation and mere suggestion also affect the autonomic nervous system and the immune system and therefore may affect the course of the skin disorder. A few case studies have documented successful treatment of psoriasis with hypnosis and biofeedback. Further study of this process is needed, and the role of stress in dermatologic diseases must always be given consideration.
The therapeutic results of hypnosis with relaxation therapy were evaluated in 15 patients with chronic urticaria of 7.8 years' average duration. Compared with baseline and control session values, the hypnosis session provided relief of pruritus as measured by three self-report parameters. There was no change in the number of hives. All subjects were given a standard test for hypnotizability. Assuming that the results were not biased by their preceding relaxation sessions, we determined that six subjects were hypnotizable and nine were nonhypnotizable. Subjects in both groups improved symptomatically, but hypnotizable subjects had fewer hives and became more symptomatic during the control (testing and history taking) session. Hypnotizable subjects also more frequently related stress as a causative factor. At a follow-up examination five to 14 months after the completion of the experimental sessions, six patients were free of hives and an additional seven reported improvement.
The details of easily replicable interventions using hypnosis and restricted environmental stimulation therapy in the treatment of 4 cases of trichotillomania are presented. Hypnosis or hypnosis combined with brief restricted environmental stimulation appeared to be effective in 3 of the 4 cases. Factors affecting treatment outcomes are discussed.
Two experiments assessed the effects of psychological variables on wart regression. In Experiment 1, subjects given hypnotic suggestion exhibited more wart regression than those given either a placebo treatment or no treatment. In Experiment 2, hypnotic and nonhypnotic subjects given the same suggestions were equally likely to exhibit wart regression and more likely to show this effect than no treatment controls. In both experiments, treated subjects who lost warts reported more vivid suggested imagery than treated subjects who did not lose warts. However, hypnotizability and attribute measures of imagery propensity were unrelated to wart loss. Subjects given the suggestion that they would lose warts on only one side of the body did not show evidence of a side-specific treatment effect.
The ability to alter delayed-type hypersensitivity via hypnotic suggestion was tested in 12 highly hypnotizable, untrained subjects and 30 nonhypnotized controls. Subjects were skin-tested bilaterally with a standardized panel of delayed hypersensitivity antigens and instructed either to enhance or suppress the skin test response unilaterally. Compared with results in controls, the skin test response reflected no effect of hypnotic suggestion with regard to either the area of induration or the degree of inflammation assessed histologically.
Physicians have long used the power of suggestion informally in their practice as a means of motivating patients and boosting compliance. Recent research shows that formal use of hypnosis can be a valuable primary or adjunctive therapy, especially in children. Children are more in touch with innate imagery processes than adults and consequently can learn and use self-hypnosis easily, particularly to control autonomic responses. Hypnotherapy has proven useful in habit and behavior disorders, psychophysiologic disorders, pain control, anxiety control, cellular growth, and chronic conditions. The cases reported here illustrate the effectiveness of this process in children. Before hypnotherapy can be used clinically, the physician should become certified by an association approved by the American Medical Association and know when hypnotherapy is indicated and how long it should be continued.
A young girl with multiple warts had been treated unsuccessfully over the course of a year with liquid nitrogen, curettage and electrodessication. Hypnotherapy was then given, using the visual imagery technique that the Simontons use to treat patients with cancer. The pertinent literature on hypnotherapy of warts is also reviewed.
The present case report describes a nine year old girl with multiple common warts. The lesions were refractory to routine dermatologic treatment but appeared to respond dramatically to hypnotherapy. The patient's schoolwork concomitantly improved. The authors present a brief discussion of the literature and indicate some problems for future study.
A 37-year-old schoolteacher, socially withdrawn and pathologically sensitive to public opinion, in psychotherapy for 3 years, inquired about hypnosis as a treatment for his stubborn, widespread psoriasis. Under hypnosis induced by a therapist other than his, sensory imagery was used to replicate the feelings in his skin that he experienced when sunbathing—an activity which had always been somewhat beneficial in the past. Taught to induce the hypnotic state in himself, the patient exercised 5 or 6 times a day for a few minutes. The psoriatic lesions improved markedly, as did his ability to work in psychotherapy, and he lost 20 pounds in weight. He experienced and discussed feelings and future plans in a manner which he had never been able to achieve previously.
Management of pain problems is one of the oldest and most enduring uses of hypnosis in clinical practice. Removal of pain with hypnosis should be done with care by persons aware of the diagnostic and treatment problems of organic illness. Although there are various psychological and physiological theories of hypnosis, some clinical observations suggest a significant neurophysiological component in hypnotic analgesia. These observations include hypnotic analgesia in (a) naive children, (b) culturally unsophisticated subjects not acquainted with the expectations of the hypnotist, and (c) those clinically sophisticated subjects who have experienced hypnosis for pain relief and have described it as similar to “cortical inhibition.” Used properly, hypnosis can alleviate much otherwise inapproachable pain and can help maintain the functional ability and dignity of many patients otherwise dependent on large quantities of medication with possible dulling of consciousness.
In the case described, an account is given of psoriasis in a female aged 38 who presented with a history of a rash of increasing severity for 20 years, originating during a period of severe emotional stress in a susceptible personality type.
During the whole of this period, there was never a time when she had been clear, and exacerbations had been most severe during her two pregnancies.
She was treated under hypnosis by a six-point schedule. This involved analysis and discussion, with interpretive (insight) psychotherapy and desensitization by reciprocal inhibition as described by Wolpe.
As well as the disappearance of the rash, overall improvement in personality was a notable impression gained from the self-rating Personality Schedule score at the end of treatment.
Hyposensitization procedures for allergic disorders, utilizing specific allergens for such disorders, have been used in medical practice for a long time. A more recent treatment is psychological desensitization, and hypnosis has been extensively studied in this connection.
The skin and the nervous system are related embryologically, both developing from ectodermal derivatives. Both organ systems may, therefore, be involved in a particular disease. Neuroectodermal diseases associated with impaired mental functioning include tuberous sclerosis, neurofibromatosis, xerodermatic deficiency, and the Sturge-Weber disease. Tile dynanfic interaction between the psyche and the skin is universally recognized by many psychotherapists. As Kroger ~ has aptly stated, "the skin mirrors the inner self." Common expressions, utilized daily, lend credence to this view and include: (a) "tie is thick-skinned." (b) "He is yellow-skinned." (c) "My nervous rash."