Management of Psychodermatologic Disorders

Philip D. Shenefelt, MD, MS


Dermatology Nursing 

In This Article

Complementary Pharmacological Psychocutaneous Therapies

Herbs and Supplements

Psychoactive herbs and supplements may have some indirect impact on skin diseases through anxiolytic, antidepressant, or soporific activities. Herbal therapy in psychiatry was reviewed by Sarris (2007). Herbal therapy in dermatology was re viewed by Bedi and Shenefelt (2002) and herbs and supplements in dermatology by Levin and Maibach (2002). Additional information is available in the Complete German Commission EMonographs (Blumenthal, 1998) and in many other textbooks and monographs. Information about individual herbs, their actions, interactions, and adverse effects is available in the PDRfor Nonprescription Drugs, DietarySupplements and Herbs (PDR Staff, 2008).


Lavender oil aromatherapy, lemon balm, magnolia bark, and passion flower have moderate anxiolytic effects. Kava Kava also has moderate anxiolytic effects, but its use is not recommended due to its hepatotoxicity.


Saint John's wort is helpful in mild-to-moderate depression but not for severe depression (Linde et al., 1996). It has significant interactions with the metabolism of a number of other drugs. S-adenosyl-Lmethionine (SAMe) is also taken as an antidepressant. A meta-analysis of studies comparing SAMe with controls showed significant clinical improvement with SAMe similar to that of standard SSRI treatment with fewer side effects (Bressa, 1994) (see Table 3).


Melatonin is effective at producing drowsiness. Caution should be used in operating dangerous machinery. Valerian is approved by the German Commission E for insomnia caused by nervousness.


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