Integrative dermatology is underused in Western medicine

Miami Beach, Fla. - Integrative dermatology is an underused therapeutic modality in Western medicine. It is a holistic approach to the and management of various dermatologic disease and conditions. When implemented appropriately, therapeutic outcomes can be improved, according to a clinician who spoke at the 71st annual meeting of the American Academy of Dermatology.

“Integrative dermatology is a rapidly growing field of study that combines the best of conventional dermatology with some of the more holistic options of an alternative treatment approach. It emphasizes an evidence-based approach to complementary healing modalities, which are hand-in-hand with what we consider to be our current standards of care in our patients,” says Reena Rupani, M.D., assistant professor of dermatology, SUNY Downstate Medical Center, Brooklyn, N.Y.

Whole body approach

Contrary to traditional therapeutic approaches such as pharmacological-based treatments that often target the symptoms of the disease itself, Dr. Rupani says treatment approaches used in integrative dermatology are aimed instead, in part, at addressing factors that precede, trigger or exacerbate a condition.

Integrative therapies could include alterations in diet, nutritional supplements, the use of botanicals and herbal medicine as well as mind-body interventions such as hypnosis.

Where possible and/or feasible, Dr. Rupani says the appropriate use and integration of such therapeutic modalities together with the current gold standard treatment approaches can result in improved treatment outcomes, as well as the healing of the patient on a whole.

“Changes in nutrition, environment and lifestyle can have a very positive impact on the dermatological disease of a patient. Integrative dermatology treatments could be ideal for those diseases and conditions that are recalcitrant to traditional and more conventional therapies and/or for those patients who prefer to limit their exposure to pharmaceuticals,” Dr. Rupani says.

Targeting disease triggers

One of the prototypical dermatologic conditions in which integrative dermatology can have a significant impact is atopic dermatitis. In adjunct to traditional and proven dermatologic therapies, Dr. Rupani says physicians can counsel patients on good bathing practices, skincare practices, the benefits of a more humidified environment, the importance of reducing stress, the incorporation of meditation in the daily routine, acupuncture, as well as discussing foods and allergenic triggers associated with a given disease.

“Standardization of therapies however can be difficult in the sense that each patient’s historical and clinical context is unique, underscoring the crucial importance of a detailed history,” Dr. Rupani said.

Other common dermatologic conditions that could be improved using integrative dermatology approaches include neurodermatitis, alopecia areata, pruritis, and acne, she says. Acne is of particular interest given the amount of current knowledge regarding the condition’s relationship with diet and glycemic loads.

“Like anything else in medicine, an integrative approach would work best in those patients who are open to it. Oftentimes, those patients who are more open for treatments such as changes in diet, lifestyle, acupuncture, meditation and other non-pharmacological approaches will show themselves by asking their doctor about such treatment possibilities,” Dr. Rupani said.

Diverse demographics

The recent upsurge in interest regarding integrative medicine and integrative dermatology may be due to the change in the diverse demographics in the United States.

According to Dr. Rupani, many patients are increasingly asking about alternative and more holistic treatment approaches and options based in folk healing and non-Western modalities, leading to a huge demand for integrative providers.

“Many of us feel frustrated by the confines of our current healthcare system and sometimes frustrated by the endpoints we are able to achieve with patients,” she says. “As such, I think many physicians are looking for other ways that they can offer in healing.”

According to Dr. Rupani, it is important for clinicians to remember - and differentiate - that integrative dermatology is not the same as alternative medicine. Thus, the practice should not be hindered by taboos. For instance, integrative dermatology practices do not advocate treating melanoma with hypnosis, Dr. Rupani says. Utilizing hypnosis to treat perioperative anxiety, however, can be very useful in select patients, she says.

“I think that formally using integrative dermatology and promoting physician education on the subject is important, in light of increasing patient interest and demand, as well as medicine’s general push towards wellness and preventative care,” Dr. Rupani says.

Disclosures: Dr. Rupani reports no relevant financial interests.