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Itching is a subjective symptom which is reported to occur in 75% of all skin diseases. Although repeatedly postulated, psychological correlations with itching have rarely been investigated. In cooperation with a public television company which prepared a scientific program on itching, interested persons were invited to participate in a public lecture: ‘Itching – what’s behind it?’. The aim of the lecturers was to initially present an itch-inducing lecture to the still uninformed audience, followed by a neutral verbal and visual stimulation to feel comfortable. Accordingly, the first part included slides that induce itching, while the second part showed slides that induce relaxation and sense of well-being. At the same time, the listeners’ tactile reactions were recorded by television cameras all around to allow rating of the scratch impulses. In an ABA design could be shown that itching measured by self-rating scales (n = 24) could be induced by the itch-inducing verbal and visual intervention. The frequency of scratching recorded by the television cameras was evaluated independently by two raters. The t-test confirmed a significant mean difference in the expected direction. In total, this study confirms the previous assumption that itching can be induced by psychic factors.

Psychological factors should be taken into consideration in the treatment of patients with HD. High-SR patients with a negative patch-test seem to require more adjuvant psychological care.

More than a cosmetic nuisance, acne can produce anxiety, depression, and other psychological problems that affect patients' lives in ways comparable to life-threatening or disabling diseases. Emotional problems due to the disease should be taken seriously and included in the treatment plan. A purely dermatological therapy by itself may not achieve its purpose. Even mild to moderate disease can be associated with significant depression and suicidal ideation, and psychologic change does not necessarily correlate with disease severity. Acne patients suffer particularly under social limitations and reduced quality of life. Psychological comorbidities in acne are probably greater than generally assumed. Attention should be paid to psychosomatic aspects especially if depressive-anxious disorders are suspected, particularly with evidence of suicidal tendencies, body dysmorphic disorders, or also in disrupted compliance.Therefore, patients who report particularly high emotional distress or dysmorphic tendencies due to the disease should be treated, if possible, by interdisciplinary therapy. The dermatologist should have some knowledge of the basics of psychotherapy and psychopharmacology, which sometimes must be combined with systemic and topical treatment of acne in conjunction with basic psychosomatic treatment.

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