Aesthetics in Psychosomatic Dermatology II: Skin Changes Experienced as Cutaneous Disease

The document discusses how certain skin changes, which may be minor and straddle the line between normal and pathological, can lead to significant distress for individuals, particularly women, as they affect their body image. These changes, while possibly minor in a clinical sense, can be perceived as major defects due to subjective self-evaluation or societal feedback, leading to a strong belief in their presence that is resistant to rational argument. The text suggests that dermatologists with cosmetic expertise should be the ones consulted for such issues, as non-specialists in cosmetics may lack the necessary knowledge of skin pathology and could have conflicting commercial interests. It proposes the creation of a public Cosmetic Dermatology Service with psychological and psychiatric consultation to ethically address these concerns without commercial influence, which could be particularly feasible in countries with a national public health service like Italy. The chapter covers common complaints such as dry or oily skin, signs of aging, excessive hair growth (hypertrichosis and hirsutism), uneven fat distribution (including cellulite), stretch marks (striae cutis distensae), graying hair, and dandruff.