Geriatric Psychodermatology: Current Concepts and Therapeutic Strategies

INTRODUCTION: Psychodermatology studies the connection between skin and mental health and is especially relevant in older adults, where visible skin changes and aging often reflect psychological well-being. This is an understudied area in dermatology. METHODS: This narrative review examined literature on the current concepts and management strategies of geriatric psychodermatology. Research databases such as MEDLINE, PubMed, Springer, Google Scholar, and others were investigated, with a total of 131 papers identified. No publication date limits were included. RESULTS: There is a complex and fascinating relationship between the skin and the brain often referred to as the "skin-brain axis." Common psychodermatologic disorders in the elderly include obsessive-compulsive and related disorders, delusional infestation, and psychogenic pruritus, and these are often difficult to diagnose and manage in the elderly. We also summarize secondary dermatoses from anxiety, depression, stress, and dementia in the elderly. Comprehensive geriatric assessment extends beyond physical health and includes dermatologic, psychiatric, cognitive, and psychosocial domains. Comprehensive care requires collaboration among dermatology, psychiatry, and geriatrics, often incorporating both pharmacologic and non-pharmacologic approaches. We also describe dermatologic signs of elder abuse, dementia complicating psychodermatoses, and review treatment strategies of these conditions. CONCLUSION: Psychocutaneous dermatology is a relevant and understudied area that dermatologists should familiarize themselves with. Multidisciplinary care including pharmacologic and non-pharmacologic strategies are often required for the management of these patients.