Hypnotherapy as an add-on to Ayurveda treatment in the management of Psoriasis: A single case experience

The psychodermatologic disorder involves interaction between the mind and the skin. In addition, emotional stress may exacerbate a number of chronic dermatoses, further initiating a vicious cycle referred to as the “itch-scratch cycle.” Since stress is a well-known triggering factor in the appearance or exacerbation of such pyschodermatologic disorders, and management of patients with psoriasis, which is one of these chronic dermatoses, becomes challenging without addressing the stress factor involved in its exacerbation. Eliminating this stressor could be a key component of any treatment strategy. Therefore, psychotherapy that reduces stress may help treat psoriatic patients who are susceptible to stress. A 48-year-old male was affected with itchy scaly lesions on both upper and lower limbs for 20 years, a known case of psoriasis, and on examination, the stress was noticed to be a triggering factor and was not responding to stand-alone therapies. The patient was under severe stress due to family circumstances and the disease itself. On assessing the patient’s condition, it was found that the International Stress Management Association (ISMA) and Psoriasis Life Stress Inventory (PLSI) scores were 14 and 20, respectively, before treatment. Considering the skin lesions, internal medications given were Mahamanjishthadi kashaya , Kaishora guggulu, and Triphala kwatha kshalana , Ayyappala kera taila was used for external application. Considering the severe stress factor, hypnotherapy was provided to the patient. After four weeks of holistic treatment protocol, the skin lesions were cured completely, with a reduction in the ISMA and PLSI scores. The case report inferred that the role of stress in psoriasis must always be given due consideration, as supportive psychotherapy is capable of providing better outcomes in the management of skin conditions.