Emergence of Integrative Medicine and Education

Conventional medicine has long been drawn from naturally derived sources – including aspirin from the willow tree, digoxin for heart failure, vincristine for cancer treatment, and statins for cholesterol. 

Dermatology is no exception. Knowledge of the natural world has been a critical part of conventional dermatology. From a safety perspective, assessment of contact based irritation and allergies requires detailed knowledge of the plant kingdom, natural products, and their side effects. Recent Food and Drug Administration approvals for topical sinecathecins (a mix of polyphenols) for genital warts^[1] and ingenol mebutate (extracted from Euphorbia) for actinic keratoses^[2] document the integration of natural product research. 

Skin assessments may seem superficial and within a finger’s touch but dermatological diseases have elaborate roots: many are either chronic, recurrent, or both, necessitating treatments that can be complex with a need for daily attention. Frequently, skin conditions have profound social, emotional, and psychological consequences for those afflicted. Perhaps equally important, medical visits often focus on diagnosis and treatment without as much exploration of the psychosocial issues that transcend the condition and the patient’s experience. The focus is on the “What is it?” and “How to treat it?” often neglecting questions such as “How does it make you feel?” and “How can I spend time to help you understand the condition?” When doctor’s visits are limited to an average of 15 minutes, exploring patient experiences further is an often-sacrificed luxury. 

While dermatologists and physicians are clinically efficient and effective, the general public appreciates more personalized and comprehensive approaches as evidenced by the progressive growth of yoga, alternative medicine, natural products, and supplements. A focus on lifestyle and diet change is often a priority when it comes to wellness and health. However, physicians are minimally trained in these areas and the growth of the National Center for Complementary and Integrative Health^[3] signals a shift that more research is needed. Much growth will be achieved by truly integrative discussions that build bridges to open dialogue between conventional and complementary medicine. Conventional medicine has evolved and adapted from the natural world and will need to continue to do so as it progresses. 

The internet made medical information easily accessible. Yet the presence of information that bridges conventional and alternative approaches is scant. This information is complex to deliver and requires a careful approach to deliver it with quality and in a simple manner. It requires an integrative team of experts, an open-minded approach in finding areas of overlap, and a commitment to the research literature. A perusal of the National Library of Medicine (pubmed.gov) medical literature database reveals a rapid growth of botanical, natural product, and alternative medical research studies over the past decade. 

We are entering the age of integrative medical research and integrative medical education. The public is primed to receive this information in a high-quality educational format, but it should be done thoughtfully and responsibly. Integrative medicine requires both conventional and complementary medicine working together and not sacrificing one for the other. Dermatologists and skin care practitioners are particularly poised to lead this charge.