In the clinical practice of dermatology many patients with skin diseases have psychological disorders in addition to skin symptoms, which we call physical and mental diseases. Many chronic skin diseases can aggravate the psychological burden, and psychological diseases can also cause many skin diseases. As society progresses and people live at a faster pace, there are more and more of these diseases, such as acne, psoriasis, nodular itchy rash, eczema-like dermatitis, chronic urticaria, etc. Dermatologists also need to grasp the impact of psychological and psychiatric factors on skin diseases. Antidepressants can improve the patient’s depressed mood disorder, and some of them also have sedative, analgesic and antihistamine effects. They have been used to treat various dermatological disorders, mostly in: ① primary psychiatric disorders, such as parasitic delusions, body image delusions, and terror states; ② dermatological disorders related to emotions or stress; ③ pure sensory disorders, such as pruritus, vulvar pain signs, and burning lip syndrome; ④ dermatological disorders not related to neuro (iv) Dermatological disorders unrelated to psychiatric disorders: these are dermatological disorders in the traditional sense, with altered skin pathology, but with poor efficacy of traditional treatment or with better efficacy with the application of antidepressants, such as postherpetic neuralgia. Among them, tricyclic antidepressants and selective 5hydroxytryptamine reuptake inhibitors are the most widely used, with good efficacy and relatively small adverse effects, which are important to improve the quality of life of patients. Tricyclic antidepressants in dermatology Tricyclic antidepressants for skin-related diseases do not require concomitant psychopathological changes, such as doxepin for chronic urticaria, amitriptyline, and gabapentin for postherpetic neuralgia. Doxepin has anxiolytic and antidepressant features that improve the patient’s mood, and treatment is generally started mostly at small doses. The U.S. Food and Drug Administration has approved 5% doxepin cream for the treatment of moderate pruritus. Amitriptyline is the most commonly used tricyclic antidepressant in neuropathic pain. It blocks a variety of ion channels, inhibits the reabsorption of 5hydroxytryptamine and norepinephrine, and enhances nociceptive inhibition in the spinal cord, which is effective in postherpetic neuralgia. The adverse effects of tricyclic antidepressants are mainly manifested in the vegetative nervous system and cardiovascular system, such as dry mouth, blurred vision, tachycardia, and conduction block. Therefore, the patient’s mental status needs to be assessed before treatment, and patients should be closely monitored for adverse effects during treatment. The mechanism of antidepressant action of SSRI is to inhibit the reuptake of presynaptic membrane 5hydroxytryptamine, increase the concentration of 5hydroxytryptamine in the synaptic gap, and improve the conduction of 5hydroxytryptamine to nerves, with little adverse effects and good tolerability. Dermatological disorders with severe psychiatric disorders and psychiatric disorders caused by dermatological disorders, such as parasitic paranoia, a common monosymptomatic psychiatric disorder in dermatology, and dermatological disorders that are obviously related to psychiatric factors, such as psoriasis, acne and alopecia. The adverse effects of SSRI are mostly gastrointestinal reactions, sleep disturbances and sexual dysfunction. Within the normal dose range, the application of SSRIs is less likely to produce adverse reactions; therefore, maintaining the minimum effective concentration is effective in controlling adverse reactions. Antidepressants have good efficacy in the treatment of dermatoses with psychiatric disorders and have become the first line of treatment, especially in dermatoses with psychiatric manifestations as the main symptom. Tricyclic antidepressants can improve a wide range of skin symptoms, and the effective dose is significantly smaller than antidepressant treatment, and the adverse effects are small. ssri tolerable, good safety.