<p>Psychodermatology, an emerging subspecialty at the intersection of dermatology, psychiatry, and psychology, addresses the bidirectional relationship between skin disease and mental health. Psychological stress, anxiety, and trauma can exacerbate dermatologic conditions, while chronic skin diseases often precipitate significant psychological distress, reduced quality of life, and psychiatric comorbidities. Despite mounting evidence of this burden, psychodermatologic care remains underrepresented in dermatology training, leading to underdiagnosis, suboptimal management, and fragmented care. This narrative review proposes a pragmatic, scalable framework for integrating mental health into dermatologic practice within the U.S. healthcare system, comprising three core components: routine psychological screening with defined score thresholds, standardized referral pathways, and tiered follow-up actions. This framework is intended to guide, rather than replace, clinical judgment and specialty psychiatric care. We outline validated screening tools, practical referral models adaptable to diverse settings, and strategies for maintaining interdisciplinary communication, including telehealth integration. The framework emphasizes cultural sensitivity, acknowledging global disparities, stigma, and variations in symptom expression that affect care delivery. Implementation considerations include the need for enhanced psychodermatology training in medical education, systemic and financial barriers to integrated care, and the potential cost-effectiveness of collaborative models. The proposed approach aims to normalize mental health screening in dermatology, reduce stigma, and improve patient outcomes through early identification, timely intervention, and coordinated management of psychocutaneous disorders. By offering a flexible yet structured model, this review provides a foundation for both immediate clinical adoption and future research into sustainable, equitable psychodermatologic care.</p>