A psychodermatology service has been running at Solihull Hospital in the West Midlands since December 2012. As we approach our five-year milestone, we thought it might be helpful to review how we set this service up, how things have developed over time and what patients we see. Services of this type are incredibly limited in the UK – both under-staffed and under-resourced – despite an enormous unmet patient need. Our hope is that we inspire others to set up similar services elsewhere, for the benefit of patients, their families and our colleagues.