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Harvard Medical School Skin Psychologist Offers a Quick Quiz

Emotional factors can trigger skin problems, or they may worsen symptoms. While heredity, bacteria, viruses, hormones, and chemical irritants play a clear role in many skin problems, mind and body always do an intricate dance together. If your skin condition doesn't seem to be improving, it may be time to determine the role that emotions are playing in your acne, psoriasis, rosacea, or whatever skin condition you're experiencing.

How important is the emotional factor in your illness?

Ask yourself:

1. Do your symptoms get worse--or better--with emotional turmoil?

2. Is your condition more stubborn, severe, or recurrent than your doctor expects?

3. Are usually effective treatments not working for you?

4. Do most treatments work but not for long?

5. Is each disappearing symptom quickly replaced with another?

6. Do your symptoms get better or worse in a very erratic, seemingly nonsensical way?

7. Do you see striking ups and downs in your symptoms with changes in your social environment: vacations, hospitalizations, business trips, or the comings of family members or bosses?

8. Do people find you strikingly stoic, unruffled, or computer like in the face of stressful life events?

9. Is your level of distress and concern about your problem strikingly high or conspicuously absent?

10. Is your skin worse in the morning, suggesting that you rub or scratch unintentionally at night?

11. Do you have trouble following your health care provider's instructions?

12. Do you do things you know will hurt your skin, such as picking or scratching, squeezing pimples, or overexposing yourself to sunlight?

13. Do you feel excessively dependent on your dermatologist or excessively angry with him or her? (Even if the faults are real, are you overreacting?)

14. Does it seem that others notice improvements in your skin before you do? Is it hard for you to acknowledge when your skin has improved?

The more of these questions you answered positively, the more likely you can helped by such psychological tools as relaxation, imaging, focused psychotherapy, biofeedback, and hypnosis and self-hypnosis. There is a substantial body of research, including many well-controlled studies, documenting how helpful these techniques can be. Mainstream doctors are more and more receptive as the newer research documents not only these tools' effectiveness, but the specific physiological mechanism that allow the techniques to work. Enhanced bloodflow, various immune system mechanisms, and stress hormones are often involved.

Emotional stress can keep the most effective medical treatment from working. Yet the same mind-body link, when it is working FOR you, can produce dramatic improvements.

SIDEBAR:

Which problems are psychological techniques most effective for?

- acne
- allergies of the skin
- alopecia
- canker sores
- eczema
- herpes (oral and genital)
- hives
- pain
- picking
- psoriasis
- rosacea
- scratching
- shingles
- vitiligo
- warts

Ted A. Grossbart, Ph.D., of Harvard Medical School is a leading authority on the psychology of skin care. His book Skin Deep: A Mind/Body Program for Health Skin (Health Press, Albuquerque, NM) is a practical guide to using your mind to cure your skin. His Skin Deep website is at http://www.grossbart.com

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