Emotional factors can worsen symptoms.

• Position: Skin Conditions

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

Psychologist Ted A. Grossbart of Harvard Medical School, Cambridge, Mass., author of Skin Deep: A Mind/Body Program for Healthy Skin, says you should ask yourself these questions:

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

* Is the condition more stubborn, severe, or recurrent than your doctor expects?

* Are usually effective treatments not working?

* Do most treatments work but not for long?

* Is each disappearing symptom quickly replaced by another?

* Do symptoms get better or worse in a very erratic, seemingly nonsensical way?

* Are there striking ups and downs in symptoms corresponding to social environment: vacations, hospitalizations, business trips, or the arrival of relatives or bosses?

* Do people find you strikingly stoic, unruffled, or computer-like in the face of stressful events?

* Is the level of distress and concern about your problem abnormally high or conspicuously absent?

* Is your skin worse in the morning, suggesting that you rub or scratch...