Skin rashes and other problems and disorders of the skin constitute a large portion of diseases seen in general practice. The problems range from simple hives to impetigo to more complicated ones such as psoriasis. Many people with skin problems have noted their tendency to vary in intensity, according to their mental states. They also notice that their emotions react strongly to the presence of the disease, especially when it makes them feel unattractive. On the other hand, he or she may not be aware of such emotional connections. Careful investigation, however, often shows fluctuation of a physical symptom along with an emotional state; perhaps incoherent information is being sent to the skin.

Actually, there is a large body of evidence in the literature of medical hypnosis documenting resolution, following hypnotherapy, of a large number of commonly occurring, noninfectious skin diseases. This is not surprising, because the majority of these problems are actually just reactions of the body. A skin lesion, whether it be a boil, an acne pimple, or a patch of psoriasis is composed primarily of the cells of the body reacting to an agent, either an external agent or process (as in an allergy) or an internal, emotional one (as in neurodermatitis). Because these lesions are not performing any desirable function for us, we would rather be without them; that is, they represent incoherent responses (behaviors).

The drug most commonly employed to treat skin reactions is hydrocortisone. Its primary function is to paralyze the skin's ability to react. When the skin can no longer react, the dermatitis disappears.

A remarkable number of skin problems seem to prefer the face to other locations. Curiously, a large percentage of people with facial skin problems are the type who are self-conscious and easily embarrassed by anything that is not "just so" on their bodies. It seems bad luck indeed that they tend to have their blemishes on the one part of the body that everyone can see! The following story, however, indicates that something more than bad luck may be involved.

Marjorie came to my office in tears, requesting cortisone for an unsightly skin condition that had appeared on her face. She had suffered intermittently with this problem since her teens. Her embarrassment was so evident that I pointed out it might be a good idea to investigate the emotions connected with her rash.

As a child she had been taught to be very conscious of her looks, and weeks before her first high school dance she began to fear something would go wrong with her appearance. Then one day on one of her frequent trips to the mirror, she noticed a small red patch of bumps and went crying to her mother. Whatever corrective responses her skin might have made were blocked by the incoherent process under way; the red bumps multiplied into many red marks and she was unable to go to the dance.

Marjorie felt miserable, but her unconscious saw things differently. It knew that if no rash had formed, it would have experienced worry and fear all the way up to the night of the dance. The unconscious, then, recognized this rash as an escape route. Thereafter whenever Marjorie had an important meeting or was to go to a party, the rash would tend to appear; not on every occasion, but enough to cause frequent unhappiness and self-consciousness. Gradually, she began to avoid these encounters.

Following her exploration, Marjorie could see this relationship, and how her feelings of inadequacy and embarrassment were so strong that the unconscious had come to her "aid" by producing a disease that would spare her the ordeal of facing anyone. It couldn't know that staying home with red blemishes on her face was not more pleasant for her. She began to realize that her emotions were the triggers for, rather than the result of her skin condition.

She rewrote her script by reliving all the times she could recall embarrassment, this time feeling secure and relaxed. She projected ahead to feeling at ease with people. She learned to smile at her face each time she passed the mirror, and to simply accept the rash in a relaxed manner, using it as an indicator that she needed to learn how to feel even more self-confident. As her internal self-image improved, the blemishes slowly faded.

Not too long ago I received a research paper in which a surgeon, who had become frustrated with the usual antibiotic treatment for acne had tried a new tack. He enthusiastically reported excellent success in shrinking acne lesions by teaching his patients to look in the mirror several times a day repeating, "That's just where it's supposed to be," each time they saw a new pimple. As a result of carrying out this ritual, the emotional tension lifts and the response is broken. His explanation was that the teenagers' embarrassment was itself part of the vicious circle which gave rise to the disease, and by programming in a sense of acceptance this circle was broken.