Imo it is the skew, or the non intuition of it, that makes (pure) option trading hard to manage a book risk (not necessarily as a mm). There are no conservation laws.
For example, if you hedge at the wrong delta not taking into consideration how skew changes as the underlying moves, or even harder, when a support point causes mm's to flatten skew (greed overtakes fear), you will overhedge, causing an already non-linear effect of path dependency to be even more pronounced on PnL. You have to anticipate these regimes and hedge accordingly. Something extremely hard to do, imo. Option trading just shifts predicting directional underlying moves to predicting skew+vola+gamma risk (if you get skew and vola right, it seems delta is pretty easy), in that order of complexity.
It is almost as if delta needs to be computed based on model+market regimes (fear dominated, greed dominated, etc):
http://www.math.columbia.edu/~smirnov/Derman.pdf
For example, if you hedge at the wrong delta not taking into consideration how skew changes as the underlying moves, or even harder, when a support point causes mm's to flatten skew (greed overtakes fear), you will overhedge, causing an already non-linear effect of path dependency to be even more pronounced on PnL. You have to anticipate these regimes and hedge accordingly. Something extremely hard to do, imo. Option trading just shifts predicting directional underlying moves to predicting skew+vola+gamma risk (if you get skew and vola right, it seems delta is pretty easy), in that order of complexity.
It is almost as if delta needs to be computed based on model+market regimes (fear dominated, greed dominated, etc):
http://www.math.columbia.edu/~smirnov/Derman.pdf